Airway obstruction and lung hyperinflation in COPD are linked to an impaired left ventricular diastolic filling

Alter, Peter; Watz, Henrik; Kahnert, Kathrin; Pfeifer, Michael; Randerath, Winfried; Andreas, Stefan; Waschki, Benjamin; Kleibrink, Bjoern E.; Welte, Tobias; Bals, Robert; Schulz, Holger; Biertz, Frank; Young, D. R.; Vogelmeier, Claus; Jörres, Rudolf A.

doi:10.1016/j.rmed.2018.02.011

Cited by 39 publications

(54 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…mediated) effects. A common approach is path analysis [18] which has recently been used in COPD research to deal with such situations [19,20]. Path analysis is particularly capable of integrating the results of a whole set of regression analyses and eliminating non-causal associations.…”

Section: Discussionmentioning

confidence: 99%

Uric acid, lung function, physical capacity and exacerbation frequency in patients with COPD: a multi-dimensional approach

et al. 2018

Self Cite

View full text Add to dashboard Cite

Background: Recent investigations showed single associations between uric acid levels, functional parameters, exacerbations and mortality in COPD patients. The aim of this study was to describe the role of uric acid within the network of multiple relationships between function, exacerbation and comorbidities. Methods: We used baseline data from the German COPD cohort COSYCONET which were evaluated by standard multiple regression analyses as well as path analysis to quantify the network of relations between parameters, particularly uric acid. Results: Data from 1966 patients were analyzed. Uric acid was significantly associated with reduced FEV 1 , reduced 6-MWD, higher burden of exacerbations (GOLD criteria) and cardiovascular comorbidities, in addition to risk factors such as BMI and packyears. These associations remained significant after taking into account their multiple interdependences. Compared to uric acid levels the diagnosis of hyperuricemia and its medication played a minor role. Conclusion: Within the limits of a cross-sectional approach, our results strongly suggest that uric acid is a biomarker of high impact in COPD and plays a genuine role for relevant outcomes such as physical capacity and exacerbations. These findings suggest that more attention should be paid to uric acid in the evaluation of COPD disease status.

show abstract

Section: Discussionmentioning

confidence: 99%

Uric acid, lung function, physical capacity and exacerbation frequency in patients with COPD: a multi-dimensional approach

et al. 2018

Self Cite

View full text Add to dashboard Cite

show abstract

“…AreaVol s3, ratio area/volume of phase 3; COPD, chronic obstructive pulmonary disease; FEF 50 , forced expired flow at 50% of vital capacity; FEV 1 , forced expiratory volume in 1 s; FVC, forced vital capacity; RV, residual volume; s3, slope of expiratory phase 3; s3/s2, ratio of slopes of phases 3 and 2; TLC, total lung capacity; Vol s2, volume of phase 2. DOI: 10.1159/000507098 gression analysis and is suitable for combining statistical results and pathophysiological or clinical information [14][15][16][17]. It allows to treat variables as dependent and independent simultaneously and to describe direct and indirect effects within a hierarchy of relationships [18].…”

Section: Discussionmentioning

confidence: 99%

Correspondence between Capnovolumetric and Conventional Lung Function Parameters in the Diagnosis of Obstructive Airway Diseases

et al. 2020

View full text Add to dashboard Cite

Background: Capnovolumetry is of interest as a method for the diagnosis of obstructive airway diseases, requiring little cooperation from the patient. Objective: To help in the interpretation of capnovolumetric parameters, we aimed to identify their correspondence to conventional lung function indices. Methods: We studied 978 patients from a diagnostic study with complete functional data and the clinical diagnosis of asthma, chronic obstructive pulmonary disease (COPD), or no respiratory disease. Using path analysis, four capnovolumetric parameters (slope of expiratory phase 3, ratio of slopes of phases 3 and 2, volume of phase 2, and the ratio area/volume of phase 3) previously identified as predictors of airway obstruction in terms of spirometry and body plethysmography, were analyzed regarding their relationship to each other and the diagnostic categories of asthma or COPD versus control, or obstruction versus no obstruction. We then identified four lung function parameters showing relationships as much as possible isomorphic to those between capnovolumetric parameters. Results: The four capnovolumetric parameters were related to COPD and obstruction via both direct and indirect influences, but only two of them to asthma. Regarding the correspondence to lung function parameters, the slope of expiratory phase 3 corresponded best to the ratio of residual volume to total lung capacity, the ratio of slopes of phases 3 and 2 to forced expiratory volume in 1 s, the volume of phase 2 to forced expired flow at 50% of vital capacity, and the ratio area/volume of phase 3 to forced vital capacity. Conclusions: Our results indicated an intricate relationship of capnovolumetric parameters to each other and to airway obstruction, asthma, or COPD. The correspondence to conventional lung function measures seemed to reflect the entities lung hyperinflation, overall ventilatory impairment, bronchoconstriction, and ventilated lung volume, in that order. These findings might be helpful for clinicians in the interpretation of capnovolumetry.

show abstract

“…Einer chronischen Aktivierung inflammatorischer Prozesse, die etwa an erhöhten Spiegeln des hochsensitiven C-reaktiven Proteins abgelesen werden kann, wird ebenfalls eine wich-tige Rolle zugeschrieben [8,20,21]. Die persistierende pulmonale Überblähung bei COPD führt zur verminderten diastolischen Füllung des linken Ventrikels, mit konsekutiv vermindertem Schlag-und Herzminutenvolumen [22,23].…”

Section: äTiologische Aspekteunclassified

Herzinsuffizienz, COPD und Betablocker-Therapie

Borst

2019

Klinikarzt

View full text Add to dashboard Cite

ZUSAMMENFASSUNGHerzinsuffizienz und COPD sind häufig und begegnen uns vielfach gemeinsam. Jede der beiden Erkrankungen führt als Komorbidität der anderen zu einer erhöhten Morbidität und Mortalität, was eine erhöhte Aufmerksamkeit erfordert. Dies gilt in der stabilen Phase und besonders während akuter Dekompensation bzw. Exazerbation. Eine exakte Diagnostik ist notwendig. Sie sollte bei Patienten mit COPD neben klinischen Parametern EKG, Echokardiografie und die Bestimmung eines natriuretischen Peptids umfassen, bei solchen mit Herzinsuffizienz zumindest eine Spirometrie. COPD und Herzinsuffizienz werden jeweils ohne Abstriche leitliniengerecht behandelt. Eine Therapie mit kardioselektiven Betablockern aus kardiologischer Indikation darf COPD-Patienten nicht verweigert werden, wie es vielfach der Fall ist. Vielmehr verbessert sie deren Prognose signifikant.

show abstract

Airway obstruction and lung hyperinflation in COPD are linked to an impaired left ventricular diastolic filling

Cited by 39 publications

References 65 publications

Uric acid, lung function, physical capacity and exacerbation frequency in patients with COPD: a multi-dimensional approach

Uric acid, lung function, physical capacity and exacerbation frequency in patients with COPD: a multi-dimensional approach

Correspondence between Capnovolumetric and Conventional Lung Function Parameters in the Diagnosis of Obstructive Airway Diseases

Herzinsuffizienz, COPD und Betablocker-Therapie

Contact Info

Product

Resources

About