Electrocardiographic characteristics of patients with chronic obstructive pulmonary disease and its correlation with disease severity

Abstract

Background: Chronic obstructive pulmonary disease is the fourth leading cause of mortality worldwide. It is defined as a disease state characterized by airflow limitation that is not fully reversible. Patients with chronic obstructive pulmonary disease (COPD) are at increased risk of cardiovascular disease. Electrocardiography (ECG) carries information about cardiac disease and prognosis in COPD patients. Present study was undertaken to correlate ECG changes with severity of COPD.Methods: 100 patients of COPD fulfilling the inclusion criteria coming to OPD/wards of NMCH, Kota were recruited. They were staged by pulmonary function test (PFT) and evaluated by electrocardiography. Statistical analysis of correlation was done with chi square test and statistical significance was taken p<0.05.Results: Mean age was 63.18±8.66 years, with male preponderance, male to female ratio 6.14:1. Mean duration of disease was 7.58±2.92 years, mean exposure to smoking of 25.06 pack years. Most common ECG finding was RAD which was present in 69% of cases, other ECG findings are P. pulmonale (45%), incomplete RBBB (15%), PPRW (35%), RVH (53%). All ECG findings except incomplete RBBB significantly correlated with disease severity (‘p’ value <0.05).Conclusions: COPD is more common in male in 5th to 7th decade of life, with a smoking history of more than 20 pack years. The occurrence of ECG findings increase as severity and duration of disease increase. It can be inferred that ECG is a useful bedside test to assess the severity of COPD.

Electrocardiographic Abnormalities in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease

“…That is, 8% of patients had ST-segment depression; 37% had T wave changes; 17% had conduction block; 6% had new abnormalities [ 15 ]. Moreover, Jatav et al and Sekhar et al reported that patients with COPD had a higher prevalence of right ventricular hypertrophy, which is consistent with our study [ 16 , 17 ]. However, our findings were contrasting to those of Singh II et al, which revealed that the frequency of right axis deviation, p-pulmonale, low voltage QRS, and ventricular conduction were higher than that of right atrial enlargement and right ventricular hypertrophy [ 18 ].…”

Electrocardiogram Characteristics of Chronic Obstructive Pulmonary Disease Patients are Associated with Severity and Disease Duration

“…26 This study found that sex and smoking were not directly related to ECG abnormalities in COPD patients. Most subjects are male, which is in line with research conducted by Jatav et al 16 that COPD patients are more men than women. The higher prevalence of men in COPD patients was also associated with smoking habits.…”

“…Hence, ECG becomes one of the examinations that can be used to assess the severity of COPD. 16,17 The severity and duration of the disease are significantly related to the incidence of ECG abnormalities. In addition, in another study, ECG examination of COPD patients showed a relationship between the severity of COPD and changes in P waves and QRS complexes.…”

Association of electrocardiographic findings in COPD patients

“…The majority of COPD-related mortality is due to cardiac involvement, which is caused by pulmonary arterial hypertension, which leads to Cor-pulmonale. Chronic Cor-pulmonale is the outcome of long-term pulmonary disease, due to pulmonary hypertension, which leads to right ventricular hypertrophy and failure (1). Both pulmonary and extra pulmonary/systemic consequences manifest pathological changes that are typical of condition.…”