BackgroundSystemic inflammation is the pathophysiological link between coronary artery disease (CAD) and COPD. However, the influence of subclinical COPD on patients with suspected or diagnosed CAD is largely unknown. Thus, this study was designed to evaluate the degree of coronary involvement in patients with COPD and suspected or confirmed CAD.MethodsIn this cross-sectional study, carried out between March 2015 and June 2017, 210 outpatients with suspected or confirmed CAD were examined by both spirometry and coronary angiography or multidetector computed tomography. These patients were divided into two groups: with and without COPD. Size, site, extent, and calcification of the coronary lesions, and the severity of COPD were analyzed.ResultsCOPD patients (n = 101) presented with a higher frequency of obstructive coronary lesions ≥50% (n = 72, 71.3%), multivessels (n = 29, 28.7%), more lesions of the left coronary trunk (n = 18, 17.8%), and more calcified atherosclerotic plaques and higher Agatston coronary calcium score than the patients without COPD (P < 0.0001). The more severe the COPD in the Global Initiative for Obstructive Lung Disease stages, the more severe the CAD and the more calcified coronary plaques (P < 0.0001). However, there was no difference between the two groups with respect to the main risk factors for CAD. In the univariate analysis, COPD was an independent predictor of obstructive CAD (odds ratio [OR] 4.78; 95% confidence interval: 2.21–10.34; P < 0.001).ConclusionIn patients with suspected CAD, comorbid COPD was associated with increased severity and extent of coronary lesions, calcific plaques, and elevated calcium score independent of the established risk factors for CAD. In addition, the more severe the COPD, the greater the severity of coronary lesions and calcification present.

Introdução: A aptidão física é um determinante no desempenho das tarefas diárias de um indivíduo, e algumas qualidades físicas, a exemplo da capacidade cardiorrespiratória e da composição corporal estão relacionadas à saúde. Objetivo: Analisar a relação do consumo máximo de oxigênio com o percentual de gordura em universitários. Métodos: Trata-se de um estudo descritivo e analítico, de corte transversal, cuja amostra selecionada por conveniência foi composta por 55 universitários, com a média de idade de 21 anos (± 2,8). Para coleta dos dados, foi utilizado o teste máximo de Balke (bicicleta) na avaliação da capacidade cardiorrespiratória (VO² em ml/kg.min-1) e a medida de quatro dobras cutâneas (subescapular, tríceps, suprailíaca, panturrilha). Na análise dos dados foram utilizados procedimentos da estatística descritiva e medidas de correlação (Sperman), p < 0,05. Resultados: A média do VO² foi de 41,8 ml/kg.min-1 (± 13,8) e do percentual de gordura 19,9 (± 7,4). Na correlação verificou-se uma relação inversa, ou seja, à medida que o percentual de gordura aumenta há uma diminuição na condição cardiorrespiratória dos sujeitos avaliados (rho = -0,55). Conclusão: Os resultados permitem concluir que a quantidade de gordura corporal é um determinante no desempenho cardiorrespiratório em jovens universitários.Palavras-chave: distribuição da gordura corporal, aptidão física, consumo de oxigênio.

Background:Stress echocardiography is well validated for diagnosis and risk stratification of coronary artery disease. Exercise stress echocardiography (ESE) has been shown to be the most physiological among the modalities of stress, but its safety is not well established.Objective:To study the complications related to ESE and clinical and echocardiographic variables most commonly associated with their occurrence.Methods:Cross-sectional study consisting of 10250 patients submitted to ESE for convenience, from January 2000 to June 2014. Cardiac Arrhythmias (CA) were the most frequent complications observed during the examination. The volunteers were divided into two groups according to the occurrence of CA during ESE: G1 group, composed of patients who have CA, and G2 formed by individuals who did not show such complication. Results: Group G1, consisting of 2843 patients (27.7%), and Group G2 consisting of 7407 patients (72.3%). There was no death, acute myocardial infarction, ventricular fibrillation or asystole. Predominant CAs were: supraventricular extrasystoles (13.7%), and ventricular extrasystoles (11.5%). G1 group had a higher mean age, higher frequency of hypertension and smoking, larger aortic roots and left atrium (LA) and lower ejection fraction than G2. G1 group also had more ischemic changes (p < 0.001). The predictor variables were age (RR 1.04; [CI] 95% from 1.038 to 1.049) and LA (RR 1.64; [CI] 95% from 1.448 to 1.872).Conclusion:ESE proved to be a safe modality of stress, with non-fatal complications only. Advanced age and enlargement of the left atrium are predictive of cardiac arrhythmias.

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