Supraventricular and ventricular arrhythmias are common among patients with chronic obstructive pulmonary disease (COPD). Multiple factors can contribute to the development of arrhythmias in patients with exacerbation of the disease, including: respiratory or heart failure, hypertension, coronary disease and also medications. In the present study we seek to determine the prevalence of cardiac arrhythmias and risk factors among patients with exacerbation of COPD. The study was a retrospective evaluation of 2753 24-h Holter recordings of patients hospitalized in 2004-2016. Exacerbation of COPD was diagnosed in 152 patients and the prevalence of arrhythmias in this group of patients was 97%. The commonest arrhythmia was ventricular premature beats (VPB) - 88.8%, followed by supraventricular premature beats (SPB) - 56.5%. Permanent atrial fibrillation accounted for 30.3% and paroxysmal atrial fibrillation (PAF) for 12.5%. Supraventricular tachycardia (SVT) was noted in 34.2% patients and ventricular tachycardia in 25.6%. Respiratory failure increased the risk of SPB, while heart failure increased the risk of VPB. Treatment with theophylline was associated with a higher proportion of PAF and SVT. In conclusion, COPD exacerbation is associated with a high prevalence of cardiac arrhythmias. COPD treatment and comorbidities increase the risk of arrhythmias.

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Granulomatosis with polyangiitis (GPA) is one of the most common forms of systemic vasculitis, which usually involves the upper and lower respiratory tract, but it may affect also multiple organs. The aim of the study was an echocardiographic evaluation of cardiac involvement in GPA patients during remission. Eighty eight patients with GPA were evaluated in the study. The control group consisted of 40 age and sex-matched patients without a previous history of cardiovascular disease. We found that there were no differences between GPA and control groups regarding left atrial enlargement and interventricular septal hypertrophy. In one GPA patient, all heart chambers were enlarged. Left ventricle systolic function was decreased (LVEF ≤ 50%) in eight patients with GPA, and left ventricle wall motion abnormalities were observed in 12 patients. Left ventricle relaxation dysfunction, mitral valve and tricuspid valve regurgitation were observed with the same frequency in both GPA and control groups. Aortic regurgitation was the single abnormality that occurred significantly more often in the GPA group than in controls (28% vs. 7.5%; p = 0.03). Pericardial effusion was observed in three GPA patients and in none from the control group. We conclude that the most common echocardiographic manifestation in GPA patients in remission was aortic valve regurgitation. However, cardiac involvement in such patients is rather rare and in the majority of cases clinically insignificant.

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Funding Acknowledgements none Background Granulomatosis with polyangiitis (GPA) is one of antineutrophil cytoplasmic autoantibody (ANCA) – associated vasculitis. This primary systemic vasculitis is multisystem disorder characterized by inflammation and necrosis of small and medium sized blood vessels. An increased risk of cardiovascular mortality and incidence of various cardiovascular events has been described among GPA patients. Purpose The aim of the present study was to assess the incidence of venous thromboembolism (VTE) and its correlation with echocardiographic parameters and laboratory findings in GPA patients. Methods The group of consecutive patients with GPA were followed in the study. In all patients echocardiography and laboratory tests were performed. Results One hundred four patients with GPA (mean age 51.6 ± 13.2 yrs) were followed for an average of 4,5 ± 1,9 years. In 24 patients venous thromboembolism was diagnosed during observation, however in majority of them (57%) VTE occurred during first year after diagnosis of GPA. There were no significant differences in creatinine, troponin T and CRP levels between patients with and without VTE. In patients with VTE there were larger right ventricle diameter (29.1 ± 4.4 vs. 32.1 ± 5.6; p = 0.04) and higher right ventricle systolic pressure (32.6 ± 5.4 vs. 37.3 ± 5.9; p = 0.02) observed. In this study group D-dimer was elevated in majority (56%) of patients. In patients with VTE D-dimer correlated positively with age (r = 0.5, p = 0.02), right ventricle diameter (r = 0.63, p = 0.001), right ventricle systolic pressure (r = 0.44, p = 0.04), and negatively with pulmonary artery acceleration time (r= -0.43, p = 0.05). Conclusions Venous thromboembolism is a common complication in patients with granulomatosis with polyangiitis, especially during first year after diagnosis. This finding is likely to be associated with changes in endothelial function and with induction of hypercoagulability resulting from changes in pro and anticoagulant factors associated with inflammation and its therapy.