Ischemic Heart Disease during Acute Exacerbations of COPD

Molina, Rosa Malo de; Aguado, Silvia; Arellano-Serrano, Carlos; Valle, Manuel; Ussetti, Piedad

doi:10.3390/medsci6040083

Cited by 7 publications

(6 citation statements)

References 60 publications

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“…15 The presence of several related mechanisms, such as tachycardia, arterial stiffness, increased occurrence of thrombus, hypoxemia, infection, and the use of short-acting b2 agonists. 17,19 causes ischemic abnormalities in COPD, as also seen in this study. Increased pulmonary artery resistance in patients with higher degrees of COPD leads to increased water trapping and lung hyperinflation.…”

Section: Discussionsupporting

confidence: 87%

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

Mayasari

Kristinawati

Krisdayanti

et al. 2022

Glob Med Health Commun

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Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitations associated with an increase in chronic inflammatory responses to the airways and lungs. COPD patients are more likely to be hospitalized and die from cardiovascular disease. This study aims to determine the factors associated with the incidence of electrocardiogram (ECG) abnormalities in COPD patients. This is a cross-sectional study with an analytical observational design. From October 30 to December 5, 2019, data was collected on 42 COPD patients, inpatients, and outpatients at Muhammadiyah Palembang Hospital who met the inclusion and exclusion criteria. A questionnaire was used to collect data, and spirometry and an electrocardiogram test were used to measure pulmonary function and detect ECG abnormalities. Research variables included age, sex, smoking habits, severity, and duration of COPD. Data analysis using the chi-square test and followed by a logistic regression test found a significant relationship between very heavy-weight COPD and ≥5 years of suffering from COPD with the incidence of ECG abnormality (p value<0.05). The severity and the length of time of suffering from COPD are significantly related to the incidence of ECG abnormalities in outpatients and inpatients.

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Section: Discussionsupporting

confidence: 87%

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

Mayasari

Kristinawati

Krisdayanti

et al. 2022

Glob Med Health Commun

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“…41 Others include oxidative stress, increased platelet activity and risk of thrombus formation, and tachycardia. [42][43][44] Precipitating events like an exacerbation of COPD may lead to atherosclerotic plaque rupture and thrombosis, further modulating the risk of acute CV events. 45,46 Chronic systemic inflammation can alter structure and function of arteries, contributing to endothelial dysfunction, atherosclerotic plaque formation, platelet activation and hyperactive coagulation state.…”

Section: Interpretation and Clinical Implicationmentioning

confidence: 99%

Association of COPD exacerbations and acute cardiovascular events: a systematic review and meta-analysis

Müllerová

Marshall

Nigris

et al. 2022

Ther Adv Respir Dis

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Background: The majority of patients with chronic obstructive pulmonary disease (COPD) suffer from comorbid cardiovascular (CV) disease. Accumulating evidence suggests a temporal association between COPD exacerbations and acute CV events, possibly due to lung hyperinflation, increased hypoxemia and systemic inflammation. The aims of the study were to estimate the risk of (1) acute CV events [acute myocardial infarction (AMI), CV-related death] or stroke in the months following a COPD exacerbation and (2) COPD exacerbation in the months following an acute CV event. Methods: A systematic literature review of observational studies published since 2000 was conducted by searching literature databases (Medline and Embase). Studies were eligible if conducted in adults with COPD, exposed to either COPD exacerbation or acute CV events, with outcomes of acute CV events or COPD exacerbation reported. Studies were appraised for relevance, bias and quality. Meta-analyses, using random-effect models, were performed for each outcome of interest, thus providing a pooled relative risk (RR) and its 95% confidence interval. Results: Eight studies were identified, of which seven were used for the meta-analyses examining the risk of CV events 1–3 months after an exacerbation compared with none. For stroke (six studies), RR was 1.68 (95% CI = 1.19–2.38). For AMI (six studies), RR was 2.43 (95% CI = 1.40–4.20). No studies exploring risk of exacerbation following an acute CV event were identified. Conclusion: This meta-analysis identified a markedly increased risk of stroke or AMI within a relatively short period of time following a COPD exacerbation. Although the underlying mechanisms are not fully elucidated, patients with COPD should be monitored for risk of CV outcomes after exacerbations. In addition, preventing exacerbations may decrease the risk of subsequent acute CV events. Registration: The study protocol was published via PROSPERO: International Prospective Register of Systematic Reviews (#CRD42020211055).

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“…Platelet reactivation is also triggered and increases the risk of thrombosis. 6 The finding of blood vessels that are more rigid in exacerbation conditions by examining the carotid-femoral aortic pulse wave velocity (aPWV) indicates endothelial dysfunction. These factors all enhance the possibility of AMI.…”

Section: Discussionmentioning

confidence: 99%

“…3 Patients are more likely to have NSTEMI than STEMI and lower cardiac enzymes (troponin and creatinine kinase) values in further studies. 2,6 The pathological picture on the ECG might describe a transient secondary ischemic condition triggered by an increase in oxygen demand, while the oxygen supply is reduced and insufficient to fulfill those demands. If ischemic heart disease is suspected, echocardiography may be adjusted to assess ventricular function and identify the location of vascular occlusion.…”

Section: Discussionmentioning

confidence: 99%

Acute Myocardial Infarction in Severe Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Surviving Case

Cempakadewi,

Puspita Sari,

Budiana

2024

J Respirol Indones

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Background: COPD is characterized by chronic respiratory symptoms with progressive, irreversible structural abnormalities and impaired lung function. Previously, COPD was known as a condition that only affected the airways and lungs, but recent studies have revealed the incidence of cardiovascular disease in this population as the prevalence increased.Case: A 68-year-old male came to the emergency room fully conscious, complaining of shortness of breath since the afternoon. A physical examination detected tachypnea, desaturation of oxygen, and additional breath sounds in both lungs. Blood gas analysis with the result of respiratory acidosis supported the diagnosis of AECOPD (acute exacerbations of chronic obstructive pulmonary disease), impending type II respiratory failure, cor-pulmonale. During the treatment in the intensive unit, the physicians recognized deteriorating conditions as unconsciousness, unstable vital signs, and ST-T segment changes on the ECG with an elevated cardiac marker. Other medications (antiplatelet, LMWH, and statin) were given immediately. The patient’s condition improved. On the ninth day of the treatments, the patient was discharged home.Discussion: Acute exacerbations of COPD have a higher risk of developing ischemic heart disease with varying underlying mechanisms (atherosclerosis process and oxygen supply-demand imbalance). Understanding the numerous pathways that contribute to AMI (acute myocardial infarction) in COPD will help physicians determine the therapy.Conclusion: Based on this case, the ECG and cardiac enzymes warrant immediate evaluation, as must symptoms, vital signs, clinical findings, and other changes. Delays in case finding and treatment can worsen the prognosis.

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Ischemic Heart Disease during Acute Exacerbations of COPD

Cited by 7 publications

References 60 publications

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

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

Association of COPD exacerbations and acute cardiovascular events: a systematic review and meta-analysis

Acute Myocardial Infarction in Severe Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Surviving Case

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