Resting heart rate is a predictor of mortality in COPD

Jensen, Magnus Thorsten; Marott, Jacob Louis; Lange, Peter; Vestbo, Jørgen; Schnohr, Peter; Nielsen, Olav Wendelboe; Jensen, Jan Skov; Jensen, Gorm

doi:10.1183/09031936.00072212

Cited by 121 publications

(78 citation statements)

References 30 publications

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“…1,3,4 Resting heart rate increases with increasing severity of COPD and tachycardia can increase both cardiovascular and all-cause mortality, independent of pulmonary function. 5 Tachycardia can reduce the exercise tolerance in COPD patients by increasing myocardial oxygen demand and decreasing coronary perfusion time. Shortened diastole also causes incomplete relaxation between beats, resulting in an increase in diastolic pressure relative to volume.…”

Section: Introductionmentioning

confidence: 99%

The effect of ivabradine on functional capacity in patients with chronic obstructive pulmonary disease

et al. 2016

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Increased sympathetic tone and use of bronchodilators increase heart rate and this may worsen functional capacity in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to look at the short-term effect of the heart rate lowering drug ivabradine on clinical status in COPD patients. We randomised 80 COPD patients with sinus heart rate ≥90 bpm into either taking ivabradine 7.5 mg twice per day or placebo for two weeks. We assessed all patients using the modifi ed Borg scale and 6-minute walk test at baseline and then again 2 weeks after randomisation. There were no signifi cant differences in age, sex, severity of airway obstruction (measured using forceful exhalation), severity of diastolic dysfunction or pulmonary artery systolic pressure between the two groups. The ivabradine group showed signifi cant improvement in 6-minute walk distance (from 192.6±108.8 m at baseline to 285.1±88.9 m at the end of the study) compared with the control group (230.6±68.4 at baseline and 250.4±65.8 m at the end of study) (p<0.001). This improvement in the drug group was associated with signifi cant improvement of dyspnea on modifi ed Borg scale (p=0.007). Lowering heart rate with ivabradine can improve exercise capacity and functional class in COPD patients with resting heart rate >90 bpm.

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Section: Introductionmentioning

confidence: 99%

The effect of ivabradine on functional capacity in patients with chronic obstructive pulmonary disease

et al. 2016

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“…Long-term follow-ups of population-based COPD cohorts, in which COPD is classified according to spirometric criteria of accepted guidelines, are rare. The Copenhagen City Heart study was recruited in 1976 and included more than 2000 subjects classified as COPD and, so far, there are three follow-ups within 25 years, the latest in 2001–2003 [43]. However, it is an open study including new subjects at each of the follow-ups and, thus, not comparable to either the OLIN COPD or the NHANES studies.…”

Section: Discussionmentioning

confidence: 99%

From COPD epidemiology to studies of pathophysiological disease mechanisms: challenges with regard to study design and recruitment process

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Bäckman

et al. 2017

European Clinical Respiratory Journal

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Background: Chronic obstructive pulmonary disease (COPD) is a largely underdiagnosed disease including several phenotypes. In this report, the design of a study intending to evaluate the pathophysiological mechanism in COPD in relation to the specific phenotypes non-rapid and rapid decline in lung function is described together with the recruitment process of the study population derived from a population based study. Method: The OLIN COPD study includes a population-based COPD cohort and referents without COPD identified in 2002–04 (n = 1986), and thereafter followed annually since 2005. Lung function decline was estimated from baseline in 2002–2004 to 2010 (first recruitment phase) or to 2012/2013 (second recruitment phase). Individuals who met the predefined criteria for the following four groups were identified; group A) COPD grade 2–3 with rapid decline in FEV1 and group B) COPD grade 2–3 without rapid decline in FEV1 (≥60 and ≤30 ml/year, respectively), group C) ever-smokers, and group D) non-smokers with normal lung function. Groups A–C included ever-smokers with >10 pack years. The intention was to recruit 15 subjects in each of the groups A-D. Results: From the database groups A–D were identified; group A n = 37, group B n = 29, group C n = 41, and group D n = 55. Fifteen subjects were recruited from groups C and D, while this goal was not reached in the groups A (n = 12) and B (n = 10). The most common reasons for excluding individuals identified as A or B were comorbidities contraindicating bronchoscopy, or inflammatory diseases/immune suppressive medication expected to affect the outcome. Conclusion: The study is expected to generate important results regarding pathophysiological mechanisms associated with rate of decline in lung function among subjects with COPD and the in-detail described recruitment process, including reasons for non-participation, is a strength when interpreting the results in forthcoming studies.

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“…Naheliegend ist der günstige Einfluss auf die Herzfrequenz. Patienten mit schwerer COPD haben zwar meist keine explizite Tachykardie, jedoch eine höhere Herzfrequenz als leicht erkrankte Personen [91]. Eine statistische Beziehung zwischen Herzfrequenz in Ruhe und Lebenserwartung wurde dargestellt: Im GOLD-Stadium III/IV war die mediane Lebenserwartung um 5 Jahre kürzer, wenn die Herzfrequenz höher als 85 In den aktuellen Leitlinien zur Behandlung von Asthma werden langwirksame Anticholinergika bisher nicht erwähnt.…”

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Expertentreffen obstruktive Atemwegserkrankungen: Kardiovaskuläre Aspekte der COPD

et al. 2013

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This overview presents data that take advantage of a new step of insight into COPD. Large population-based retrospective studies and intensively investigated prospective cohorts are two important sources of knowledge that have been recently developed. One of the contributions introduces the German COSYCONET which is on its way shortly after the American ECLIPSE cohort. The vast amount of new data has also contributed to some corrections of the recommendations of the international GOLD committee. Clinically important are the waiver of the reversibility test for the diagnosis of COPD, the inclusion of sympotom scores to evaluate quality of life and the estimation of exacerbations. The COPD types I through IV were originally the result of expert opinion, but their impact on prognosis has recently been evaluated empirically.The top issues of the expert meeting were cardiovascular aspects of COPD. Besides the comorbidity of two significant chronic diseases, it became clear that cardiovascular events have an outstanding significance for COPD patients. Inversely, advanced COPD is an important risk factor in cardiac and vascular diseases. The mutual influence of both disease entities does not only affect the long term progression but also the outcome of acute events like myocardial infarction and COPD exacerbation. The following contributions investigate the topic with regard to epidemiology, the biology of vessels, and especially with regard to acute COPD exacerbations and pharmakotherapy. Recent evidence enables a fresh view on the cardiovascular toxicity of COPD medication and on possible protective effects of cardiovascular drugs (i.e. statins and ß-receptor antagonists) for patients with COPD.

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Resting heart rate is a predictor of mortality in COPD

Cited by 121 publications

References 30 publications

The effect of ivabradine on functional capacity in patients with chronic obstructive pulmonary disease

The effect of ivabradine on functional capacity in patients with chronic obstructive pulmonary disease

From COPD epidemiology to studies of pathophysiological disease mechanisms: challenges with regard to study design and recruitment process

Expertentreffen obstruktive Atemwegserkrankungen: Kardiovaskuläre Aspekte der COPD

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