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Clinical and functional status of patients with chronic obstructive pulmonary disease and atrial fibrillation

https://doi.org/10.18093/0869-0189-2017-27-6-760-766

Abstract

The aim of this study was to investigate functional status and typical symptoms in patients with chronic obstructive pulmonary disease (COPD) and atrial fibrillation (AF). Methods. Stable patients with moderate to very severe COPD (n = 94) with or without AF were involved in the study. Spirometry, 24-h monitoring of electrocardiogram and arterial pressure were done in all patients. COPD symptoms were assessed using Modified Medical Research Council Scale (mMRC) and COPD Assessment Test (CAT). We analyzed a rate of moderate and severe acute exacerbations of COPD during the previous year; parameters of 6-minute walk test (distance, pulse oximetry and dyspnea using Borg’s scale) and BODE index. Results. AF paroxysms were registered in 46 patients; AF was asymptomatic in 22 patients. Thereafter, COPD patients were divided into two clusters, with and without AF. Comparison of the two clusters showed that patients with COPD and AF had more severe bronchial obstruction (p < 0.001), more frequent acute exacerbations of COPD (р = 0.038), more severe COPD symptoms (CAT, р < 0.001; mMRC, р = 0.007) and higher BODE index (р < 0.001). Also, patients with COPD and AF had more severe hypoxemia (р = 0.012), more severe dyspnea evaluated with Borg’s scale (р < 0.001) and shorter distance in 6-minute walk test (р ˂ 0.001) compared to COPD patient without AF. Conclusion. Higher rate of acute exacerbations of COPD, prominent decrease both in FEV1 and in physical tolerance, higher BODE index and higher mMRC and CAT scores were typical for COPD patients with AF paroxysms.

About the Authors

E. I. Leonova
Federal Central Research Institute of Tuberculosis
Russian Federation

Elena I. Leonova, Candidate of Medicine, Researcher, Division of Differential Diagnosis of Pulmonary Tuberculosis and Extracorporeal Therapeutic Methods 

Yauzskaya alleya 2, Moscow, 107564, Russia

 



T. V. Adasheva
A.I. Evdokimov Moscow State University of Medicine and Dentistry
Russian Federation

Tat'yana V. Adasheva, Doctor of Medicine, Professor, Department of Ambulatory Therapy 

ul. Delegatskaya 20, build. 1, Moscow, 127473, Russia



V. S. Zadionchenko
A.I. Evdokimov Moscow State University of Medicine and Dentistry
Russian Federation

Vladimir S. Zadionchenko, Doctor of Medicine, Professor, Department of Ambulatory 

 

ul. Delegatskaya 20, build. 1, Moscow, 127473, Russia



G. G. Shekhyan
A.I. Evdokimov Moscow State University of Medicine and Dentistry
Russian Federation

Grant G. Shekhyan, Candidate of Medicine, Associate Professor, Department of Ambulatory Therapy 

ul. Delegatskaya 20, build. 1, Moscow, 127473, Russia



S. V. Pavlov
A.I. Evdokimov Moscow State University of Medicine and Dentistry
Russian Federation

Sergey V. Pavlov, Candidate of Medicine, Assistant Lecturer, Department of Ambulatory Therapy 

ul. Delegatskaya 20, build. 1, Moscow, 127473, Russia



References

1. Losano R., Naghavi M., Foreman K. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Diseases study. Lancet. 2012; 380 (9859): 2095–2118. DOI: 10.1016/S0140-6736(12)61728-0.

2. Sin D.D., Anthonisen N.R., Soriano J.B., Agusti F.G. Mortality in COPD: Role of comorbidities. Eur. Respir. J. 2006; 28 (6): 1245–1257. DOI: 10.1183/09031936.00133805.

3. Buch P., Friberg J., Scharling H. et al. Reduced lung function and risk of atrial fibrillation in the Copenhagen City Heart study. Eur. Respir. J. 2003; 21 (6): 1012–1016. DOI: 10.1183/09031936.03.00051502.

4. Shibata Y., Watanabe T., Osaka D. et al. Impairment of pulmonary function is an independent risk factor for atrial fibrillation: the Takahata study. Int. J. Med. Sci. 2011; 8 (7): 514–522.

5. Stewart S., Hart C.L., Hole D.J. Population prevalence, incidence, and predictors of atrial fibrillation in the Renfrew/Paisley study. Heart. 2001; 86 (5): 516–521. DOI: 10.1136/heart.86.5.516.

6. Li J., Agarwal S.K., Alonso A. et al. Airflow obstruction, lung function, and incidence of atrial fibrillation the Atherosclerosis Risk in Communities (ARIC) study. Circulation. 2014; 129 (9): 971–980. DOI: 10.1161/CIRCULATIONAHA.113.004050.

7. Yo C.H., Lee S.H., Chang S.S. et al. Value of high-sensitivity C-reactive protein assays in predicting atrial fibrillation recurrence: a systematic review and meta-analysis. Br. Med. J. Open. 2014; 4 (2): e004418. DOI: 10.1136/bmjopen-2013-004418.

8. Feary J.R., Rodrigues L.C., Smith C.J. et al. Prevalence of major comorbidities in subjects with COPD and incidence of myocardial infarction and stroke: a comprehensive analysis using data from primary care. Thorax. 2010; 65 (11): 956–962. DOI: 10.1136/thx.2009.128082.

9. Nagorni-Obradovic L.M., Vukovic D.S. The prevalence of COPD co-morbidities in Serbia: results of a national survey. NPJ Prim. Care Respir. Med. 2014; 24: 140–148.

10. Truelsen T., Prescott E., Lange P. et al. Lung function and risk of fatal and non-fatal stroke. The Copenhagen City Heart study. Int. J. Epidemiol. 2001; 30 (1):145–151.

11. Andersson T., Magnuson A., Bryngelsson I.L. et al. All-cause mortality in 272 186 patients hospitalized with incident atrial fibrillation 1995–2008: a Swedish nationwide long-term case–control study. Eur. Heart J. 2013; 34 (14): 1061–1067. DOI: 10.1093/eurheartj/ehs469.

12. Waatevik M., Johannessen A., Real F.G. et al. Oxygen desaturation in 6-min walk test is a risk factor for adverse outcomes in COPD. 2016; 48 (1): 82–91. DOI: 10.1183/13993003.00975-2015.

13. Singh S.J., Puhan M.A., Andrianopoulos V. et al. An official systematic review of the European Respiratory Society/American Thoracic Society: measurement properties of field walking tests in chronic respiratory disease. Eur. Respir. J. 2014; 44 (6): 1447–1478. DOI: 10.1183/09031936.00150414.

14. Gökdeniz T., Kalaycıoğlu E., Boyacı F. et al. The BODE index, a multidimensional grading system, reflects impairment of right ventricle functions in patients with chronic obstructive pulmonary disease: a speckle-tracking study. Respiration. 2014; 88 (3): 223–233. DOI: 10.1159/000365222.

15. Aanerud M., Saure E.W., Benet M. et al. Serial Measurements of Arterial Oxygen Tension are Associated with Mortality in COPD. COPD. 2015; 12 (3): 287–294.

16. Sundh J., Jansen C., Lisspers K. et al. The Dyspnoea, Obstruction, Smoking, Exacerbation (DOSE) index is predictive of mortality in COPD. Prim. Care Respir. J. 2012; 21 (3): 295–301.

17. Ladeira I., Gomes T., Castro A. The overall impact of COPD (CAT) and BODE index on COPD male patients: correlation? Rev. Port. Pneumol. 2015; 21 (1): 11–15.

18. de Torres J.P., Casanova C., Marín J.M. et al. Prognostic evaluation of COPD patients: GOLD 2011 versus BODE and the COPD comorbidity index COTE. Thorax. 2014; 69 (9): 799–804. DOI: 10.1136/thoraxjnl-2014-205770.

19. Stolz D., Meyer A., Rakic J. et al. Mortality risk prediction in COPD by a prognostic biomarker panel. Eur. Respir. J. 2014; 44 (6): 1557–1570. DOI: 10.1183/09031936.00043814.

20. Belevskiy A.S., ed. Сhronic obstructive pulmonary disease. M.: Rossiyskoe respiratornoe obshchestvo; 2016 (in Russian).

21. Kuang-Ming Liao, Chung-Yu Chen. Incidence and risk factors of atrial fibrillation in Asian COPD patients. Int. J. Chron. Obstruct. Pulmon. Dis. 2017; 12: 2523–2530. DOI: 10.2147/COPD.S143691.

22. MacDonald M.I., Shafuddin E., King P.T. et al. Cardiac dysfunction during exacerbations of chronic obstructive pulmonary disease. Lancet Respir. Med. 2016; 4 (2): 138–148.

23. Terzano C., Romani S., Conti V. et al. Atrial fibrillation in the acute, hypercapnic exacerbations of COPD. Eur. Rev. Med. Pharmacol. Sci. 2014; 18 (19): 2908–2917.

24. Vukic Dugac A., Ruzic A., Samarzija M. et al. Persistent endothelial dysfunction turns the frequent exacerbator COPD from respiratory disorder into a progressive pulmonary and systemic vascular disease. Med. Hypotheses. 2015; 84 (2): 155–158. DOI: 10.1016/j.mehy.2014.11.017.

25. Gel'tser B.I., Brodskaya T.A., Nevzorova V.A. An assessment of arterial stiffness in patients with chronic obstructive pulmonary disease. Pul'monologiya. 2008; 1: 45–50 (in Russian).

26. Kinyaykin M.F., Sukhanova G.I., Udovichenko I.A. A role of hypoxemia in development of myocardial injury and dyshomeostasis in patients with chronic obstructive pulmonary disease. Byulleten' fiziologii i patologii dykhaniya. 2011; 41: 8–12 (in Russian).

27. Tükek T., Yildiz P., Atilgan D. et al. Effect of diurnal variability of heart rate on development of arrhythmia in patients with chronic obstructive pulmonary disease. Int. J. Cardiol. 2003; 88 (2): 199–206.

28. Pavlova O.V., Kichigin V.A., Madyanov I.V. Blood level of adrenal cortex hormones in patients with chronic obstructive pulmonary disease. Zdravookhranenie Chuvashii. 2012; 4 (32): 66–72 (in Russian).


Review

For citations:


Leonova E.I., Adasheva T.V., Zadionchenko V.S., Shekhyan G.G., Pavlov S.V. Clinical and functional status of patients with chronic obstructive pulmonary disease and atrial fibrillation. PULMONOLOGIYA. 2017;27(6):760-766. (In Russ.) https://doi.org/10.18093/0869-0189-2017-27-6-760-766

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ISSN 0869-0189 (Print)
ISSN 2541-9617 (Online)