1
|
Laratta CR, van Eeden S. Acute exacerbation of chronic obstructive pulmonary disease: cardiovascular links. BIOMED RESEARCH INTERNATIONAL 2014; 2014:528789. [PMID: 24724085 PMCID: PMC3958649 DOI: 10.1155/2014/528789] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 12/16/2013] [Indexed: 01/03/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is a chronic, progressive lung disease resulting from exposure to cigarette smoke, noxious gases, particulate matter, and air pollutants. COPD is exacerbated by acute inflammatory insults such as lung infections (viral and bacterial) and air pollutants which further accelerate the steady decline in lung function. The chronic inflammatory process in the lung contributes to the extrapulmonary manifestations of COPD which are predominantly cardiovascular in nature. Here we review the significant burden of cardiovascular disease in COPD and discuss the clinical and pathological links between acute exacerbations of COPD and cardiovascular disease.
Collapse
Affiliation(s)
- Cheryl R Laratta
- Department of Medicine, University of Alberta, Edmonton, AB, Canada ; UBC James Hogg Research Center, Institute for Heart and Lung Health, University of British Columbia, Canada
| | - Stephan van Eeden
- UBC James Hogg Research Center, Institute for Heart and Lung Health, University of British Columbia, Canada ; Respiratory Division, Department of Medicine, St. Paul's Hospital, Vancouver, BC, Canada
| |
Collapse
|
2
|
Puente-Maestu L, Calle M, Ortega-González A, Fuster A, González C, Márquez-Martín E, Marcos-Rodriguez PJ, Calero C, Rodríguez-Hermosa JL, Malo de Molina R, Aburto M, Sobradillo P, Alcázar B, Tirado-Conde G. Multicentric study on the beta-blocker use and relation with exacerbations in COPD. Respir Med 2014; 108:737-44. [PMID: 24635914 DOI: 10.1016/j.rmed.2014.02.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 02/10/2014] [Accepted: 02/12/2014] [Indexed: 12/11/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is frequently associated with chronic heart failure (CHF) or coronary artery disease (CAD). In spite of the recommendation to use beta-blockers (BB) they are likely under-prescribed to patients with concurrent COPD and heart diseases. To find out the prevalence of use of BB, 256 COPD patients were consecutively recruited by pulmonary physicians from 14 hospitals in 7 regions of Spain in their outpatient offices if they had a diagnosis of COPD, were not on long-term oxygen therapy, had CHF or CAD, and met the criteria for BB treatment. In patients with indication 58% (95%CI, 52-64%) of the COPD patients and 97% of the non-COPD patients were on BB (p < 0.001). In patients with COPD, several factors were independently related to at least one visit to the emergency room in the previous year such as use of BB, adjusted OR = 0.27 (95% CI 0.15-0.50), GOLD stage D, OR = 2.52 (1.40-4.53), baseline heart rate >70, OR 2.19 (1.24-3.86) use of long-acting beta2-agonists OR = 2.18 (1.29-3.68), previous episodes of left ventricular failure OR 2.27 (1.19-4.33) and diabetes, OR = 1.82 (1.08-3.38). We conclude that, according to what is recommended by current guidelines, BB are still under-prescribed in COPD patients. COPD patients with CHF or CAD using BB suffer fewer exacerbations and visits to the ER. GOLD stage, use of long-acting beta2-agonists, baseline heart rate and comorbidities are also risk factors for exacerbations in this population.
Collapse
Affiliation(s)
- Luis Puente-Maestu
- Servicio de Neumología, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain.
| | - Myriam Calle
- Servicio de Neumología, Hospital Clínico San Carlos, Madrid, Spain
| | - Angel Ortega-González
- Unidad de Neumología, Hospital General Nuestra Señora del Prado, Talavera de la Reina, Toledo, Spain
| | - Antonia Fuster
- Servicio de Neumología, Hospital Son Llàtzer (Palma de Mallorca), Spain
| | - Cruz González
- Servicio de Neumología, Hospital Clínico Universitario, Valencia, Spain
| | - Eduardo Márquez-Martín
- Unidad Médico Quirúrgica de Enfermedades Respiratorias, Hospital Virgen del Rocío, Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBIS), Spain; Universidad Hispalense, Sevilla, Spain
| | | | - Carmen Calero
- Unidad Médico Quirúrgica de Enfermedades Respiratorias, Hospital Virgen del Rocío, Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBIS), Spain
| | | | | | | | | | - Bernardino Alcázar
- Neumología, Agencia Sanitaria Poniente Hospital de Alta Resolución de Loja, Granada, Spain
| | | | | |
Collapse
|
3
|
Matera MG, Calzetta L, Cazzola M. β-Adrenoceptor Modulation in Chronic Obstructive Pulmonary Disease: Present and Future Perspectives. Drugs 2013; 73:1653-63. [DOI: 10.1007/s40265-013-0120-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|
4
|
Odigie-Okon E, Jordan B, Dijeh S, Wolff A, Dadu R, Lall P, Zarich S, Amoateng-Adjepong Y, Manthous CA. Cardiac injury in patients with COPD presenting with dyspnea: a pilot study. Int J Chron Obstruct Pulmon Dis 2010; 5:395-9. [PMID: 21103406 PMCID: PMC2981154 DOI: 10.2147/copd.s11975] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Indexed: 01/20/2023] Open
Abstract
PURPOSE The aim of this pilot study was to test the hypothesis that myocardial ischemia complicates the management of some patients with chest-pain-free chronic obstructive pulmonary disease (COPD) exacerbations. METHODS In this prospective, observational, cohort study, patients admitted to a 350-bed community teaching hospital, with dyspnea and a primary diagnosis of COPD exacerbation, were followed for enzymatic and electrocardiographic evidence of myocardial ischemia for the first 24 hours of hospital admission. RESULTS A total of 114 patients were studied. Overall, four patients had definite myocardial infarctions, one had definite myocardial ischemia and 14 had possible myocardial ischemia. In multiple logistic regression models, age, number of coronary risk factors, and amount of administered albuterol were not associated with myocardial injury. CONCLUSION While unrecognized myocardial injury is relatively rare in patients with an exacerbation of COPD, it occurs frequently enough to warrant some caution since beta-agonists are the mainstays of therapy.
Collapse
Affiliation(s)
- Esosa Odigie-Okon
- Bridgeport Hospital and Yale University School of Medicine, Bridgeport, CT, USA
| | - Bryan Jordan
- Bridgeport Hospital and Yale University School of Medicine, Bridgeport, CT, USA
| | - Sylvester Dijeh
- Bridgeport Hospital and Yale University School of Medicine, Bridgeport, CT, USA
| | - Armand Wolff
- Bridgeport Hospital and Yale University School of Medicine, Bridgeport, CT, USA
| | - Razvan Dadu
- Bridgeport Hospital and Yale University School of Medicine, Bridgeport, CT, USA
| | - Priyanka Lall
- Bridgeport Hospital and Yale University School of Medicine, Bridgeport, CT, USA
| | - Stuart Zarich
- Bridgeport Hospital and Yale University School of Medicine, Bridgeport, CT, USA
| | | | | |
Collapse
|
5
|
Palaniswamy C, Guleria R, Mohan A, Selvaraj DR. Wheezy patient with heart failure and chronic obstructive pulmonary disease: what to treat with? Am J Emerg Med 2008; 26:1060. [DOI: 10.1016/j.ajem.2008.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2008] [Accepted: 06/04/2008] [Indexed: 11/30/2022] Open
|