1
|
Zhu J, Cao J, Zhao S. Association between dietary anthocyanin intake and chronic obstructive pulmonary disease in US adults: A public database survey. Heart Lung 2024; 67:108-113. [PMID: 38749346 DOI: 10.1016/j.hrtlng.2024.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 05/07/2024] [Accepted: 05/08/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Anthocyanins have anti-inflammatory and antioxidant properties. Several studies have demonstrated that anthocyanins are associated with many chronic diseases, but few studies have focused on the relationship between anthocyanins and chronic obstructive pulmonary disease (COPD). OBJECTIVES This survey aimed to explore the relationship between dietary anthocyanin intake and COPD in US adults over the age of 40. METHODS A cross-sectional study from the National Health and Nutrition Examination Survey (NHANES) 2017-2018 was conducted. We used univariate and multivariate logistic regression and restricted cubic spline (RCS) to analyze the relationship between dietary anthocyanins and COPD. Subgroup and interaction analyses were adopted to assess whether there were differences in the relationship between dietary anthocyanin intake and COPD in different groups. RESULTS A total of 2862 participants aged ≥ 40 years were analyzed, of whom 213 were diagnosed with COPD. The highest tertile of dietary anthocyanin intake was negatively correlated with COPD compared to the lowest after adjusting potential confounders (Model 1, OR = 0.414; 95% CI: (0.245, 0.699), P-trend = 0.002; Model 2, OR = 0.363; 95% CI: (0.210, 0.627), P-trend = 0.002; Model 3, OR = 0.614; 95% CI: (0.383, 0.985), P-trend = 0.040). The RCS curve showed a significant inverse linear relationship between dietary anthocyanin intake and COPD (P non-linear = 0.734). In subgroup analyses, the negative correlation between dietary anthocyanin intake and COPD existed across different subgroups. CONCLUSION Our study indicated that higher dietary anthocyanins are a protective factor against the presence of COPD in the US aged over 40.
Collapse
Affiliation(s)
- Jinqi Zhu
- Department of Respiratory and Critical Care Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, PR China
| | - Jing Cao
- Medical Department, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, PR China
| | - Sue Zhao
- Department of Respiratory and Critical Care Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, PR China.
| |
Collapse
|
2
|
Tais Leonardi N, da Silva Rocha Tomaz C, Zavaglia Kabbach E, Domingues Heubel A, Souza Schafauser N, Mayumi de Oliveira Kawakami D, Borghi-Silva A, Goi Roscani M, Castello-Simões V, Gonçalves Mendes R. Left ventricular concentric remodeling in COPD patients: A cross-sectional observational study. Med Clin (Barc) 2024; 163:8-13. [PMID: 38614905 DOI: 10.1016/j.medcli.2024.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 01/19/2024] [Accepted: 01/24/2024] [Indexed: 04/15/2024]
Abstract
OBJECTIVE To investigate the association between left ventricular structure and disease severity in COPD patients. METHODS Twenty-eight COPD patients were stratified according to the disease severity, using the BODE index, into Lower (n=17) and Higher (n=11) groups, composed of patients with lower severity (BODE <5) and higher severity (BODE ≥5), respectively. Left ventricle (LV) was assessed by 2D-echocardiography. BODE index was calculated using body mass index (BMI); forced expiratory volume in the first second (FEV1, %); modified Medical Research Council (mMRC) and distance walked during 6-minute walk test (6MWD). RESULTS Patients in the Higher group showed lower oxygen arterial saturation (p=0.02), FEV1 (p<0.01) and 6MWD (p=0.02) and higher value of relative posterior wall thickness (RWT) compared to Lower group (p=0.02). There were significant associations between LV end-systolic diameter (LVESD) and BODE index (r=-0.38, p=0.04), LV end-diastolic diameter (LVEDD) and FEV1 (r=0.44, p=0.02), LVEDD and BMI (r=0.45, p=0.02), LVESD and BMI (r=0.54, p=0.003) and interventricular septal thickness and 6MWD (r=-0.39, p=0.04). CONCLUSIONS More severe COPD patients, BODE score ≥5, may have higher RWT, featuring a possible higher concentric remodeling of LV in this group. Besides that, a greater disease severity may be related to LV chamber size reduction.
Collapse
Affiliation(s)
- Naiara Tais Leonardi
- Department of Physical Therapy, Federal University of Sao Carlos, Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil
| | - Camila da Silva Rocha Tomaz
- Department of Physical Therapy, Federal University of Sao Carlos, Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil
| | - Erika Zavaglia Kabbach
- Department of Physical Therapy, Federal University of Sao Carlos, Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil
| | - Alessandro Domingues Heubel
- Department of Physical Therapy, Federal University of Sao Carlos, Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil
| | - Nathany Souza Schafauser
- Department of Physical Therapy, Federal University of Sao Carlos, Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil
| | - Débora Mayumi de Oliveira Kawakami
- Department of Physical Therapy, Federal University of Sao Carlos, Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil
| | - Audrey Borghi-Silva
- Department of Physical Therapy, Federal University of Sao Carlos, Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil
| | - Meliza Goi Roscani
- Department of Medicine, Federal University of Sao Carlos (UFSCar), Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil
| | - Viviane Castello-Simões
- Department of Physical Therapy, Federal University of Sao Carlos, Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil
| | - Renata Gonçalves Mendes
- Department of Physical Therapy, Federal University of Sao Carlos, Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil.
| |
Collapse
|
3
|
Wang K, Zhao S, Yau SZM, Wei Y, Li YC, Orr RWC, Lam IHL, Wu Y, Wong ELY, Hung CT, Yeoh EK. Outcomes and Hospital Service Use Among Patients With COPD in a Nurse- and Allied Health-Led Clinic. JAMA HEALTH FORUM 2024; 5:e241575. [PMID: 38967950 PMCID: PMC11227079 DOI: 10.1001/jamahealthforum.2024.1575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/24/2024] [Indexed: 07/06/2024] Open
Abstract
Importance Multidisciplinary disease management efforts enable the improvement in lung function among patients with chronic obstructive pulmonary disease (COPD), but there is little evidence of its association with risks of adverse health outcomes and health care service use. Objective To examine the association between the use of a nurse- and allied health-led primary care clinic for respiratory patients, namely the Nurse and Allied Health Clinic-Respiratory Care (NAHC-Respiratory), and their risks of mortality and morbidity and health care service use. Design, Setting, and Participants This territory-wide, population-based, propensity-matched, retrospective cohort study used data from the electronic health records of all patients who used public health care services in Hong Kong, China, from January 1, 2010, to December 31, 2019. All patients with COPD treated in public outpatient clinics between January 1, 2010, and December 31, 2014, were included. Patients who attended NAHC-Respiratory and usual care only were propensity score-matched at a 1:2 ratio. Data analyses were conducted between August 2023 and April 2024. Exposure Attendance at NAHC-Respiratory. Main Outcomes and Measures All-cause and cause-specific mortality, incidence of COPD complications, and use of emergency department and inpatient services until the end of 2019 were compared between the NAHC-Respiratory and usual care participants using Cox proportional hazard regression, Poisson regression, and log-link gamma regression models after matching. Results This study included 9048 eligible patients after matching, including 3093 in the exposure group (2814 [91.0%] men; mean [SD] age, 69.8 [9.5] years) and 5955 in the reference group (5431 [91.2%] men; mean [SD] age, 69.5 [11.7] years). Compared with patients in the usual care-only group (reference), patients in the exposure group had lower risks of all-cause mortality (hazard ratio [HR], 0.84; 95% CI, 0.78-0.90) as well as pneumonia-caused (HR, 0.85; 95% CI, 0.74-0.97), respiratory-caused (HR, 0.86; 95% CI, 0.77-0.96), and cardiovascular-caused (HR, 0.74; 95% CI, 0.59-0.93) mortality. Exposure was associated with reduced rates of emergency department visits (incidence rate ratio [IRR], 0.92; 95% CI, 0.86-0.98) and hospitalization through emergency department (IRR, 0.89; 95% CI, 0.83-0.95). Conclusions In this cohort study, the use of a nurse- and allied health-led clinic in primary care settings was associated with reduced risks of mortality and use of hospital services among patients with COPD. These findings emphasize the important role of health care workers other than physicians in disease management in the primary care setting. The NAHC-Respiratory model and service components can be used to help improve primary care programs to benefit more patients with COPD.
Collapse
Affiliation(s)
- Kailu Wang
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Shi Zhao
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Susan Zi-May Yau
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Yuchen Wei
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Yim-Chu Li
- Department of Family Medicine and General Out-patient Clinics, Kowloon Central Cluster, Hospital Authority, Hong Kong, China
| | - Ryan Wai-Ching Orr
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Ivan Hin-Lai Lam
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Yushan Wu
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Eliza Lai-Yi Wong
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Chi-Tim Hung
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Eng-Kiong Yeoh
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| |
Collapse
|
4
|
Sukosd IE, Gadde ST, Pravallika M, Pescariu SA, Prodan M, Toma AO, Fericean RM, Hrubaru I, Sarau OS, Fira-Mladinescu O. Evaluating the Health-Related Quality of Life in Patients with COPD and Chronic Heart Failure Post-Hospitalization after COVID-19 Using the EQ-5D and KCCQ Questionnaires. Diseases 2024; 12:124. [PMID: 38920556 PMCID: PMC11203136 DOI: 10.3390/diseases12060124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Revised: 05/29/2024] [Accepted: 06/01/2024] [Indexed: 06/27/2024] Open
Abstract
Chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) frequently coexist, significantly impacting health-related quality of life (HRQoL). This study evaluated HRQoL in patients with CHF, COPD, or both, three months post-COVID-19 discharge using EQ-5D and KCCQ questionnaires to guide targeted healthcare interventions. We conducted a cross-sectional study at "Victor Babes" Hospital in Timisoara, enrolling 180 patients who had recovered from COVID-19 (60 in each group including CHF, COPD, and both conditions). HRQoL was assessed via EQ-5D and KCCQ. Significant disparities in HRQoL measures were noted across the groups. Patients with both CHF and COPD reported the worst outcomes, especially in terms of hospital stay lengths due to COVID-19 (11.63 days) and initial oxygen saturation levels (88.7%). HRQoL improvements from discharge to three months post-discharge were significant, with EQ-5D mobility scores improving notably across all groups (CHF and COPD: 2.87 to 2.34, p = 0.010). KCCQ results reflected substantial enhancements in physical limitation (CHF and COPD: 38.94 to 58.54, p = 0.001) and quality of life scores (CHF and COPD: 41.38 to 61.92, p = 0.0031). Regression analysis revealed that dual diagnosis (CHF and COPD) significantly impacted usual activities and quality of life (β = -0.252, p = 0.048; β = -0.448, p = 0.017), whereas the initial severity of COVID-19 was a significant predictor of worse HRQoL outcomes (β = -0.298, p = 0.037; β = -0.342, p = 0.024). The presence of both CHF and COPD in patients recovering from COVID-19 was associated with more severe HRQoL impairment compared with either condition alone. These findings emphasize the need for specialized, comprehensive post-COVID-19 recovery programs that address the complex interplay among chronic conditions to optimize patient outcomes and enhance quality of life.
Collapse
Affiliation(s)
- Ilona Emoke Sukosd
- Doctoral School, Department of General Medicine, Victor Babeş University of Medicine and Pharmacy, 300041 Timisoara, Romania; (I.E.S.); (O.S.S.)
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, Victor Babeş University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (M.P.); (O.F.-M.)
| | - Sai Teja Gadde
- Faculty of General Medicine, All India Institute of Medical Sciences (AIIMS), Mangalagiri 522503, India;
| | | | | | - Mihaela Prodan
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, Victor Babeş University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (M.P.); (O.F.-M.)
- Department of Plastic Surgery, “Pius Brinzeu” Timis County Emergency Clinical Hospital, 300723 Timisoara, Romania
| | - Ana-Olivia Toma
- Discipline of Dermatology, Victor Babeş University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Dermatology, Timisoara Municipal Emergency Hospital, 300254 Timisoara, Romania;
| | - Roxana Manuela Fericean
- Department of Dermatology, Timisoara Municipal Emergency Hospital, 300254 Timisoara, Romania;
| | - Ingrid Hrubaru
- Department of Obstetrics and Gynecology, Victor Babeş University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Oana Silvana Sarau
- Doctoral School, Department of General Medicine, Victor Babeş University of Medicine and Pharmacy, 300041 Timisoara, Romania; (I.E.S.); (O.S.S.)
- Department V, Internal Medicine, Discipline of Hematology, Victor Babeş University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Ovidiu Fira-Mladinescu
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, Victor Babeş University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (M.P.); (O.F.-M.)
- Department of Infectious Diseases, Discipline of Pulmonology, Victor Babeş University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| |
Collapse
|
5
|
Maeda T, Dransfield MT. Chronic obstructive pulmonary disease and cardiovascular disease: mechanistic links and implications for practice. Curr Opin Pulm Med 2024; 30:141-149. [PMID: 38085609 PMCID: PMC10948016 DOI: 10.1097/mcp.0000000000001040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
PURPOSE OF REVIEW Chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) are both significant burdens on the healthcare system and often coexist. Mechanistic links between the two conditions and their clinical impact are increasingly understood. RECENT FINDINGS Recent studies demonstrate multiple mechanisms by which the pathobiology of COPD may have negative effects on the cardiovascular system. These include extrapulmonary consequences of the COPD inflammatory state, cardiac autonomic dysfunction, which has been recently implicated in worsening respiratory symptoms and exacerbation risk, and mechanical effects of lung hyperinflation on left ventricular diastolic function.Clinical studies have consistently shown a high prevalence of CVD in COPD patients and worsened outcomes (and vice versa ). Exacerbations of COPD have also been demonstrated to dramatically increase the risk of cardiovascular events. While some safety concerns exist, medications for COPD and cardiovascular disease should be used in accordance with respective guidelines. However, real-world data show suboptimal management for patients with COPD and CVD. SUMMARY COPD and cardiovascular disease have complicated interrelationships. Further mechanistic studies may lead to defining better targets for interventions. Education for medical professionals and implementation of novel screening protocols should be encouraged to fill in the gaps in clinical care for these patients.
Collapse
Affiliation(s)
- Tetsuro Maeda
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | |
Collapse
|
6
|
Ponticelli D, Losa L, Antonazzo IC, Zampella A, Di Marino F, Mottola G, Fede MN, Gallucci F, Magliuolo R, Rainone A, Arcari A, Del Giudice C, Ferrara P. Respiratory Syncytial Virus (RSV) and Intention to Recommend RSV Vaccination: A Cross-Sectional Survey of Cardiologists and Cardiac Nurses in Southern Italy. Infect Dis Rep 2024; 16:128-141. [PMID: 38391588 PMCID: PMC10888396 DOI: 10.3390/idr16010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/05/2024] [Accepted: 02/10/2024] [Indexed: 02/24/2024] Open
Abstract
As respiratory syncytial virus (RSV) vaccine distribution gains traction in Europe and Italy, healthcare workers (HCWs) can strategize about vaccine promotion to increase uptake among patients at risk of RSV consequences, such cardiac patients. This cross-sectional survey investigated the knowledge about and attitude towards RSV and RSV vaccines, and the intention to recommend vaccination within a cardiological hospital in Italy. To explore factors associated with the outcomes of interest, multivariate logistic regression analyses were conducted. Of 197 invited HCWs, 78.2% returned the survey. The knowledge about market authorisation for new RSV vaccines for older adults (present in 46.9% of respondents) was significantly associated with the HCWs' age, education, and previous update on vaccinations. HCWs with a higher educational level and those with a positive attitude towards RSV vaccines safety reported a higher attitude towards the importance of vaccinating people at risk. The willingness of recommending RSV vaccination to patients (70.5% of respondents) was more likely in HCWs who were knowledgeable about market authorisation for RSV vaccines and in physicians. This tempestive research sheds light on current factors influencing the strategies of cardiac HCWs regarding RSV vaccination. The results suggest the need for training events on the protective role of RSV vaccination in cardiac patients.
Collapse
Affiliation(s)
| | - Lorenzo Losa
- Center for Public Health Research, University of Milan-Bicocca, 20900 Monza, Italy
| | - Ippazio Cosimo Antonazzo
- Center for Public Health Research, University of Milan-Bicocca, 20900 Monza, Italy
- Laboratory of Public Health, IRCCS Istituto Auxologico Italiano, 20165 Milan, Italy
| | | | | | | | | | | | | | | | | | | | - Pietro Ferrara
- Center for Public Health Research, University of Milan-Bicocca, 20900 Monza, Italy
- Laboratory of Public Health, IRCCS Istituto Auxologico Italiano, 20165 Milan, Italy
| |
Collapse
|