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23-12-2009 | Respiratory | Article

COPD increases risk for subclinical LV dysfunction

Abstract

Free abstract

MedWire News: The presence of chronic obstructive pulmonary disease (COPD) is associated with an increased risk for subclinical left ventricular (LV) dysfunction in vascular surgery patients, study results show.

“The co-existence between COPD and heart failure has been previously described,” explain lead researcher Don Poldermans (Erasmus Medical Center, Rotterdam, The Netherlands) and team.

“However, the co-existence between COPD and subclinical LV dysfunction, without the presence of heart failure symptoms, is less well understood,” they add.

To investigate, the researchers used spirometry and echocardiography to assess 1005 consecutive vascular surgery patients for the presence of COPD and subclinical LV dysfunction.

Mild COPD was defined as a FEV1 of at least 80% of predicted and a FEV1/forced vital capacity (FVC) ratio of less than 0.70, while moderate-to-severe COPD was defined as a FEV1 of less than 80% of predicted and a FEV1/FVC-ratio of less than 0.70.

In total, 367 (37%) patients had COPD, including 175 with mild and 192 with moderate-to-severe COPD, and 506 (50%) had LV dysfunction.

Analysis revealed that the presence of mild and moderate-to-severe COPD were associated with a respective 1.6- and 1.7-fold increased risk for subclinical LV dysfunction.

The researchers also found that, over a mean follow-up period of 2.2 years, mild COPD combined with LV dysfunction was associated with a 1.7-fold increased risk for all-cause mortality, while moderate-to-severe COPD combined with LV dysfunction was associated with a 2.5-fold increased risk for all-cause mortality, compared with an absence of these conditions.

Patients with COPD and LV dysfunction also had significantly higher all-cause mortality rates than those with COPD alone, Poldermans and team note in the journal Respiratory Medicine.

They conclude: “The current study showed that both mild and moderate-to-severe COPD are associated with increased risk of LV dysfunction in vascular surgery patients.”

They add: “These data suggest that preoperative echocardiography may be useful to detect subclinical cardiovascular disease and risk-stratify COPD patients undergoing vascular surgery.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2009

By Mark Cowen

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