PURPOSE: Left ventricular hypertrophy (LVH) is a significant cardiac risk factor, associated with increased mortality. The impact of LVH on mortality in chronic obstructive pulmonary disease (COPD) is unknown. We evaluated the impact of LVH on mortality in COPD patients by measurement of left ventricular dimensions by echocardiography. METHODS: Retrospective cohort study utilizing a NHS database of COPD patients (TARDIS), in Tayside, Scotland (2001-2010), linked with databases regarding echocardiograms, pharmacy prescription, and the General Register Office for Scotland death registry. Cox proportional hazard regression was used to determine hazard ratios for mortality and hospital admissions based upon left ventricular mass index (LVMI) and left ventricular internal diastolic diameter after correction for all available influential covariates. Increased LVIDd was defined as >5.3 cm (female) and >5.9 cm (male). LVH was defined as an LVMI of >95 g/m(2) (female) and >115 g/m(2) (male). RESULTS: 617 patients were included for analysis. Mean (SD) age at diagnosis, 70 (9); mean FEV1 % (SD), 60.6 (19.3); mean resting SaO2 % (SD), 92.7 (10). Mean follow-up 4.5 years. Increased LVIDd was not associated with increased mortality, χ (2)= 0.767, p = 0.381. Increased LVMI was associated with a significant increased risk of mortality, χ (2) = 5.447, p = 0.02 with an adjusted HR (95 % CI) of 1.542 (1.068-2.228), p = 0.021. CONCLUSIONS: The presence of LVH, demonstrated by elevated left ventricular mass index is associated with a significantly increased risk of mortality in COPD patients. Therapeutic interventions are required to address this important modifiable risk factor in COPD patients.
PURPOSE:Left ventricular hypertrophy (LVH) is a significant cardiac risk factor, associated with increased mortality. The impact of LVH on mortality in chronic obstructive pulmonary disease (COPD) is unknown. We evaluated the impact of LVH on mortality in COPDpatients by measurement of left ventricular dimensions by echocardiography. METHODS: Retrospective cohort study utilizing a NHS database of COPDpatients (TARDIS), in Tayside, Scotland (2001-2010), linked with databases regarding echocardiograms, pharmacy prescription, and the General Register Office for Scotland death registry. Cox proportional hazard regression was used to determine hazard ratios for mortality and hospital admissions based upon left ventricular mass index (LVMI) and left ventricular internal diastolic diameter after correction for all available influential covariates. Increased LVIDd was defined as >5.3 cm (female) and >5.9 cm (male). LVH was defined as an LVMI of >95 g/m(2) (female) and >115 g/m(2) (male). RESULTS: 617 patients were included for analysis. Mean (SD) age at diagnosis, 70 (9); mean FEV1 % (SD), 60.6 (19.3); mean resting SaO2 % (SD), 92.7 (10). Mean follow-up 4.5 years. Increased LVIDd was not associated with increased mortality, χ (2)= 0.767, p = 0.381. Increased LVMI was associated with a significant increased risk of mortality, χ (2) = 5.447, p = 0.02 with an adjusted HR (95 % CI) of 1.542 (1.068-2.228), p = 0.021. CONCLUSIONS: The presence of LVH, demonstrated by elevated left ventricular mass index is associated with a significantly increased risk of mortality in COPDpatients. Therapeutic interventions are required to address this important modifiable risk factor in COPDpatients.
Authors: Benjamin R Szwejkowski; Stephen J Gandy; Sushma Rekhraj; John G Houston; Chim C Lang; Andrew D Morris; Jacob George; Allan D Struthers Journal: J Am Coll Cardiol Date: 2013-08-28 Impact factor: 24.094
Authors: R Graham Barr; David A Bluemke; Firas S Ahmed; J Jeffery Carr; Paul L Enright; Eric A Hoffman; Rui Jiang; Steven M Kawut; Richard A Kronmal; João A C Lima; Eyal Shahar; Lewis J Smith; Karol E Watson Journal: N Engl J Med Date: 2010-01-21 Impact factor: 91.245
Authors: David A McAllister; John D Maclay; Nicholas L Mills; Andrew Leitch; Philip Reid; Ross Carruthers; Jennifer O'Connor; Lawrence McAlpine; George Chalmers; David E Newby; Elaine Clark; Peter W Macfarlane; William Macnee Journal: Eur Respir J Date: 2012-02-09 Impact factor: 16.671
Authors: Sushma Rekhraj; Stephen J Gandy; Benjamin R Szwejkowski; M Adnan Nadir; Awsan Noman; J Graeme Houston; Chim C Lang; Jacob George; Allan D Struthers Journal: J Am Coll Cardiol Date: 2013-03-05 Impact factor: 24.094
Authors: Alison J Dicker; Megan L Crichton; Eleanor G Pumphrey; Andrew J Cassidy; Guillermo Suarez-Cuartin; Oriol Sibila; Elizabeth Furrie; Christopher J Fong; Wasyla Ibrahim; Gill Brady; Gisli G Einarsson; J Stuart Elborn; Stuart Schembri; Sara E Marshall; Colin N A Palmer; James D Chalmers Journal: J Allergy Clin Immunol Date: 2017-05-13 Impact factor: 10.793
Authors: Jonathan R Weir-McCall; Patrick Sk Liu-Shiu-Cheong; Allan D Struthers; Brian J Lipworth; J Graeme Houston Journal: Int J Chron Obstruct Pulmon Dis Date: 2018-05-28