Peter Alter1, Henrik Watz2, Kathrin Kahnert3, Michael Pfeifer4, Winfried J Randerath5, Stefan Andreas6, Benjamin Waschki7, Björn E Kleibrink8, Tobias Welte9, Robert Bals10, Holger Schulz11, Frank Biertz12, David Young13, Claus F Vogelmeier14, Rudolf A Jörres15. 1. Department of Medicine, Pulmonary and Critical Care Medicine, Philipps University of Marburg, Member of the German Centre for Lung Research (DZL), Marburg, Germany. Electronic address: Alter@uni-marburg.de. 2. Pulmonary Research Institute at LungClinic Grosshansdorf, Airway Research Centre North (ARCN), Member of the German Centre for Lung Research (DZL), Grosshansdorf, Germany. 3. Department of Internal Medicine V, University of Munich (LMU), Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany. 4. Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany; Department of Pneumology, Donaustauf Hospital, Donaustauf, Germany. 5. University of Cologne, Clinic for Pneumology and Allergology, Centre of Sleep Medicine and Respiratory Care, Bethanien Hospital, Solingen, Germany. 6. Department of Cardiology and Pneumology, University Medical Center, Goettingen, Germany; Lung Clinic, Immenhausen, Germany. 7. Department of Pneumology, LungenClinic Grosshansdorf, Airway Research Centre North (ARCN), Member of the German Centre for Lung Research (DZL), Grosshansdorf, Germany; Department of General and Interventional Cardiology, University Heart Center, Hamburg, Germany. 8. Department of Pneumology, Ruhrlandklinik, West German Lung Center, University Hospital Essen, University Duisburg, Essen, Germany. 9. Clinic for Pneumology, Hannover Medical School, Member of the German Centre for Lung Research (DZL), Hannover, Germany. 10. Department of Internal Medicine V - Pulmonology, Allergology, Intensive Care Medicine, Saarland University Hospital, Germany. 11. Helmholtz-Zentrum München, Institute of Epidemiology I, German Research Center for Environmental Health, Comprehensive Pneumology Centre Munich (CPC-M), Member of the German Centre for Lung Research (DZL), Munich, Germany. 12. Institute for Biostatistics, Centre for Biometry, Medical Informatics and Medical Technology, Hannover Medical School, Hannover, Germany. 13. Young Medical Communications and Consulting Limited, Horsham, UK. 14. Department of Medicine, Pulmonary and Critical Care Medicine, Philipps University of Marburg, Member of the German Centre for Lung Research (DZL), Marburg, Germany. 15. Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig Maximilians University, Comprehensive Pneumology Centre Munich (CPC-M), Member of the German Centre for Lung Research (DZL), Munich, Germany. Electronic address: Rudolf.Joerres@med.uni-muenchen.de.
Abstract
AIMS: Chronic obstructive pulmonary disease (COPD) and cardiovascular diseases are thought to be linked through various factors. We aimed to assess the relationship between airway obstruction, lung hyperinflation and diastolic filling in COPD. METHODS: The study population was a subset of the COPD cohort COSYCONET. Echocardiographic parameters included the left atrial diameter (LA), early (E) and late (A) transmitral flow, mitral annulus velocity (e'), E wave deceleration time (E[dt]), and isovolumic relaxation time (IVRT). We quantified the effect of various predictors including forced expiratory volume in 1 s (FEV1) and intrathoracic gas volume (ITGV) on the echocardiographic parameters by multiple linear regression and integrated the relationships into a path analysis model. RESULTS: A total of 615 COPD patients were included (mean FEV1 52.6% predicted). In addition to influences of age, BMI and blood pressure, ITGV was positively related to e'-septal and negatively to LA, FEV1 positively to E(dt) (p < 0.05 each). The effect of predictors was most pronounced for LA, e'-septal and E(dt), and less for E/A, IVRT and E/e'. Path analysis was used to take into account the additional relationships between the echocardiographic parameters themselves, demonstrating that their associations with the predictors were maintained and robust. CONCLUSIONS: Airway obstruction and lung hyperinflation were significantly associated with cardiac diastolic filling in patients with COPD, suggesting a decreased preload rather than an inherently impaired myocardial relaxation itself. This suggests that a reduction in obstruction and hyperinflation could help to improve cardiac filling.
AIMS: Chronic obstructive pulmonary disease (COPD) and cardiovascular diseases are thought to be linked through various factors. We aimed to assess the relationship between airway obstruction, lung hyperinflation and diastolic filling in COPD. METHODS: The study population was a subset of the COPD cohort COSYCONET. Echocardiographic parameters included the left atrial diameter (LA), early (E) and late (A) transmitral flow, mitral annulus velocity (e'), E wave deceleration time (E[dt]), and isovolumic relaxation time (IVRT). We quantified the effect of various predictors including forced expiratory volume in 1 s (FEV1) and intrathoracic gas volume (ITGV) on the echocardiographic parameters by multiple linear regression and integrated the relationships into a path analysis model. RESULTS: A total of 615 COPDpatients were included (mean FEV1 52.6% predicted). In addition to influences of age, BMI and blood pressure, ITGV was positively related to e'-septal and negatively to LA, FEV1 positively to E(dt) (p < 0.05 each). The effect of predictors was most pronounced for LA, e'-septal and E(dt), and less for E/A, IVRT and E/e'. Path analysis was used to take into account the additional relationships between the echocardiographic parameters themselves, demonstrating that their associations with the predictors were maintained and robust. CONCLUSIONS:Airway obstruction and lung hyperinflation were significantly associated with cardiac diastolic filling in patients with COPD, suggesting a decreased preload rather than an inherently impaired myocardial relaxation itself. This suggests that a reduction in obstruction and hyperinflation could help to improve cardiac filling.
Authors: Peter Alter; Jan Orszag; Christina Kellerer; Kathrin Kahnert; Tim Speicher; Henrik Watz; Robert Bals; Tobias Welte; Claus F Vogelmeier; Rudolf A Jörres Journal: ERJ Open Res Date: 2020-07-27
Authors: Peter Alter; Barbara A Mayerhofer; Kathrin Kahnert; Henrik Watz; Benjamin Waschki; Stefan Andreas; Frank Biertz; Robert Bals; Claus F Vogelmeier; Rudolf A Jörres Journal: Int J Chron Obstruct Pulmon Dis Date: 2019-09-20
Authors: Sarah Marietta von Siemens; Robert Perneczky; Claus F Vogelmeier; Jürgen Behr; Diego Kauffmann-Guerrero; Peter Alter; Franziska C Trudzinski; Robert Bals; Christian Grohé; Sandra Söhler; Benjamin Waschki; Johanna I Lutter; Tobias Welte; Rudolf A Jörres; Kathrin Kahnert Journal: Respir Res Date: 2019-11-14
Authors: Neele Jankrift; Christina Kellerer; Helgo Magnussen; Dennis Nowak; Rudolf A Jörres; Antonius Schneider Journal: J Thorac Dis Date: 2021-06 Impact factor: 2.895
Authors: Kathrin Kahnert; Peter Alter; Tobias Welte; Rudolf M Huber; Jürgen Behr; Frank Biertz; Henrik Watz; Robert Bals; Claus F Vogelmeier; Rudolf A Jörres Journal: Respir Res Date: 2018-06-04
Authors: Frits Me Franssen; Peter Alter; Nadav Bar; Birke J Benedikter; Stella Iurato; Dieter Maier; Michael Maxheim; Fabienne K Roessler; Martijn A Spruit; Claus F Vogelmeier; Emiel Fm Wouters; Bernd Schmeck Journal: Int J Chron Obstruct Pulmon Dis Date: 2019-07-09
Authors: K Kahnert; M Föhrenbach; T Lucke; P Alter; F T Trudzinski; R Bals; J I Lutter; H Timmermann; S Söhler; S Förderreuther; D Nowak; H Watz; B Waschki; J Behr; T Welte; C F Vogelmeier; R A Jörres Journal: Respir Res Date: 2020-01-20
Authors: Stefan Andreas; Ulrich Bothner; Alberto de la Hoz; Isabel Kloer; Matthias Trampisch; Peter Alter Journal: Int J Chron Obstruct Pulmon Dis Date: 2020-08-10