Peter Alter1, Rudolf A Jörres2, Henrik Watz3, Tobias Welte4, Sven Gläser5, Holger Schulz6, Robert Bals7, Annika Karch8, Emiel F M Wouters9, Jørgen Vestbo10, David Young11, Claus F Vogelmeier12. 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. 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. 3. Pulmonary Research Institute at Lungen Clinic Grosshansdorf, Airway Research Centre North (ARCN), Member of the German Centre for Lung Research (DZL), Grosshansdorf, Germany. 4. Clinic for Pneumology, Hannover Medical School, Member of the German Centre for Lung Research (DZL), Hannover, Germany. 5. Department for Pneumology, University of Greifswald, Greifswald, Germany. 6. Helmholtz Centre Munich, Institute of Epidemiology, German Research Centre for Environmental Health, Comprehensive Pneumology Centre Munich (CPC-M), Member of the German Centre for Lung Research (DZL), Munich, Germany. 7. Department of Internal Medicine V - Pulmonology, Allergology, Intensive Care Medicine, Saarland University Hospital, Germany. 8. Institute for Biostatistics, Centre for Biometry, Medical Informatics and Medical Technology, Hannover Medical School, Hannover, Germany. 9. Department of Respiratory Medicine, Maastricht University Medical Centre, Maastricht, Netherlands. 10. Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK. 11. Young Medical Communications and Consulting Limited, Horsham, UK. 12. Department of Medicine, Pulmonary and Critical Care Medicine, Philipps University of Marburg, Member of the German Centre for Lung Research (DZL), Marburg, Germany.
Abstract
BACKGROUND: Cardiovascular comorbidities are common in chronic obstructive pulmonary disease (COPD). We examined the association between airflow limitation, hyperinflation and the left ventricle (LV). METHODS: Patients from the COPD cohort COSYCONET underwent evaluations including forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), effective airway resistance (Reff), intrathoracic gas volume (ITGV), and echocardiographic LV end-diastolic volume (LVEDV), stroke volume (LVSV), end-systolic volume (LVESV), and end-diastolic and end-systolic LV wall stress. Data from Visit 1 (baseline) and Visit 3 (18 months later) were used. In addition to comparisons of both visits, multivariate regression analysis was conducted, followed by structural equation modelling (SEM) with latent variables "Lung" and "Left heart". RESULTS: A total of 641 participants were included in this analysis. From Visit 1 to Visit 3, there were significant declines in FEV1 and FEV1/FVC, and increases in Reff, ITGV and LV end-diastolic wall stress, and a borderline significant decrease in LV mass. There were significant correlations of: FEV1% predicted with LVEDV and LVSV; Reff with LVSV; and ITGV with LV mass and LV end-diastolic wall stress. The SEM fitted the data of both visits well (comparative fit index: 0.978, 0.962), with strong correlation between "Lung" and "Left heart". CONCLUSIONS: We demonstrated a relationship between lung function impairment and LV wall stress in patients with COPD. This supports the hypothesis that LV impairment in COPD could be initiated or promoted, at least partly, by mechanical factors exerted by the lung disorder.
BACKGROUND: Cardiovascular comorbidities are common in chronic obstructive pulmonary disease (COPD). We examined the association between airflow limitation, hyperinflation and the left ventricle (LV). METHODS:Patients from the COPD cohort COSYCONET underwent evaluations including forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), effective airway resistance (Reff), intrathoracic gas volume (ITGV), and echocardiographic LV end-diastolic volume (LVEDV), stroke volume (LVSV), end-systolic volume (LVESV), and end-diastolic and end-systolic LV wall stress. Data from Visit 1 (baseline) and Visit 3 (18 months later) were used. In addition to comparisons of both visits, multivariate regression analysis was conducted, followed by structural equation modelling (SEM) with latent variables "Lung" and "Left heart". RESULTS: A total of 641 participants were included in this analysis. From Visit 1 to Visit 3, there were significant declines in FEV1 and FEV1/FVC, and increases in Reff, ITGV and LV end-diastolic wall stress, and a borderline significant decrease in LV mass. There were significant correlations of: FEV1% predicted with LVEDV and LVSV; Reff with LVSV; and ITGV with LV mass and LV end-diastolic wall stress. The SEM fitted the data of both visits well (comparative fit index: 0.978, 0.962), with strong correlation between "Lung" and "Left heart". CONCLUSIONS: We demonstrated a relationship between lung function impairment and LV wall stress in patients with COPD. This supports the hypothesis that LV impairment in COPD could be initiated or promoted, at least partly, by mechanical factors exerted by the lung disorder.
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: Leanne Mooney; Nathaniel M Hawkins; Pardeep S Jhund; Margaret M Redfield; Muthiah Vaduganathan; Akshay S Desai; Jean L Rouleau; Masatoshi Minamisawa; Amil M Shah; Martin P Lefkowitz; Michael R Zile; Dirk J Van Veldhuisen; Marc A Pfeffer; Inder S Anand; Aldo P Maggioni; Michele Senni; Brian L Claggett; Scott D Solomon; John J V McMurray Journal: J Am Heart Assoc Date: 2021-11-19 Impact factor: 6.106
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: Matthias Helmut Urban; Anna Katharina Mayr; Ingrid Schmidt; Eduard Margulies; Erwin Grasmuk-Siegl; Otto Chris Burghuber; Georg-Christian Funk Journal: Exp Physiol Date: 2020-11-23 Impact factor: 2.969