ARE THE EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE A RISK FACTOR FOR CARDIAC ARRHYTHMIA? Kronik Obstrüktif Akciğer Hastalığı Alevlenmeleri Kardiyak Aritmi İçin Risk Faktörü müdür?

Year 2024, Volume: 14 Issue: 2, 97 - 103, 14.06.2024

Murtaza Kaya , Harun Yıldırım , Abdil Çoşkun , Hasan Aydın , Esref Genc , Emine Kadıoğlu , Ali Halıcı

Abstract

Objective: Hypoxemia, hypercapnia, and increased automaticity during exacerbations contribute to abnormal
atrial and ventricular repolarization in chronic obstructive pulmonary disease (COPD), raising the risk
of arrhythmias. This study aimed to predict the likelihood of arrhythmias by analyzing electrocardiograms
(ECGs) of patients experiencing COPD attacks.
Material and Methods: A total of 120 patients (66 in the COPD group and 54 in the control group) were
included. Statistical analysis compared QT and QTc interval maximum (max), minimum (min), and dispersion
(disp); T-wave peak to end (Tp-e) max, min, and disp; Tp-e max/QT max, Tp-e max/QTc max ratios; and P
wave max, min, and disp durations among patients.
Results: Of the males in the study, 48 (64%) were in the COPD group and 27 (36%) in the control group, while
18 (40%) of the females were in the COPD group and 27 (60%) in the control group. There were no significant
differences in patient ages or levels of sodium and potassium (p = 0.189, 0.353, and 0.071). Significant
differences were found in QT max and min between groups, while QT disp showed no significant difference
(p < 0.001, p < 0.001, and p = 0.490). Tp-e max, min, and disp values differed significantly between the COPD
and control groups (p = 0.041, p < 0.001, and p = 0.001, respectively). No significant difference was observed
between groups in terms of P max duration (p = 0.442), but significant differences were found in P min and
disp durations (p = 0.003 and p < 0.001, respectively). Receiver operating characteristic analysis identified 30
ms as the cutoff for both P disp and Tp-e disp values, showing a significant difference.
Conclusion: This study is the first to detect increased dispersions of P wave and Tp-e intervals (without an
increase in QTc disp.) during the evaluation of atrial and ventricular arrhythmia risks during COPD acute
attacks.

Keywords

ARE THE EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE A RISK FACTOR FOR CARDIAC ARRHYTHMIA?, Kronik Obstrüktif Akciğer Hastalığı Alevlenmeleri Kardiyak Aritmi İçin Risk Faktörü müdür?, ARE THE EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE A RISK FACTOR FOR CARDIAC ARRHYTHMIA? Kronik Obstrüktif Akciğer Hastalığı Alevlenmeleri Kardiyak Aritmi İçin Risk Faktörü müdür?

References

• 1. Adeloye D, Chua S, Lee C, Basquill C, Papana A, Theodoratou E et al. Global Health Epidemiology Reference Group (GHERG). Global and regional estimates of COPD prevalence: Systematic review and meta-analysis. J Glob Health. 2015 ;5(2):020415
• 2. Sievi NA, Clarenbach CF, Camen G, Rossi VA, van Gestel AJ, Kohler M. High prevalence of altered cardiac repolarization in patients with COPD. BMC Pulm Med. 2014 ;2:14:55.
• 3. Straus SM, Kors JA, De Bruin ML, van der Hooft CS, Hofman A, Heeringa J, et al. Prolonged QTc interval and risk of sudden cardiac death in a population of older adults. J Am Coll Cardiol. 2006;47(2):362-7
• 4. Larssen MS, Steine K, Hilde JM, Skjørten I, Hodnesdal C, Liestøl K, et al. Mechanisms of ECG signs in chronic obstructive pulmonary disease. Open Heart. 2017;4(1):e000552
• 5. Fuso L, Incalzi RA, Pistelli R, Muzzolon R, Valente S, Pagliari G, et al. Predicting mortality of patients hospitalized for acutely exacerbated chronic obstructive pulmonary disease. Am J Med. 1995;98(3):272-7
• 6. Hudson LD, Kurt TL, Petty TL. Genton E. Arrhythmias associated with acute respiratory failure in patients with chronic airway obstruction. Chest. 1973;63(5):661-5
• 7. Sarubbi B, Esposito V, Ducceschi V, Meoli I, Grella E, Santangelo L, et al. Effect of blood gas derangement on QTc dispersion in severe chronic obstructive pulmonary disease: evidence of an electropathy?. Int J Cardiol. 1997;58(3):287-92
• 8. Kiely DG, Cargill RI, Lipworth BJ. Effects of hypercapnia on hemodynamic, inotropic, lusitropic, and electrophysiologic indices in humans. Chest. 1996;109(5):1215-21.
• 9. Goudis CA, Konstantinidis AK, Ntalas IV, Korantzopoulos P. Electrocardiographic abnormalities and cardiac arrhythmias in chronic obstructive pulmonary disease. Int J Cardiol. 2015;199:264-73
• 10. Rosenthal TM, Masvidal D, Abi Samra FM, Bernard ML, Khatib S, Polin GM, et al. Optimal method of measuring the T-peak to T-end interval for risk stratification in primary prevention. Europace. 2018;20(4):698-705