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Impact of Left Ventricular Hypertrophy on Survival in Chronic Obstructive Pulmonary Disease
Philip M Short1, William J Anderson, Douglas H J Elder
1Scottish Centre for Respiratory Research, Cardiovascular & Diabetes Medicine, Medical Research Institute, Ninewells Hospital, University of Dundee, Dundee, DD1 9SY, Scotland, UK.
Insights
Left ventricular hypertrophy (LVH) increases mortality risk in COPD patients. Elevated left ventricular mass index (LVMI) is linked to higher mortality, highlighting LVH as a critical factor in COPD outcomes.
Area of Science:
- Cardiology
- Pulmonology
- Medical Research
Background:
- Left ventricular hypertrophy (LVH) is a known cardiac risk factor associated with increased mortality.
- The specific impact of LVH on mortality within the chronic obstructive pulmonary disease (COPD) population remains under investigation.
Purpose of the Study:
- To evaluate the association between left ventricular hypertrophy (LVH) and mortality in patients diagnosed with chronic obstructive pulmonary disease (COPD).
- To assess the impact of left ventricular dimensions, measured via echocardiography, on mortality risk in COPD patients.
Main Methods:
- A retrospective cohort study analyzed data from 617 COPD patients (2001-2010) using NHS databases, including echocardiograms and death registry records.
- Cox proportional hazard regression models were employed to determine mortality risk based on left ventricular mass index (LVMI) and left ventricular internal diastolic diameter (LVIDd), adjusting for covariates.
- LVH was defined by LVMI thresholds (female: >95 g/m², male: >115 g/m²), and increased LVIDd was defined by sex-specific diameter cutoffs.
Main Results:
- Increased left ventricular internal diastolic diameter (LVIDd) did not show a significant association with increased mortality (p = 0.381).
- Elevated left ventricular mass index (LVMI), indicative of LVH, was significantly associated with an increased risk of mortality (p = 0.02).
- The adjusted Hazard Ratio (HR) for mortality in patients with elevated LVMI was 1.542 (95% CI: 1.068–2.228), indicating a 54.2% increased risk.
Conclusions:
- The presence of left ventricular hypertrophy (LVH), as indicated by an elevated left ventricular mass index (LVMI), is a significant predictor of increased mortality in patients with COPD.
- Addressing LVH through therapeutic interventions is crucial for managing this modifiable risk factor and improving outcomes in the COPD population.
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.
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