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Chronic obstructive pulmonary disease and sudden cardiac death: A systematic review
Marten E van den Berg1, Bruno H Stricker2, Guy G Brusselle3
1Department of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands.
Insights
Chronic obstructive pulmonary disease (COPD) significantly increases the risk of sudden cardiac death (SCD), independent of other cardiovascular factors. Further research is needed to understand the mechanisms behind this association.
Area of Science:
- Cardiology
- Pulmonology
- Public Health
Background:
- Chronic obstructive pulmonary disease (COPD) and sudden cardiac death (SCD) represent significant global health challenges.
- Existing research suggests a link between COPD and SCD, but a comprehensive overview is lacking.
Purpose of the Study:
- To systematically review and summarize the existing literature on the association between COPD and SCD.
- To provide an overview of studies investigating COPD's impact on cardiac events and mortality.
Main Methods:
- A comprehensive literature search was conducted on PubMed using MeSH headings and free-text keywords.
- Original human studies examining COPD and SCD, electrocardiographic markers for SCD, ventricular arrhythmias, or asystole were selected.
- 27 full-text articles were included after screening 251 initially identified records.
Main Results:
- COPD was linked to both prolonged and shortened QT intervals.
- In myocardial infarction patients, COPD increased ventricular arrhythmias and decreased survival.
- COPD emerged as an independent risk factor for SCD in both cardiovascular and community-based populations.
- Respiratory treatment effects on SCD occurrence yielded conflicting results.
Conclusions:
- Growing evidence indicates that COPD is associated with an elevated risk of SCD.
- Asystole and pulseless electrical activity may be more prevalent than ventricular tachycardia/fibrillation in COPD-related deaths.
- The underlying pathophysiological mechanisms connecting COPD and SCD warrant further investigation.
Abstract:
Both chronic obstructive pulmonary disease (COPD) and sudden cardiac death (SCD) are major health burdens. A number of studies have addressed their interrelationship, but currently no systematic review has been published. Our objective is to give an overview of the literature of the association between COPD and SCD. A search on PubMed with both MeSH headings and free-text keywords was performed. We selected all original articles of studies in humans that assessed COPD on the one hand and SCD, electrocardiographic markers for SCD, ventricular arrhythmias, or asystole on the other. The electronic search yielded 251 articles, from which 27 full publications were selected after careful evaluation of the full-text articles. In these studies, COPD was associated with a prolonged and shortened QT interval. In patients with a myocardial infarction (MI), COPD was associated with an increased risk of ventricular arrhythmias and decreased survival. COPD was a risk factor for SCD both in cardiovascular patient groups and in community-based studies, independent from cardiovascular risk profile. Studies of the potential impact of respiratory treatment on the occurrence of SCD showed conflicting results. In conclusion, cumulating evidence associates COPD with an increased risk of SCD. Asystole and pulseless electric activity could be more common than VT/VF in deaths associated with COPD. Underlying mechanisms explaining this association require further investigation.
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