{"title":"慢性阻塞性肺病患者的左心室同心重塑:横断面观察研究","authors":"Naiara Tais Leonardi , Camila da Silva Rocha Tomaz , Erika Zavaglia Kabbach , Alessandro Domingues Heubel , Nathany Souza Schafauser , Débora Mayumi de Oliveira Kawakami , Audrey Borghi-Silva , Meliza Goi Roscani , Viviane Castello-Simões , Renata Gonçalves Mendes","doi":"10.1016/j.medcle.2024.01.017","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the association between left ventricular structure and disease severity in COPD patients.</p></div><div><h3>Methods</h3><p>Twenty-eight COPD patients were stratified according to the disease severity, using the BODE index, into L<sub>ower</sub> (<em>n</em> <!-->=<!--> <!-->17) and H<sub>igher</sub> (<em>n</em> <!-->=<!--> <!-->11) groups, composed of patients with lower severity (BODE <5) and higher severity (BODE ≥5), respectively. Left ventricle (LV) was assessed by 2D-echocardiography. BODE index was calculated using body mass index (BMI); forced expiratory volume in the first second (FEV<sub>1</sub>, %); modified Medical Research Council (mMRC) and distance walked during 6-minute walk test (6MWD).</p></div><div><h3>Results</h3><p>Patients in the H<sub>igher</sub> group showed lower oxygen arterial saturation (<em>p</em> <!-->=<!--> <!-->0.02), FEV<sub>1</sub> (<em>p</em> <!--><<!--> <!-->0.01) and 6MWD (<em>p</em> <!-->=<!--> <!-->0.02) and higher value of relative posterior wall thickness (RWT) compared to L<sub>ower</sub> group (<em>p</em> <!-->=<!--> <!-->0.02). There were significant associations between LV end-systolic diameter (LVESD) and BODE index (<em>r</em> <!-->=<!--> <!-->−0.38, <em>p</em> <!-->=<!--> <!-->0.04), LV end-diastolic diameter (LVEDD) and FEV<sub>1</sub> (<em>r</em> <!-->=<!--> <!-->0.44, <em>p</em> <!-->=<!--> <!-->0.02), LVEDD and BMI (<em>r</em> <!-->=<!--> <!-->0.45, <em>p</em> <!-->=<!--> <!-->0.02), LVESD and BMI (<em>r</em> <!-->=<!--> <!-->0.54, <em>p</em> <!-->=<!--> <!-->0.003) and interventricular septal thickness and 6MWD (<em>r</em> <!-->=<!--> <!-->−0.39, <em>p</em> <!-->=<!--> <!-->0.04).</p></div><div><h3>Conclusions</h3><p>More severe COPD patients, BODE score ≥5, may have higher RWT, featuring a possible higher concentric remodeling of LV in this group. Besides that, a greater disease severity may be related to LV chamber size reduction.</p></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Left ventricular concentric remodeling in COPD patients: A cross-sectional observational study\",\"authors\":\"Naiara Tais Leonardi , Camila da Silva Rocha Tomaz , Erika Zavaglia Kabbach , Alessandro Domingues Heubel , Nathany Souza Schafauser , Débora Mayumi de Oliveira Kawakami , Audrey Borghi-Silva , Meliza Goi Roscani , Viviane Castello-Simões , Renata Gonçalves Mendes\",\"doi\":\"10.1016/j.medcle.2024.01.017\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>To investigate the association between left ventricular structure and disease severity in COPD patients.</p></div><div><h3>Methods</h3><p>Twenty-eight COPD patients were stratified according to the disease severity, using the BODE index, into L<sub>ower</sub> (<em>n</em> <!-->=<!--> <!-->17) and H<sub>igher</sub> (<em>n</em> <!-->=<!--> <!-->11) groups, composed of patients with lower severity (BODE <5) and higher severity (BODE ≥5), respectively. Left ventricle (LV) was assessed by 2D-echocardiography. BODE index was calculated using body mass index (BMI); forced expiratory volume in the first second (FEV<sub>1</sub>, %); modified Medical Research Council (mMRC) and distance walked during 6-minute walk test (6MWD).</p></div><div><h3>Results</h3><p>Patients in the H<sub>igher</sub> group showed lower oxygen arterial saturation (<em>p</em> <!-->=<!--> <!-->0.02), FEV<sub>1</sub> (<em>p</em> <!--><<!--> <!-->0.01) and 6MWD (<em>p</em> <!-->=<!--> <!-->0.02) and higher value of relative posterior wall thickness (RWT) compared to L<sub>ower</sub> group (<em>p</em> <!-->=<!--> <!-->0.02). There were significant associations between LV end-systolic diameter (LVESD) and BODE index (<em>r</em> <!-->=<!--> <!-->−0.38, <em>p</em> <!-->=<!--> <!-->0.04), LV end-diastolic diameter (LVEDD) and FEV<sub>1</sub> (<em>r</em> <!-->=<!--> <!-->0.44, <em>p</em> <!-->=<!--> <!-->0.02), LVEDD and BMI (<em>r</em> <!-->=<!--> <!-->0.45, <em>p</em> <!-->=<!--> <!-->0.02), LVESD and BMI (<em>r</em> <!-->=<!--> <!-->0.54, <em>p</em> <!-->=<!--> <!-->0.003) and interventricular septal thickness and 6MWD (<em>r</em> <!-->=<!--> <!-->−0.39, <em>p</em> <!-->=<!--> <!-->0.04).</p></div><div><h3>Conclusions</h3><p>More severe COPD patients, BODE score ≥5, may have higher RWT, featuring a possible higher concentric remodeling of LV in this group. Besides that, a greater disease severity may be related to LV chamber size reduction.</p></div>\",\"PeriodicalId\":74154,\"journal\":{\"name\":\"Medicina clinica (English ed.)\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-07-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Medicina clinica (English ed.)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2387020624002614\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medicina clinica (English ed.)","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2387020624002614","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Left ventricular concentric remodeling in COPD patients: A cross-sectional observational study
Objective
To investigate the association between left ventricular structure and disease severity in COPD patients.
Methods
Twenty-eight COPD patients were stratified according to the disease severity, using the BODE index, into Lower (n = 17) and Higher (n = 11) groups, composed of patients with lower severity (BODE <5) and higher severity (BODE ≥5), respectively. Left ventricle (LV) was assessed by 2D-echocardiography. BODE index was calculated using body mass index (BMI); forced expiratory volume in the first second (FEV1, %); modified Medical Research Council (mMRC) and distance walked during 6-minute walk test (6MWD).
Results
Patients in the Higher group showed lower oxygen arterial saturation (p = 0.02), FEV1 (p < 0.01) and 6MWD (p = 0.02) and higher value of relative posterior wall thickness (RWT) compared to Lower group (p = 0.02). There were significant associations between LV end-systolic diameter (LVESD) and BODE index (r = −0.38, p = 0.04), LV end-diastolic diameter (LVEDD) and FEV1 (r = 0.44, p = 0.02), LVEDD and BMI (r = 0.45, p = 0.02), LVESD and BMI (r = 0.54, p = 0.003) and interventricular septal thickness and 6MWD (r = −0.39, p = 0.04).
Conclusions
More severe COPD patients, BODE score ≥5, may have higher RWT, featuring a possible higher concentric remodeling of LV in this group. Besides that, a greater disease severity may be related to LV chamber size reduction.