心房颤动的肺活量测定:有什么问题?

Expert review of respiratory medicine Pub Date : 2023-07-01 Epub Date: 2023-11-24 DOI:10.1080/17476348.2023.2279236
Anne E Ioannides, Upasana Tayal, Jennifer K Quint
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摘要

引言:COPD患者很少单独患有COPD,与COPD发生的最常见的合并症是心血管疾病。虽然多项研究探讨了主要心血管事件与COPD之间的关系,但对心律失常,特别是心房颤动(AF)的关注较少。房颤和慢性阻塞性肺病经常同时发生,这给诊断和管理带来了挑战。在这篇综述中,我们从流行病学和生理学角度描述了房颤与COPD之间的关系,证明了肺活量测定作为诊断和疾病管理工具的作用。涵盖的领域:我们提供了流行病学证据,证明COPD和AF是彼此独立的风险因素,其中一种疾病在人群中高度流行,并且它们有共同的风险因素;所有这些都会导致不良预后。我们阐明了AF-COPD的常见病理生理机制。我们最终提出流行病学和生理学证据,以强调我们认为肺活量测定在AF-COPD管理中有价值的特定领域。专家意见:AF和COPD通常同时发生,通常存在诊断延迟,心脏复律成功率降低的风险增加,并错过了干预以降低中风风险的机会。提高认识、及时诊断和指导方针指导的管理可能会改善这两种疾病患者的预后。
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Spirometry in atrial fibrillation: what's the catch?

Introduction: People with COPD rarely have COPD alone, and the commonest co-morbidities occurring with COPD are cardiovascular. Whilst multiple studies have explored the association between major cardiovascular events and COPD, less attention has been paid to arrhythmias, specifically atrial fibrillation (AF). AF and COPD frequently occur together, posing challenges in diagnosis and management. In this review, we describe the relationship between AF and COPD epidemiologically and physiologically, demonstrating the role of spirometry as a diagnostic and disease management tool.

Areas covered: We provide epidemiological evidence that COPD and AF are independent risk factors for one another, that either disease is highly prevalent amongst people with the other, and that they have shared risk factors; all of which contribute to adverse prognostic. We elucidated common pathophysiological mechanisms implicated in AF-COPD. We ultimately present the epidemiological and physiological evidence with a view to highlight specific areas where we feel spirometry is of value in the management of AF-COPD.

Expert opinion: AF and COPD commonly co-occur, there is often diagnostic delay, increased risk of reduced cardioversion success, and missed opportunity to intervene to reduce stroke risk. Greater awareness and timelier diagnosis and guideline directed management may improve outcomes for people with both diseases.

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