Ventricular rhythm disturbances during computer spirography in patients with stable ischemic heart disease and chronic obstructive pulmonary disease: clinical and functional predictors of occurrence

Authors

  • Yu. M. Mostovoi National Pirogov Memorial Medical University, Vinnytsia, Ukraine,
  • L. V. Rasputina National Pirogov Memorial Medical University, Vinnytsia, Ukraine,
  • D. V. Didenko National Pirogov Memorial Medical University, Vinnytsia, Ukraine,
  • A. O. Dovhan National Pirogov Memorial Medical University, Vinnytsia, Ukraine,

DOI:

https://doi.org/10.14739/2310-1210.2019.3.169008

Keywords:

myocardial ischemia, chronic obstructive pulmonary disease, spirography, diagnosis

Abstract

 

The purpose of the study is to determine the predictors of cardiac rhythm disturbance during spirography in patients with a combination of stable coronary heart disease and chronic obstructive pulmonary disease.

Materials and methods. The study included 53 patients with a combination of stable ischemic heart disease and chronic obstructive pulmonary disease, 53 patients with stable ischemic heart disease without concomitant chronic obstructive pulmonary disease, and 42 patients with chronic obstructive pulmonary disease without ischemic heart disease. Cardiac rhythm disturbances during spirography were examined by synchronous determination of the external respiration function and 24-hour Holter ECG monitoring, predictors of high grade ventricular extrasystoles appearance in patients with combined pathology were calculated.

Results. It has been established that 20.7 % of patients with a combination of stable ischemic heart disease and chronic obstructive pulmonary disease have high grade ventricular extrasystoles (P = 0.008) during spirography, whereas among patients with isolated ischemic heart disease – 9.4 %, among people with chronic obstructive pulmonary disease – 7.1 %. The chances of high grade ventricular extrasystoles occurring during spirography are 5.7 times more in patients with a combined course of stable ischemic heart disease and chronic obstructive pulmonary disease in case of the left atrial size of more than42.9 mm, 3.93 times in case of end-systolic volume of the left ventricle of more than 76.1 ml, 6.7 times if the left ventricular ejection fraction of less than 49.1 %, 43.3 times if the patient has more than 1319 ventricular extrasystoles during the day, 2.37 times in the presence of more than 12.3 ventricular bigeminy per day; if the maximum heart rate is increased during the active period or over one day more than 95.5 beats/min and 106.9 beats/min, chances are 2.77 and 3.23 times increased, respectively.

Conclusions. Patients with a combination of stable ischemic heart disease and chronic obstructive pulmonary disease differ from those with an isolated course of pathologies in the incidence of ventricular rhythm disorders during spirography. To assess the risk of developing high grade ventricular extrasystoles for patients with combined pathology, additional examinations should be performed before spirography, namely 24-hour Holter ECG monitoring and echocardiography.

 

References

Dorohoi, A. P., Manoilenko, T. S., Revenko, I. L., & Dorokhina, H. M. (2017) Problemy zhdorovia i tryvalosti zhyttia v suchasnykh umovakh [The problem of health and life expectancy in modern conditions]. Kyiv. [in Ukrainian].

Nakaz MOZ Ukrainy «Pro zatverdzhennia ta vprovadzhennia medyko-tekhnolohichnykh dokumentiv zi standartyzatsii medychnoi dopomohy pry stabilnii ishemichnii khvorobi sertsia» №152 vid 02.03.2016 r. [Order of Ministry of Health of Ukraine «Approval and implementation medical-technological documents on the standardization of medical care in stable ischemic heart disease» №152 March, 2, 2016]. Retrieved fromhttp://moz.gov.ua/ua/portal/dn_20160302_0152.html. [in Ukrainian].

Sanchis-Gomar, F., Perez-Quilis, C., Leischik, R., & Lucia, A. (2016). Epidemiology of coronary heart disease and acute coronary syndrome. AnnTranslMed, 4(13), 256–263. doi: 10.21037/atm.2016.06.33

Tuleta, I., Farrag, T., Busse, L., Pizarro, C., Schaefer, C., Pingel, S., et al. (2017). High prevalence of COPD inatherosclerosis patients. IntJChronObstructPulmonDis., 12, 3047–3053. doi: 10.2147/COPD.S141988

Mooe, T., & Stenfors, N. (2014). The prevalence of COPD in individuals with acute coronary syndrome: A spirometry-based screening study. COPD, 12(4), 453–61. doi: 10.3109/15412555.2014.974742

Andell, P., Koul, S., Martinsson, A., Sundström, J., Jernberg, T., Smith, J., et al. (2014). Impact of chronic obstructive pulmonary disease on morbidity and mortality after myocardial infarction. Open Heart, 1(1), e000002. doi: 10.1136/openhrt-2013-000002

Lahousse, L., Niemeijer, M. N., van den Berg, M. E., Rijnbeek, P. R., Joos, G. F., Hofman, A., et al. (2014). Chronic obstructive pulmonary disease and sudden cardiac death: the Rotterdam study. Open Heart, 36(27), 1754–61. doi: 10.1093/eurheartj/ehv121

Zhang, M., Cheng, Y. J., Zheng, W. P., Liu, G. H., Chen, H. S., Ning, Y., et al. (2016). Impact of chronic obstructive pulmonary disease on long-term outcome in patients with coronary artery disease undergoing percutaneous coronary intervention. Biomed Res Int., 2016, 8212459. doi: 10.1155/2016/8212459

Nakaz MOZ Ukrainy «Pro zatverdzhennia ta vprovadzhennia medyko-tekhnolohichnykh dokumentiv zi standartyzatsii medychnoi dopomohy pry khronichnomu obstruktyvnomu zakhvoriuvanni lehen» №555 vid 27.06.2013 [Order of Ministry of Health of Ukraine «Approval and implementation medical-technological documents on the standardization of medical care in chronic obstructive pulmonary disease» №555 from June 27, 2013]. Retrieved from http://moz.gov.ua/ua/portal/dn_20130627_0555.html. [in Ukrainian].

Global Initiative for Chronic Obstructive Lung Disease (Updated 2017). Retrieved from www.goldcopd.com.

García-Río, F., Calle, M., Burgos, F., Casan, P., Del Campo, F., Galdiz, J. B., et al. (2013). Recommendations of SEPAR Spirometry. Arch Bronconeumol., 49(9), 388–401.

Bokov P., & Delclaux C. (2016) Interpretation and use of routine pulmonary function tests: Spirometry, static lung volumes, lung diffusion, arterial blood gas, methacholine challenge test and 6-minute walk test. Rev Med Interne, 37(2), 100–110. doi: 10.1016/j.revmed.2015.10.356

Edgell, Н., Moore, L. E., Chung, C., Byers, B. W., & Stickland, M. K. (2016). Short-term cardiovascular and autonomic effects of inhaled salbutamol. Respir Physiol Neurobiol., 231, 14–20. doi: 10.1016/j.resp.2016.05.014

Celujko, V. I., & Radchenko, O. V. (2016). Holterovskoe monitorirovanie v diagnostike narushenij ritma i provodimosti serdca [Holter monitoring in the diagnosis of disturbances of rhythm and conduction of the heart]. Liky Ukrainy, 5–6(201–202), 21–34. [in Russian].

Wills, B. K., Kwan, C., Bailey, M., Johnson, L., & Allan, N. (2015) Recalcitrant supraventricular tachycardia: occult albuterol toxicity due to a factitious disorder. J Emerg Med., 49(4), 436–8. doi: 10.1016/j.jemermed.2015.05.007

De Jong, E., van Dijk, W. D., Heijdra, Y., Lenders, J. W., van Weel, C., Akkermans, R., et al. Short-acting anticholinergic bronchodilation does not increase cardiovascular events in smokers with mild to moderate pulmonary obstruction. Respirology, 18(4), 663–668. doi: 10.1111/resp.12040

Ali-Saleh, M., Sarig, G., Ablin, J. N., Brenner, B., & Jacob, G. (2016) Inhalation of a short-acting β2-adrenoreceptor agonist induces a hypercoagulable state in healthy subjects. PLoS One, 11(7), e0158652. doi: 10.1371/journal.pone.0158652

How to Cite

1.
Mostovoi YM, Rasputina LV, Didenko DV, Dovhan AO. Ventricular rhythm disturbances during computer spirography in patients with stable ischemic heart disease and chronic obstructive pulmonary disease: clinical and functional predictors of occurrence. Zaporozhye Medical Journal [Internet]. 2019May31 [cited 2024Nov.23];(3). Available from: http://zmj.zsmu.edu.ua/article/view/169008

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Section

Original research