Acta Scientific Microbiology (ASMI) (ISSN: 2581-3226)

Research Article Volume 3 Issue 4

Evolution of ECG Abnormalities in Immune Dysfunction Exacerbation Patients with Chronic Obstructive Pulmonary Disease

Khan Salman1*, Singh Priti2 and Salieva Rana3*

1Associate Professor, Department of Pathological Analysis, Knowledge University , Erbil, Iraq
2International medical faculty, Osh State University, Osh, Kyrgyzstan
3Lecturer, Department of pulmonary, Osh State University, Osh, Kyrgyzstan

*Corresponding Author: Khan Salman, Associate Professor, Medical Microbiology and Immunology, Department of Pathological Analysis, Knowledge University, Erbil, Iraq.

Received: March 23, 2020; Published: March 31, 2020

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Abstract

Objective: Chronic obstructive pulmonary disease (COPD) is a major cause of death worldwide. Early identification of the complications, particularly, atherosclerosis, pulmonary hypertension and right ventricular dysfunction can prevent or delay long-term complications. The aim of the present study was to evaluate the prevalence of ECG abnormalities in COPD patients with exacerbation and COPD phenotypes.

Methods: The study population consisted of 364 COPD patients aged 21 to 85 years of either sex. This study was carried out in the department of pulmonology, Osh Interregional United Clinical Hospital, Osh, Kyrgyzstan. Between December 2016 to February 2020. The patients who are diagnosed as having COPD as per GOLD guidelines. ECG was performed with the help of Department of Cardiology.

Results: Highest cases of COPD were found in the age group of 51-65. According to physical examination, spirometry and x-ray out of 364 COPD patients, blue bloaters (BB) 257 (70.60%), Pink puffers (PP) 41 (11.26%) and Mixed 66 (18.31%) were found. Highest BB and mixed were found in 51-65 age group, PP in > 65 age group. Out of 218 male COPD patients, BB 149 (66.97%), PP 26 (11.93%) and Mixed 43 (19.72%) were found. Out of 146 female COPD patients, BB 108 (73.97%), PP 15 (10.27%) and Mixed 23 (15.75%) were found.
Out of 364 patients P wave was abnormal in 128 (35.16%). Tachycardia was observed in 113 (31.04%), Bradycardia 9 (2.47%) and 247 (66.86%) were with normal heart rate. Right heart axis deviation was found in 77 (21.15%), left 39 (10.17%), vertical 1 (0.27%) and 247 (66.86%) found normal. Vertical heart positioned patients found 87 (23.90%), horizontal 38 (10.44%) and 239 (65.66%) found normal. Low voltage was observed in 20 (5.49%). Incomplete right bundle branch block found in 64 (17.58%) and complete right bundle branch block found in 02 (0.55%). ST changes observed in 146 (40.11%). Tall RV1 was seen in 42 (11.54%) and Deep SV6 was observed in 169 (46.43%).

Conclusion: Comparative prevalence was higher in males and 51 - 65 age group at high risk in both sex. Highest BB and mixed found in 51 - 65 age group, PP in > 65 age group. Phenotype BB was more prevalent.ECG abnormalities P-pulmonale, Tachycardia, Right heart axis deviation, Vertical heart position, IRBBB, ST changes Tall RV1 and SV6 was most prevalent. Early diagnosis and management can prevent disease progression of atherosclerosis and hypertension.

Keywords: COPD; Electrocardiography; Blue Bloaters; Pink Puffers; Hypertension; Atherosclerosis

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References

  1. American Thoracic Society. “Chronic bronchitis, asthma and pulmonary emphysema Definitions and classification”. American Review of Respiratory Disease 85 (1962): 762-768.
  2. American Thoracic Society. “Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease” (1995): 78-79.
  3. World Health Organization. “Global Surveillance, Prevention and Control of Chronic Respiratory Diseases: A Comprehensive Approach”. Geneva, Switzerland: World Health Organization (2007).
  4. Murray CJ., et al. “The Global Burden of Disease 2000 project: aims, methods and data sources” (2001).
  5. Devine JF. “Chronic obstructive pulmonary disease: an overview”. American Health and Drug Benefits 1 (2008): 34-42.
  6. Global Initiative for Chronic Obstructive Lung Disease. “Global Strategy for Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease” (2020).
  7. Postma DS., et al. “Asthma and chronic obstructive pulmonary disease: common genes, common environments?” American Journal of Respiratory and Critical Care Medicine 183 (2011): 1588-1594.
  8. Thorley AJ and Tetley TD. “Pulmonary epithelium, cigarette smoke, and chronic obstructive pulmonary disease”. International Journal of Chronic Obstructive Pulmonary Disease 2 (2007): 409-428.
  9. Brusselle GG., et al. “New insights into the immunology of chronic obstructive pulmonary disease”. Lancet 378 (2011): 1015-1026.
  10. Lee J., et al. “Cigarette smoking and inflammation: cellular and molecular mechanisms”. Journal of Dental Research 91 (2012): 142-149.
  11. Rovina N., et al. “Inflammation and immune response in COPD: where do we stand?” Mediators of Inflammation (2013): 413735.
  12. Barnes PJ. “Cellular and molecular mechanisms of chronic obstructive pulmonary disease”. Clinics in Chest Medicine 35 (2014): 71-86.
  13. Karimi K., et al. “Toll-like receptor-4 mediates cigarette smoke-induced cytokine production by human macrophages”. Respiratory Research7 (2006): 66.
  14. Moodie FM., et al. “Oxidative stress and cigarette smoke alter chromatin remodeling but differentially regulate NF-kappaB activation and proinflammatory cytokine release in alveolar epithelial cells”. The FASEB Journal 15 (2004): 1897-1899.
  15. Silva MT. “Neutrophils and macrophages work in concert as inducers and effectors of adaptive immunity against extracellular and intracellular microbial pathogens”. Journal of Leukocyte Biology 87 (2010): 805-813.
  16. Silva MT. “Macrophage phagocytosis of neutrophils at inflammatory/ infectious foci: a cooperative mechanism in the control of infection and infectious inflammation”. Journal of Leukocyte Biology 89 (2011): 675-683.
  17. Kirkham PA., et al. “Macrophage phagocytosis of apoptotic neutrophils is compromised by matrix proteins modified by cigarette smoke and lipid peroxidation products”. Biochemical and Biophysical Research Communications 318 (2004): 32-37.
  18. Xu Y., et al. “Cigarette smoke (CS) and nicotine delay neutrophil spontaneous death via suppressing production of diphosphoinositol pentakisphosphate”. Proceedings of the National Academy of Sciences of the United States of America 110 (2013): 7726-7731.
  19. Kirkham PA., et al. “Oxidative stress-induced antibodies to carbonyl-modified protein correlate with severity of chronic obstructive pulmonary disease”. American Journal of Respiratory and Critical Care Medicine 7 (2011): 796- 802.
  20. Ichinose M., et al. “Increase in reactive nitrogen species production in chronic obstructive pulmonary disease airways”. American Journal of Respiratory and Critical Care Medicine 2-1 (2000): 701-706.
  21. Paredi P., et al. “Exhaled ethane, a marker of lipid peroxidation, is elevated in chronic obstructive pulmonary disease”. American Journal of Respiratory and Critical Care Medicine 2-1 (2000): 369-373.
  22. Lim S., et al. “Relationship between exhaled nitric oxide and mucosal eosinophilic inflammation in mild to moderately severe asthma”. Thorax3 (2000): 184-188.
  23. Maziak W., et al. “Exhaled nitric oxide in chronic obstructive pulmonary disease”. American Journal of Respiratory and Critical Care Medicine 3.1 (1998): 998- 1002.
  24. Sapey E and Stockley RA. “COPD exacerbations. 2: aetiology”. Thorax3 (2006): 250-258.
  25. Ricciardolo FL., et al. “Nitrosative stress in the bronchial mucosa of severe chronic obstructive pulmonary disease”. The Journal of Allergy and Clinical Immunology 5 (2005): 1028-1035.
  26. Yoshida T and Tuder RM. “Pathobiology of cigarette smoke induced chronic obstructive pulmonary disease”. Physiological Reviews 3 (2007): 1047-1082.
  27. Capettini LS., et al. “Decreased production of neuronal NOS-derived hydrogen peroxide contributes to endothelial dysfunction in atherosclerosis”. British Journal of Pharmacology 164 (2011): 1738-1748.
  28. Silva GC., et al. “Endothelial dysfunction in DOCA-salt-hypertensive mice: role of neuronal nitric oxide synthase-derived hydrogen peroxide”. Clinical Science 130 (2016): 895-906.
  29. Brusselle GG., et al. “New insights into the immunology of chronic obstructive pulmonary disease”. Lancet9795 (2011): 1015-1026.
  30. Bonarius HP., et al. “Antinuclear autoantibodies are more prevalent in COPD in association with low body mass index but not with smoking history”. Thorax2 (2011): 101-107.
  31. Lee SH., et al. “Antielastin autoimmunity in tobacco smoking induced emphysema”. Nature Medicine 5 (2007): 567-569.
  32. Rinaldi M., et al. “Antielastin B-cell and T-cell immunity in patients with chronic obstructive pulmonary disease”. Thorax8 (2012): 694-700.
  33. Kuo YB., et al. “Identification and clinical association of anti-cytokeratin 18 autoantibody in COPD”. Immunology Letters 2 (2010): 131-136.
  34. Feghali-Bostwick CA., et al. “Autoantibodies in patients with chronic obstructive pulmonary disease”. American Journal of Respiratory and Critical Care Medicine 2 (2008): 156-163.
  35. Brandsma CA., et al. “Differential switching to IgG and IgA in active smoking COPD patients and healthy controls”. European Respiratory Journal 2 (2012): 313-321.
  36. Packard TA., et al. “COPD is associated with production of autoantibodies to a broad spectrum of self-antigens, correlative with disease phenotype”. Immunology Research 1-3 (2013): 48-57.
  37. Lazović B., et al. “Analysis of electrocardiogram in chronic obstructive pulmonary disease patients”. Medicinski Pregled 3-4 (2013): 126-129.
  38. Hina Banker and Anita Verma. “Electrocardiographic changes in COPD”. NHL Journal of Medical Sciences2 (2013): 55-58.
  39. Jayadev S Mod., et al. “ Ecg changes in chronic cor pulmonale”. Indian Journal of Applied Research12 (2014): ISSN-2249-555X.
  40. Sandeep Krishna Nalabothu and Leela Krishna Kaku. “A study of electrocardiographic changes in chronic obstructive pulmonary disease”. Scholars Journal of Applied Medical Sciences 1 (2015): 470-472.
  41. Alexander V., et al. “Prevalence cardiac comorbidities and its relation to severity staging of chronic obstructive pulmonary disease”. International Journal of Contemporary Research and Review 17 (2015): 27-33.
  42. Sarath Kumar Reddy B., et al. “Electrocardiographic changes in chronic obstructive pulmonary disease”. Journal of Evidence Based Medicine and Healthcare3 (2014): 111-117.
  43. Ram Abhishek Sharma., et al. “Diagnosis of severity of COPD on the basis of electrocardiogram”. Indian Journal of Basic and Applied Medical Research2 (2013): 527-530.
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Citation

Citation: Khan Salman., et al. “Evolution of ECG Abnormalities in Immune Dysfunction Exacerbation Patients with Chronic Obstructive Pulmonary Disease". Acta Scientific Microbiology 3.4 (2020): 195-201.




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