Right ventricular end-diastolic volume and outcomes in exacerbations of COPD.


Journal

Respirology (Carlton, Vic.)
ISSN: 1440-1843
Titre abrégé: Respirology
Pays: Australia
ID NLM: 9616368

Informations de publication

Date de publication:
01 2022
Historique:
revised: 05 09 2021
received: 01 08 2021
accepted: 28 09 2021
pubmed: 26 10 2021
medline: 7 4 2022
entrez: 25 10 2021
Statut: ppublish

Résumé

Right ventricular (RV) volumes are crucial outcome determinants in pulmonary diseases. Little is known about the associations of RV volumes during hospitalized acute exacerbations of chronic obstructive pulmonary disease (AECOPD). We aimed to ascertain associations of RV end-diastolic volume indexed to body surface area (RVEDVI) during hospitalized AECOPD and its relationship with mortality in long-term follow-up. This is a prospective observational cohort study (December 2013-November 2019, ACTRN12617001562369) using dynamic retrospective ECG-gated computed tomography during hospitalized AECOPD. RVEDVI was defined as normal or high using Framingham Offspring Cohort values. Cox regression determined the prognostic relevance of RVEDVI for death. A total of 148 participants (70 ± 10 years [mean ± SD], 88 [59%] men) were included, of whom 75 (51%) had high RVEDVI. This was associated with more frequent hospital admissions in the 12 months before admission (52/75 [69%] vs. 38/73 [52%], p = 0.04) and higher breathlessness (modified Medical Research Council score, 2.9 ± 1.3 vs. 2.4 ± 1.2, p = 0.007). During follow-up, high RVEDVI was associated with greater mortality (log-rank p = 0.001). In univariable Cox regression, increasing RVEDVI was associated with higher mortality (hazard ratio [HR]: 1.02 per ml/m In patients with hospitalized AECOPD, higher RV end-diastolic volume was associated with worse acute clinical parameters and greater mortality.

Sections du résumé

BACKGROUND AND OBJECTIVE
Right ventricular (RV) volumes are crucial outcome determinants in pulmonary diseases. Little is known about the associations of RV volumes during hospitalized acute exacerbations of chronic obstructive pulmonary disease (AECOPD). We aimed to ascertain associations of RV end-diastolic volume indexed to body surface area (RVEDVI) during hospitalized AECOPD and its relationship with mortality in long-term follow-up.
METHODS
This is a prospective observational cohort study (December 2013-November 2019, ACTRN12617001562369) using dynamic retrospective ECG-gated computed tomography during hospitalized AECOPD. RVEDVI was defined as normal or high using Framingham Offspring Cohort values. Cox regression determined the prognostic relevance of RVEDVI for death.
RESULTS
A total of 148 participants (70 ± 10 years [mean ± SD], 88 [59%] men) were included, of whom 75 (51%) had high RVEDVI. This was associated with more frequent hospital admissions in the 12 months before admission (52/75 [69%] vs. 38/73 [52%], p = 0.04) and higher breathlessness (modified Medical Research Council score, 2.9 ± 1.3 vs. 2.4 ± 1.2, p = 0.007). During follow-up, high RVEDVI was associated with greater mortality (log-rank p = 0.001). In univariable Cox regression, increasing RVEDVI was associated with higher mortality (hazard ratio [HR]: 1.02 per ml/m
CONCLUSION
In patients with hospitalized AECOPD, higher RV end-diastolic volume was associated with worse acute clinical parameters and greater mortality.

Identifiants

pubmed: 34693587
doi: 10.1111/resp.14170
doi:

Banques de données

ANZCTR
['ACTRN12617001562369']

Types de publication

Journal Article Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

56-65

Commentaires et corrections

Type : CommentIn

Informations de copyright

© 2021 Asian Pacific Society of Respirology.

Références

Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global Strategy for the Diagnosis, Management and Prevention of COPD. 2020.
Leong P, Macdonald MI, Ko BS, Bardin PG. Coexisting chronic obstructive pulmonary disease and cardiovascular disease in clinical practice: a diagnostic and therapeutic challenge. Med J Aust. 2019;210:417-23.
MacDonald MI, Shafuddin E, King PT, Chang CL, Bardin PG, Hancox RJ. Cardiac dysfunction during exacerbations of chronic obstructive pulmonary disease. Lancet Respir Med. 2016;4:138-48.
Mathioudakis AG, Janssens W, Sivapalan P, Singanayagam A, Dransfield MT, Jensen J-US, et al. Acute exacerbations of chronic obstructive pulmonary disease: in search of diagnostic biomarkers and treatable traits. Thorax. 2020;75:520-7.
Abraham AS, Cole RB, Green ID, Hedworth-Whitty RB, Clarke SW, Bishop JM. Factors contributing to the reversible pulmonary hypertension of patients with acute respiratory failure studied by serial observations during recovery. Circ Res. 1969;24:51-60.
Vonk Noordegraaf A, Westerhof BE, Westerhof N. The relationship between the right ventricle and its load in pulmonary hypertension. J Am Coll Cardiol. 2017;69:236-43.
Tannus-Silva DGS, Rabahi MF. State of the art review of the right ventricle in COPD patients: it is time to look closer. Lung. 2017;195:9-17.
Washko GR, Nardelli P, Ash SY, Vegas Sanchez-Ferrero G, Rahaghi FN, Come CE, et al. Arterial vascular pruning, right ventricular size and clinical outcomes in COPD. Am J Respir Crit Care Med. 2019;200:454-61.
Kawut SM, Poor HD, Parikh MA, Hueper K, Smith BM, Bluemke DA, et al. Cor pulmonale parvus in chronic obstructive pulmonary disease and emphysema. J Am Coll Cardiol. 2014;64:2000-9.
Leong P, MacDonald MI, Ko BS, Lau KK, Troupis JM, Bardin PG. Single-breath comprehensive cardiopulmonary assessment utilizing computerized tomography. Respirology. 2019;24:1026-9.
Leong P, MacDonald MI, King P, Osadnik CR, Ko BS, Landry SA, et al. Treatable cardiac disease in hospitalised COPD exacerbations. ERJ Open Res. 2021;7:00756-2020.
Schoenfeld DA. Sample-size formula for the proportional-hazards regression model. Biometrics. 1983;39:499-503.
Xu B, Seneviratne S, Nasis A. Beyond the coronary arteries: evolving applications of multi-detector cardiac computed tomography in the assessment of non-coronary structures. Int Cardiovasc Forum J. 2016;6:6-12.
Raman SV, Shah M, McCarthy B, Garcia A, Ferketich AK. Multi-detector row cardiac computed tomography accurately quantifies right and left ventricular size and function compared with cardiac magnetic resonance. Am Heart J. 2006;151:736-44.
Plumhans C, Mühlenbruch G, Rapaee A, Sim K-H, Seyfarth T, Günther RW, et al. Assessment of global right ventricular function on 64-MDCT compared with MRI. Am J Roentgenol. 2008;190:1358-61.
Foppa M, Arora G, Gona P, Ashrafi A, Salton CJ, Yeon SB, et al. Right ventricular volumes and systolic function by cardiac magnetic resonance and the impact of sex, age, and obesity in a longitudinally followed cohort free of pulmonary and cardiovascular disease. Circ Cardiovasc Imaging. 2016;9:e003810.
Gevenois PA, De Vuyst P, de Maertelaer V, Zanen J, Jacobovitz D, Cosio MG, et al. Comparison of computed density and microscopic morphometry in pulmonary emphysema. Am J Respir Crit Care Med. 1996;154:187-92.
Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361-70.
Jones PW, Harding G, Berry P, Wiklund I, Chen W-H, Leidy NK. Development and first validation of the COPD Assessment Test. Eur Respir J. 2009;34:648-54.
Shorr AF, Sun X, Johannes RS, Yaitanes A, Tabak YP. Validation of a novel risk score for severity of illness in acute exacerbations of COPD. Chest. 2011;140:1177-83.
Steer J, Gibson J, Bourke SC. The DECAF score: predicting hospital mortality in exacerbations of chronic obstructive pulmonary disease. Thorax. 2012;67:970-6.
Oga T, Tsukino M, Hajiro T, Ikeda A, Nishimura K. Predictive properties of different multidimensional staging systems in patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2011;6:521-6.
Li K-H, Meng X-L, Raghunathan TE, Rubin DB. Significance levels from repeated P-values with multiply-imputed data. Stat Sin. 1991;1:65-92.
Heymans M, Eekhout I. Applied missing data analysis with SPSS and (R)studio [Internet]. Amsterdam; 2019. Available from: https://bookdown.org/mwheymans/bookmi/
Kenward MG, Carpenter J. Multiple imputation: current perspectives. Stat Methods Med Res. 2007;16:199-218.
MacNee W, Wathen CG, Flenley DC, Muir AD. The effects of controlled oxygen therapy on ventricular function in patients with stable and decompensated cor pulmonale. Am Rev Respir Dis. 1988;137:1289-95.
Weir-McCall JR, Struthers AD, Lipworth BJ, Houston JG. The role of pulmonary arterial stiffness in COPD. Respir Med. 2015;109:1381-90.
Jenkins CR, Chapman KR, Donohue JF, Roche N, Tsiligianni I, Han MK. Improving the management of COPD in women. Chest. 2017;151:686-96.
Divo M, Cote C, de Torres JP, Casanova C, Marin JM, Pinto-Plata V, et al. Comorbidities and risk of mortality in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2012;186:155-61.
Bhatt SP, Vegas-Sánchez-Ferrero G, Rahaghi FN, MacLean ES, Gonzalez-Serrano G, Come CE, et al. Cardiac morphometry on computed tomography and exacerbation reduction with β-blocker therapy in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2017;196:1484-8.
Dransfield MT, Voelker H, Bhatt SP, Brenner K, Casaburi R, Come CE, et al. Metoprolol for the prevention of acute exacerbations of COPD. N Engl J Med. 2019;381:2304-14.
Lederer DJ, Bell SC, Branson RD, Chalmers JD, Marshall R, Maslove DM, et al. Control of confounding and reporting of results in causal inference studies: guidance for authors from editors of respiratory, sleep, and critical care journals. Ann Am Thorac Soc [Internet]. 2018 [cited 2018 Sep 24];16:22-8. Available from: https://www.atsjournals.org/doi/10.1513/AnnalsATS.201808-564PS

Auteurs

Paul Leong (P)

Monash Lung and Sleep, Monash Health, Clayton, Victoria, Australia.
School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.

Christian R Osadnik (CR)

Monash Lung and Sleep, Monash Health, Clayton, Victoria, Australia.
School of Primary and Allied Health Care, Monash University, Clayton, Victoria, Australia.

Paul T King (PT)

Monash Lung and Sleep, Monash Health, Clayton, Victoria, Australia.
School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.

Martin I MacDonald (MI)

Monash Lung and Sleep, Monash Health, Clayton, Victoria, Australia.
School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.

Brian S Ko (BS)

School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.
Monash Heart, Monash Health, Clayton, Victoria, Australia.

Kenneth K Lau (KK)

School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.
Monash Imaging, Monash Health, Clayton, Victoria, Australia.

Simon A Joosten (SA)

Monash Lung and Sleep, Monash Health, Clayton, Victoria, Australia.
School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.

Gayan Kathriachchige (G)

Monash Lung and Sleep, Monash Health, Clayton, Victoria, Australia.

Alexander Chua (A)

Monash Heart, Monash Health, Clayton, Victoria, Australia.

Kais Hamza (K)

School of Mathematical Sciences, Monash University, Clayton, Victoria, Australia.

Ahilan Kuganesan (A)

Monash Imaging, Monash Health, Clayton, Victoria, Australia.

John M Troupis (JM)

School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.
Monash Imaging, Monash Health, Clayton, Victoria, Australia.

Philip G Bardin (PG)

Monash Lung and Sleep, Monash Health, Clayton, Victoria, Australia.
School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH