scholarly journals Possibilities and limitations of the use of beta-blockers in patients with cardiovascular disease and chronic obstructive pulmonary disease

Kardiologiia ◽  
2021 ◽  
Vol 61 (10) ◽  
pp. 89-98
Author(s):  
N. A. Karoli ◽  
A. P. Rebrov
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Beta Blockers ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
Intrinsic Sympathomimetic Activity ◽  
Obstructive Pulmonary Disease ◽  
Pharmaceutical Group ◽  
Copd Patients ◽  
Exacerbation Of Copd

In medical literature, increasing attention is paid to comorbidities in patients with chronic obstructive pulmonary disease (COPD). In clinical practice, physicians often hesitate to prescribe beta-blockers (β1-adrenoblockers) to COPD patients. This article summarized new results of using beta-blockers in patients with COPD. According to reports, the selective β1-blocker treatment considerably increases the survival rate of patients with COPD and ischemic heart disease, particularly after myocardial infarction (MI), and with chronic heart failure (CHF). The benefit of administering selective β1-blockers to patients with CHF and/or a history of MI overweighs a potential risk related with the treatment even in patients with severe COPD. Convincing data in favor of the β1-blocker treatment in COPD patients without the above-mentioned comorbidities are not available. At present, the selective β1-blocker treatment is considered safe for patients with cardiovascular diseases and COPD. For this reason, selective β1-blockers, such as bisoprolol, metoprolol or nebivolol can be used in managing this patient cohort. Nonselective β1-blockers may induce bronchospasm and are not recommended for COPD patients. For the treatment with β-blockers with intrinsic sympathomimetic activity, the probability of bronchial obstruction in COPD patients is lower; however, drugs of this pharmaceutical group have not been compared with cardioselective beta-blockers. For safety reasons, the beta-blocker treatment should be started outside exacerbation of COPD and from a small dose. Careful monitoring is recommended for possible new symptoms, such as emergence/increase of shortness of breath, cough or changes in dosing of other drugs (for example, increased frequency of using short-acting bronchodilators).

scholarly journals Morphological and functional erythrocyte parameters in smokers with chronic obstructive pulmonary disease

2008 ◽  
pp. 48-52
Author(s):  
E. V. Privalova ◽  
T. V. Vavilova ◽  
N. A. Kuzubova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
Obstructive Pulmonary Disease ◽  
Compensatory Reaction ◽  
Copd Patients

The aim of this study was to investigate morphological and functional erythrocyte parameters in smokers with chronic obstructive pulmonary disease (COPD). We measured erythrocyte parameters (RBC, HGB, HCT, MCV, MCH, MCHC, RDW-SD) using the automatic hematological analyzer Sysmex XT-2000i. Sixty-nine patients participated in the study. The patients were divided into 3 groups: 34 patients with COPD (mean age 63 yrs, median smoking history 36 packyrs); 15 smokers without bronchial obstruction (mean age 56 yrs, median smoking history 28 packyrs) and 20 nonsmokers of the sane age without bronchial obstruction. Smokers with COPD and smokers without bronchial obstruction had significantly higher erythrocyte parameters compared to those of nonsmokers. Smokers demonstrated higher HGB level that could be as a compensatory reaction to nicotine-related preclinical hypoxia. Marked increase in RBC number and anisocytosis (RDW-SD) reflected the erythron activation in smokers with COPD. These results suggest that measurement of erythrocyte parameters could be useful to assess symptomatic erythrocytosis in COPD patients.

scholarly journals The Combination of Hemogram Indexes to Predict Exacerbation in Stable Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 7 ◽  
Author(s):  
Xuanqi Liu ◽  
Haiyan Ge ◽  
Xiumin Feng ◽  
Jingqing Hang ◽  
Fengying Zhang ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Calibration Curve ◽  
Roc Curve ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Copd Patients ◽  
Exacerbation Of Copd

Background: Chronic obstructive pulmonary disease (COPD) is characterized by pulmonary and systemic inflammatory processes, and exacerbation of COPD represents a critical moment in the progression of COPD. Several biomarkers of inflammation have been proposed to have a predictive function in acute exacerbation. However, their use is still limited in routine clinical practice. The purpose of our study is to explore the prognostic efficacy of novel inflammatory hemogram indexes in the exacerbation among stable COPD patients.Method: A total of 275 stable COPD patients from the Shanghai COPD Investigation Comorbidity Program were analyzed in our study. Blood examinations, especially ratio indexes like platelet–lymphocyte ratio (PLR), platelet × neutrophil/lymphocyte ratio [systemic immune-inflammation index (SII)], and monocyte × neutrophil/lymphocyte ratio [systemic inflammation response index (SIRI)], lung function test, CT scans, and questionnaires were performed at baseline and routine follow-ups. Clinical characteristics and information of exacerbations were collected every 6 months. The relationship between hemogram indexes and diverse degrees of exacerbation was assessed by logistic regression. The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the ability of hemogram indexes to predict exacerbation of COPD. Furthermore, the discrimination and accuracy of combined indexes were measured by ROC and calibration curve.Result: There was a significant positive correlation between PLR levels and total exacerbation of COPD patients in a stable stage in a year. Also, the predictive ability of PLR exceeded any other ratio indexes, with an AUC of 0.66. SII and SIRI ranked second only to PLR, with an AUC of 0.64. When combining PLR with other indexes (sex, COPD year, and St. George's Respiratory Questionnaire scores), they were considered as the most suitable panel of index to predict total exacerbation. Based on the result of the ROC curve and calibration curve, the combination shows optimal discrimination and accuracy to predict exacerbation events in COPD patients.Conclusion: The hemogram indexes PLR, SII, and SIRI were associated with COPD exacerbation. Moreover, the prediction capacity of exacerbation was significantly elevated after combining inflammatory hemogram index PLR with other indexes, which will make it a promisingly simple and effective marker to predict exacerbation in patients with stable COPD.

scholarly journals Serum Procalcitonin Guided Antibiotic Therapy in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

2015 ◽  
Vol 3 (2) ◽  
pp. 67-70
Author(s):  
Rawshan Arra Khanam ◽  
Md Ashraful Haque ◽  
Mohammad Omar Faruq
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Antibiotic Therapy ◽  
Pulmonary Disease ◽  
Hospital Admissions ◽  
Respiratory Infections ◽  
Chronic Obstructive ◽  
Acute Phase Reactants ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Exacerbation Of Copd

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable, but progressive disease. Hospital admissions of patients with COPD are frequently due to acute exacerbations of COPD (AECOPD). AECOPD are very common, affecting about 20% of COPD patients. The bacterial infection plays an important role in the exacerbation of COPD patients. In addition, recent studies using molecular diagnostics indicate that a substantial proportion of AECOPD are associated with viral infection. Accurate methods to differentiate viral and bacterial respiratory infections to allow targeted antibiotic therapy would be beneficial. Acute phase reactants are capable of demonstrating the inflammation; however, they cannot be employed to make a difference between bacterial and nonbacterial causes of the inflammation. Recently, measurement of procalcitonin (PCT) levels appears to be useful in order to minimize this problem.Bangladesh Crit Care J September 2015; 3 (2): 67-70

scholarly journals Host-Pathogen Interaction during Pneumococcal Infection in Patients with Chronic Obstructive Pulmonary Disease

2004 ◽  
Vol 72 (2) ◽  
pp. 818-823 ◽  
Author(s):  
Debby Bogaert ◽  
Paul van der Valk ◽  
Reshmi Ramdin ◽  
Marcel Sluijter ◽  
Evelyn Monninkhof ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Pneumococcal Infection ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Antibody Titers ◽  
Pneumococcal Colonization ◽  
Exacerbation Of Copd

ABSTRACT Acute exacerbation is a frequent complication of chronic obstructive pulmonary disease (COPD). Recent studies suggested a role for bacteria such as Streptococcus pneumoniae in the development of acute exacerbation. For this study, we investigated the following in COPD patients: (i) the epidemiology of pneumococcal colonization and infection, (ii) the effect of pneumococcal colonization on the development of exacerbation, and (iii) the immunological response against S. pneumoniae. We cultured sputa of 269 COPD patients during a stable state and during exacerbation of COPD and characterized 115 pneumococcal isolates by use of serotyping. Moreover, we studied serum immunoglobulin G (IgG) antibody titers, antibody avidities, and functional antibody titers against the seven conjugate vaccine serotypes in these patients. Colonization with only pneumococci (monocultures) increased the risk of exacerbation, with a hazard ratio of 2.93 (95% confidence interval, 1.41 to 6.07). The most prevalent pneumococcal serotypes found were serotypes 19F, 3, 14, 9L/N/V, 23A/B, and 11. We calculated the theoretical coverage for the 7- and 11-valent pneumococcal vaccines to be 60 and 73%, respectively. All patients had detectable IgG levels against the seven conjugate vaccine serotypes. These antibody titers were significantly lower than those in vaccinated healthy adults. Finally, on average, a 2.5-fold rise in serotype-specific and functional antibodies in S. pneumoniae-positive sputum cultures was observed during exacerbation. Our data indicate that pneumococcal colonization in COPD patients is frequently caused by vaccine serotype strains. Moreover, pneumococcal colonization is a risk factor for exacerbation of COPD. Finally, our findings demonstrate that COPD patients are able to mount a significant immune response to pneumococcal infection. COPD patients may therefore benefit from pneumococcal vaccination.

scholarly journals Associations Between Sputum Torque Teno Virus Load and Lung Function and Disease Severity in Patients With Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Yu Xie ◽  
Qing Xue ◽  
Weike Jiao ◽  
Jianhui Wu ◽  
Yan Yu ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Viral Load ◽  
Lung Function ◽  
Pulmonary Disease ◽  
Disease Severity ◽  
Torque Teno Virus ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Exacerbation Of Copd

Purpose: Viral load of Torque Teno virus (TTV) is elevated in immunosuppressed patients. The weakened immune response is typical in chronic obstructive pulmonary disease (COPD) patients. However, the relationship between TTV and COPD is still unknown.Patients and Methods: We enrolled 91 patients admitted to hospitals with acute exacerbation of COPD (AECOPD) between January 2017 and August 2017 (ClinicalTrials.gov ID, NCT03236480). Sputum samples were gathered during hospitalization and the 120-day follow-up. TTV distribution and genogroups were assessed, and the associations between viral loads and clinical parameters were analyzed.Results: TTV DNA was detected in 95.6% of COPD patients, and the viral load was nearly invariable at the stable and exacerbation states. Most TTV DNA-positive patients carried four distinct genotypes. Sputum load of TTV was positively associated with RV/TLC (r = 0.378, p = 0.030), and negatively correlated with FEV1/pre and FEV1/FVC (r = −0.484, −0.432, p = 0.011, 0.024, respectively). Neutral correlation between the TTV DNA load and COPD assessment test (CAT) scores (r = 0.258, p = 0.018) was observed.Conclusion: Sputum loads of TTV DNA could be a novel indicator for lung function and disease severity assessment in COPD patients.

scholarly journals Chronic obstructive pulmonary disease and cardiovascular comorbidity

Kardiologiia ◽  
2019 ◽  
Vol 59 (8S) ◽  
pp. 24-36 ◽  
Author(s):  
Z. R. Aisanov ◽  
A. G. Chuchalin ◽  
E. N. Kalmanova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
General Population ◽  
Pulmonary Disease ◽  
Point Of View ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
Obstructive Pulmonary Disease ◽  
Cardiovascular Comorbidity ◽  
Copd Patients ◽  
The Relationship

In recent years, a greater understanding of the heterogeneity and complexity of chronic obstructive pulmonary disease (COPD) has come from the point of view of an integrated clinical assessment of severity, pathophysiology, and the relationship with other pathologies. A typical COPD patient suffers on average 4 or more concomitant diseases and every day about a third of patients take from 5 to 10 different drugs. The mechanisms of the interaction of COPD and cardiovascular disease (CVD) include the effects of systemic inflammation, hyperinflation (hyperinflation) of the lungs and bronchial obstruction. The risk of developing CVD in patients with COPD is on average 2–3 times higher than in people of a comparable age in the general population, even taking into account the risk of smoking. The prevalence of coronary heart disease, heart failure, and rhythm disturbances among COPD patients is significantly higher than in the general population. The article discusses in detail the safety of prescribing various groups of drugs for the treatment of CVD in patients with COPD. Achieving success in understanding and managing patients with COPD and CVD is possible using an integrated multidisciplinary approach.

Beta Blockers and Chronic Obstructive Pulmonary Disease (COPD): Sum of Evidence

2020 ◽  
Vol 16 ◽  
Author(s):  
Katerina Baou ◽  
Vasiliki Katsi ◽  
Thomas Makris ◽  
Dimitris Tousoulis
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Coronary Artery Disease ◽  
Pulmonary Disease ◽  
Cardiac Arrhythmias ◽  
Beta Blockers ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Artery Disease

Abstract:: Approximately, half a century has passed since the discovery of beta blockers. Then, their prime therapeutic purpose was to treat angina and cardiac arrhythmias, nowadays, beta blockers’ usage and effectiveness is extended to treat other cardiovascular diseases, such as hypertension, congestive heart failure, and coronary artery disease. Safety concerns were raised about beta blockers and their use for chronic obstructive pulmonary disease (COPD) patients with concurrent cardiovascular disease. After a thorough research of the literature, this review summarizes the evidence proving that beta blockers not only might be well tolerated in COPD patients, but they might also have a beneficial effect in this group of patients.

scholarly journals Use of beta blockers in patients with asthma and chronic obstructive pulmonary disease

2021 ◽  
Vol 74 (3-4) ◽  
pp. 127-133
Author(s):  
Andrej Preveden ◽  
Mirko Todic ◽  
Vanja Drljevic-Todic ◽  
Mihaela Preveden ◽  
Ranko Zdravkovic ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Cardiovascular Diseases ◽  
Airway Obstruction ◽  
Pulmonary Disease ◽  
Beta Blockers ◽  
Clinical Signs ◽  
Pulmonary Diseases ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
Obstructive Pulmonary Disease

Introduction. Beta blockers play an essential role in the treatment of cardiovascular diseases, but also various other endocrinological, gastroenterological, ophthalmological and neurological disorders. The most important effects of beta blockers are a reduction in myocardial oxygen consumption and inhibition of renin secretion. Beta blockers are divided into three generations according to their selectivity - non-selective, cardioselective and vasodilating beta blockers. Beta blockers and obstructive pulmonary diseases. Patients with obstructive pulmonary diseases are significantly more likely to develop cardiovascular diseases compared to general population, largely due to common risk factors such as smoking, systemic inflammation, age, and genetic predisposition. The use of nonselective beta blockers carries a great risk for patients with obstructive pulmonary diseases, while cardioselective beta blockers can be used more extensively. Reversible airway obstruction is predominantly present in asthma, so that the adverse effects of beta blockers on the airways are significantly more pronounced in asthma compared to chronic obstructive pulmonary disease. Conclusion. In both asthma and chronic obstructive pulmonary disease, the use of highly cardioselective beta blockers such as bisoprolol and nebivolol is preferred. The use of beta blockers in patients with asthma requires great caution due to the possibility of bronchial obstruction, while in patients with chronic obstructive pulmonary disease they are somewhat safer. Patients must be closely monitored by a physician, with special attention focused on clinical signs of airway obstruction such as wheezing, shortness of breath, and prolonged expiration.

scholarly journals Possibilities and limitations of inhaled corticosteroids in the treatment of chronic obstructive pulmonary disease

2018 ◽  
Vol 28 (5) ◽  
pp. 602-612
Author(s):  
I. V. Leshchenko
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Inhaled Corticosteroids ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
History Of ◽  
Long Acting ◽  
Exacerbation Of Copd

Combinations of inhaled corticosteroids (ICS) and long-acting bronchodilators are recommended for those patients with chronic obstructive pulmonary disease (COPD) who did not improve significantly with regular long-acting bronchodilators. ICS are known to increase the risk of pneumonia in elderly patients (over 55 years), current smokers, patients with acute exacerbation of COPD, patients with history of previous pneumonia, patients with body mass index < 25 kg/m2, and patients with dyspnea or severe airflow limitation. The risk-benefit ratio should be considered before initiating the treatment with ICS in COPD patients, particularly in patients with the risk factors of adverse events associated with ICS.

scholarly journals Comorbidity of Chronic Obstructive Pulmonary Disease and Cardiovascular Diseases: Place of Therapy with Modern β-Adrenoblockers

Kardiologiia ◽  
2019 ◽  
Vol 59 (6) ◽  
pp. 48-55 ◽  
Author(s):  
Yu. N. Belenkov ◽  
O. A. Tsvetkova ◽  
E. V. Privalova ◽  
G. V. An ◽  
I. S. Ilgisonis ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Cardiovascular Diseases ◽  
Pulmonary Disease ◽  
Beta Blockers ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Common Risk Factors ◽  
Artery Disease ◽  
Morbidity Risk

Chronic obstructive pulmonary disease (COPD) is the fourth largest cause of worldwide mortality.  Presence of comorbidities is registered in 96% of COPD patients. The most important of these are cardiovascular diseases (coronary artery disease, arterial hypertension, chronic heart failure), which contribute to COPD patients’ mortality in every third case. COPD and cardiovascular diseases have common risk factors and pathogenesis mechanisms. Cardioselective beta-blockers reduce morbidity risk and frequency of COPD exacerbation, are effective and safe in treatment of COPD patients.

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