A correlation between severity of chronic obstructive pulmonary disorders, electrocardiography and echocardiography of patients: a prospective observational study

Background: Chronic obstructive pulmonary disease (COPD) is defined as a disease state characterised by persistent respiratory symptom and airflow limitation which is not fully reversible. It has been reported that patient with COPD has higher mortality due to cardiac disorder. We have designed this study with an aim to evaluate electrocardiography and echocardiography changes in COPD patients and correlate this finding with severity of disease.Method: In present study 60 randomly selected COPD patients were evaluated clinically, echocardiographically, electrocardiographically and pulmonary function test was performed. A careful history of patient was taken regarding demography, symptoms and aggravation factors. Detailed clinical examination of patient was done to know the sign symptom of cardiological and respiratory involvement.Result: In patients with severe COPD 4 (20%) patients have normal ECG, 12 (60%) have P pulmonale, 14 (70%) patients have right ventricular hypertrophy, low voltage complex was found in 6 (30%), RBBB was present in 4 (20%) patients, 12 (60%) have r wave in their electrocardiograph (ECG) and 2 (10%) patients presented with arrhythmia.Conclusions: From our study we can conclude that most of the patients with COPD were in 5th and 6th decade of life with male predominance. Patients with moderate airflow obstruction were common than severe obstruction. Cardiovascular changes depend upon the severity of disease.

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Cytokine profile in the sputum of subjects with post-tuberculosis airflow obstruction and in those with tobacco related chronic obstructive pulmonary disease

10.21203/rs.2.21950/v2 ◽

2020 ◽

Author(s):

Elise Guiedem ◽

Eric Walter Pefura-Yone ◽

George Mondinde Ikomey ◽

Céline Nkenfou ◽

Martha Mesembe ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Airflow Obstruction ◽

Forced Expiratory Volume ◽

Airflow Limitation ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

P Values ◽

Copd Patients ◽

History Of

Abstract Background: Previous studies have shown that tuberculosis (TB) is a risk factor for chronic airflow limitation. Chronic obstructive pulmonary disease (COPD) is recognized as the result of chronic inflammation, usually related to noxious particles. Post-TB airflow obstruction and tobacco-related COPD have the same functional pathway characterized by persistent airflow limitation. We sought to compare the profile of 29 cytokines in the sputum of subjects with post-TB airflow obstruction and those with COPD related to tobacco.Results: The forced expiratory volume in the first second (FEV1) and forced expiratory volume/forced vital capacity (FEV/FVC) ratio were lower in the COPD patients with the history of smoking compared to the post-TB airflow obstruction subgroup. The stages of the disease were more advanced in COPD / tobacco patients. Among the cytokines, IL-1α, IL-1β, MIP-1β, sCD40L and VEGF levels were higher in COPD patients, compared to the controls with p values of 0.003, 0.0001, 0.03, 0.0001 and 0.02 respectively. When the two COPD subgroups were compared, IL-1α, IL-6, TNF-α and IL-8 levels were higher in the COPD patients with the history of tobacco compared to the COPD patients with the history of TB with p-values of 0.031, 0.05, 0.021 and 0.016, respectively. Conclusion: COPD related to tobacco is more severe than post-TB airflow obstruction. The pathogenesis of post-TB airflow obstruction appears to involve the cytokines IL-1RA, IL-1α, IL-1β, IL-17, GRO and sCD40L, while COPD related to tobacco involves more cytokines.

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Cytokine profile in the sputum of subjects with post-tuberculosis airflow obstruction and in those with tobacco related chronic obstructive pulmonary disease

10.21203/rs.2.21950/v3 ◽

2020 ◽

Author(s):

Elise Guiedem ◽

Eric Walter Pefura-Yone ◽

George Mondinde Ikomey ◽

Céline Nguefeu Nkenfou ◽

Martha Mesembe ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Airflow Obstruction ◽

Forced Expiratory Volume ◽

Airflow Limitation ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

P Values ◽

Copd Patients ◽

History Of

Abstract Background: Previous studies have shown that tuberculosis (TB) is a risk factor for chronic airflow limitation. Chronic obstructive pulmonary disease (COPD) is recognized as the result of chronic inflammation, usually related to noxious particles. Post-TB airflow obstruction and tobacco-related COPD have the same functional pathway characterized by persistent airflow limitation. We sought to compare the profile of 29 cytokines in the sputum of subjects with post-TB airflow obstruction and those with COPD related to tobacco.Results: The forced expiratory volume in the first second (FEV1) and forced expiratory volume/forced vital capacity (FEV/FVC) ratio were lower in the COPD patients with the history of smoking compared to the post-TB airflow obstruction subgroup. The stages of the disease were more advanced in COPD / tobacco patients. Among the cytokines, IL-1α, IL-1β, MIP-1β, sCD40L and VEGF levels were higher in COPD patients, compared to the controls with p values of 0.003, 0.0001, 0.03, 0.0001 and 0.02 respectively. When the two COPD subgroups were compared, IL-1α, IL-6, TNF-α and IL-8 levels were higher in the COPD patients with the history of tobacco compared to the COPD patients with the history of TB with p-values of 0.031, 0.05, 0.021 and 0.016, respectively.Conclusion: COPD related to tobacco is more severe than post-TB airflow obstruction. The pathogenesis of post-TB airflow obstruction appears to involve the cytokines IL-1RA, IL-1α, IL-1β, IL-17, GRO and sCD40L, while COPD related to tobacco involves more cytokines.

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Cytokine profile in the sputum of subjects with post-tuberculosis airflow obstruction and in those with tobacco related chronic obstructive pulmonary disease

BMC Immunology ◽

10.1186/s12865-020-00381-w ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Elise Guiedem ◽

Eric Walter Pefura-Yone ◽

George Mondinde Ikomey ◽

Céline Nguefeu Nkenfou ◽

Martha Mesembe ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Airflow Obstruction ◽

Forced Expiratory Volume ◽

Airflow Limitation ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

History Of ◽

Functional Pathway

Abstract Background Previous studies have shown that tuberculosis (TB) is a risk factor for chronic airflow limitation. Chronic obstructive pulmonary disease (COPD) is recognized as the result of chronic inflammation, usually related to noxious particles. Post-TB airflow obstruction and tobacco-related COPD have the same functional pathway characterized by persistent airflow limitation. We sought to compare the profile of 29 cytokines in the sputum of subjects with post-TB airflow obstruction and those with COPD related to tobacco. Results The forced expiratory volume in the first second (FEV1) and forced expiratory volume/forced vital capacity (FEV/FVC) ratio were lower in the COPD patients with the history of smoking compared to the post-TB airflow obstruction subgroup. The stages of the disease were more advanced in COPD / tobacco patients. Among the cytokines, IL-1α, IL-1β, MIP-1β, sCD40L and VEGF levels were higher in COPD patients, compared to the controls with p values of 0.003, 0.0001, 0.03, 0.0001 and 0.02 respectively. When the two COPD subgroups were compared, IL-1α, IL-6, TNF-α and IL-8 levels were higher in the COPD patients with the history of tobacco compared to the COPD patients with the history of TB with p-values of 0.031, 0.05, 0.021 and 0.016, respectively. Conclusion COPD related to tobacco is more severe than post-TB airflow obstruction. The pathogenesis of post-TB airflow obstruction appears to involve the cytokines IL-1RA, IL-1α, IL-1β, IL-17, GRO and sCD40L, while COPD related to tobacco involves more cytokines.

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Cytokine profile in the sputum of subjects with post-tuberculosis airflow obstruction and in those with tobacco related chronic obstructive pulmonary disease

10.21203/rs.2.21950/v4 ◽

2020 ◽

Author(s):

Elise Guiedem ◽

Eric Walter Pefura-Yone ◽

George Mondinde Ikomey ◽

Céline Nguefeu Nkenfou ◽

Martha Mesembe ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Airflow Obstruction ◽

Forced Expiratory Volume ◽

Airflow Limitation ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

P Values ◽

Copd Patients ◽

History Of

Abstract Background: Previous studies have shown that tuberculosis (TB) is a risk factor for chronic airflow limitation. Chronic obstructive pulmonary disease (COPD) is recognized as the result of chronic inflammation, usually related to noxious particles. Post-TB airflow obstruction and tobacco-related COPD have the same functional pathway characterized by persistent airflow limitation. We sought to compare the profile of 29 cytokines in the sputum of subjects with post-TB airflow obstruction and those with COPD related to tobacco. Results: The forced expiratory volume in the first second (FEV1) and forced expiratory volume/forced vital capacity (FEV/FVC) ratio were lower in the COPD patients with the history of smoking compared to the post-TB airflow obstruction subgroup. The stages of the disease were more advanced in COPD / tobacco patients.Among the cytokines, IL-1α, IL-1β, MIP-1β, sCD40L and VEGF levels were higher in COPD patients, compared to the controls with p values of 0.003, 0.0001, 0.03, 0.0001 and 0.02 respectively. When the two COPD subgroups were compared, IL-1α, IL-6, TNF-α and IL-8 levels were higher in the COPD patients with the history of tobacco compared to the COPD patients with the history of TB with p-values of 0.031, 0.05, 0.021 and 0.016, respectively.Conclusion: COPD related to tobacco is more severe than post-TB airflow obstruction. The pathogenesis of post-TB airflow obstruction appears to involve the cytokines IL-1RA, IL-1α, IL-1β, IL-17, GRO and sCD40L, while COPD related to tobacco involves more cytokines.

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Somatotypes trajectories during adulthood and their association with COPD phenotypes

ERJ Open Research ◽

10.1183/23120541.00122-2020 ◽

2020 ◽

Vol 6 (3) ◽

pp. 00122-2020

Author(s):

Miguel J. Divo ◽

Marta Marin Oto ◽

Ciro Casanova Macario ◽

Carlos Cabrera Lopez ◽

Juan P. de-Torres ◽

...

Keyword(s):

Early Adulthood ◽

Airflow Obstruction ◽

Forced Expiratory Volume ◽

Multiple Organ ◽

Airflow Limitation ◽

Initial Increase ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Continuous Increase ◽

Copd Patients

RationaleChronic obstructive pulmonary disease (COPD) comprises distinct phenotypes, all characterised by airflow limitation.ObjectivesWe hypothesised that somatotype changes – as a surrogate of adiposity – from early adulthood follow different trajectories to reach distinct phenotypes.MethodsUsing the validated Stunkard's Pictogram, 356 COPD patients chose the somatotype that best reflects their current body build and those at ages 18, 30, 40 and 50 years. An unbiased group-based trajectory modelling was used to determine somatotype trajectories. We then compared the current COPD-related clinical and phenotypic characteristics of subjects belonging to each trajectory.Measurements and main resultsAt 18 years of age, 88% of the participants described having a lean or medium somatotype (estimated body mass index (BMI) between 19 and 23 kg·m−2) while the other 12% a heavier somatotype (estimated BMI between 25 and 27 kg·m−2). From age 18 onwards, five distinct trajectories were observed. Four of them demonstrating a continuous increase in adiposity throughout adulthood with the exception of one, where the initial increase was followed by loss of adiposity after age 40. Patients with this trajectory were primarily females with low BMI and DLCO (diffusing capacity of the lung for carbon monoxide). A persistently lean trajectory was seen in 14% of the cohort. This group had significantly lower forced expiratory volume in 1 s (FEV1), DLCO, more emphysema and a worse BODE (BMI, airflow obstruction, dyspnoea and exercise capacity) score thus resembling the multiple organ loss of tissue (MOLT) phenotype.ConclusionsCOPD patients have distinct somatotype trajectories throughout adulthood. Those with the MOLT phenotype maintain a lean trajectory throughout life. Smoking subjects with this lean phenotype in early adulthood deserve particular attention as they seem to develop more severe COPD.

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Incidence of Post Tuberculosis Chronic Obstructive Pulmonary Disease in a Tertiary Centre In Malaysia

Medicine & Health ◽

10.17576/mh.2020.1502.10 ◽

2020 ◽

Vol 15 (2) ◽

pp. 85-95

Author(s):

Mohamed Faisal Abdul Hamid ◽

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Tuberculosis ◽

Pulmonary Disease ◽

Airflow Obstruction ◽

Chronic Obstructive ◽

Past Infection ◽

Cross Sectional ◽

Obstructive Pulmonary Disease ◽

Male Predominance ◽

History Of

Pulmonary tuberculosis (PTB) and chronic obstructive pulmonary disease (COPD) are important causes of mortality and morbidity in Malaysia. The number of tuberculosis (TB) cases in Malaysia appears to be increasing and there were 500,000 Malaysians diagnosed with COPD in 2016. A substantial number of PTB patients go on to develop post tubular airway disease. Past infection with TB has been shown to contribute to the aetiology of COPD. We conducted a one year cross-sectional study in outpatient setting involving adult subjects in Universiti Kebangsaan Malaysia Medical Centre (UKMMC) with a history of pulmonary tuberculosis three years prior to the study. We excluded subjects with bronchial asthma, COPD, interstitial lung disease and bronchiectasis. Airflow obstruction was defined as FEV1: FVC ratio <0.70. The COPD Assessment Test (CAT) questionnaire was used. Eighty-two subjects were recruited with a median age of 52.5 years (IQR 36-62). Male predominance (56.1%) with 29 (35.4%) smokers. Eighteen (22%) subjects had airflow obstruction. Six (33%) out of these subjects were smokers. Fourteen(17%) had restrictive pattern and 50 (61%) had normal spirometry results. Five subjects (22.22%) had mild obstruction, 7 (44.44%) moderate obstruction, and 6 (33.33%) had severe obstruction. There was a positive correlation between chest X-ray abnormalities and age with airflow obstruction (P<0.05). Abnormal spirometry pattern was found in 39% of subjects. Post TB-COPD incidence was 22% in those who completed TB treatment. There appeared to be an association between abnormal chest radiograph findings with airflow obstruction in subjects with history of PTB.

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

Russian Pulmonology ◽

10.18093/0869-0189-2018-28-5-602-612 ◽

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.

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Cytokine profile in the sputum of subjects with post-tuberculosis airflow obstruction and in those with tobacco related chronic obstructive pulmonary disease

10.21203/rs.2.21950/v1 ◽

2020 ◽

Author(s):

Guiedem Elise ◽

Elise Guiedem ◽

Eric Walter Pefura-Yone ◽

George Mondinde Ikomey ◽

Céline Nkenfou ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Airflow Obstruction ◽

Forced Expiratory Volume ◽

Airflow Limitation ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

P Values ◽

Copd Patients ◽

Functional Pathway

Abstract Background: Previous studies have shown that tuberculosis (TB) is a risk factor for chronic airflow limitation. Chronic obstructive pulmonary disease (COPD) is recognized as the result of chronic inflammation, usually related to noxious particles. Post-TB airflow obstruction (post-TB/AFO) and tobacco-related COPD (COPD/tobacco) have the same functional pathway characterized by persistent airflow limitation. We sought to compare the profile of 29 cytokines in the sputum of subjects with post-TB/AFO and those with COPD/tobacco. Results: The forced expiratory volume in the first second (FEV 1 ) and FEV1/forced vital capacity (FEV 1 /FVC) ratio were lower in the COPD/tobacco subgroup compared to the COPD/post-TB subgroup. The stages of the disease were more advanced in COPD / tobacco patients. Among the cytokines, IL-1α, IL-1β, MIP-1β, sCD40L and VEGF levels were higher in COPD patients, compared to the controls with p values of 0.003, 0.0001, 0.03, 0.0001 and 0.02 respectively. When the two COPD subgroups were compared, IL-1α, IL-6, TNF-α and IL-8 levels were higher in the COPD/tobacco subgroup compared to the COPD/post-TB subgroup with p-values of 0.031, 0.05, 0.021 and 0.016 respectively. Conclusion: COPD/tobacco is more severe than post-TB/AFO. The pathogenesis of post-TB/AFO appears to involve the cytokines IL-1RA, IL-1α, IL-1β, IL-17, GRO and sCD40L, while COPD/tobacco involves more cytokines.

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Implementation of a Targeted Screening Program to Detect Airflow Obstruction Suggestive of Chronic Obstructive Pulmonary Disease within a Presurgical Screening Clinic

Canadian Respiratory Journal ◽

10.1155/2015/306720 ◽

2015 ◽

Vol 22 (4) ◽

pp. 209-214 ◽

Cited By ~ 5

Author(s):

Chantal Robitaille ◽

Esther Dajczman ◽

Andrew M Hirsch ◽

David Small ◽

Pierre Ernst ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Screening Program ◽

Tertiary Care ◽

Airflow Obstruction ◽

University Hospital ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Targeted Screening ◽

History Of

BACKGROUND: Targeted spirometry screening for chronic obstructive pulmonary disease (COPD) has been studied in primary care and community settings. Limitations regarding availability and quality of testing remain. A targeted spirometry screening program was implemented within a presurgical screening (PSS) clinic to detect undiagnosed airways disease and identify patients with COPD/asthma in need of treatment optimization.OBJECTIVE: The present quality assurance study evaluated airflow obstruction detection rates and examined characteristics of patients identified through the targeted screening program.METHODS: The targeted spirometry screening program was implemented within the PSS clinic of a tertiary care university hospital. Current or ex-smokers with respiratory symptoms and patients with a history of COPD or asthma underwent prebronchodilator spirometry. History of airways disease and smoking status were obtained during the PSS assessment and confirmed through chart reviews.RESULTS: After exclusions, the study sample included 449 current or ex-smokers. Abnormal spirometry results were found in 184 (41%) patients: 73 (16%) had mild, 93 (21%) had moderate and 18 (4%) had severe or very severe airflow obstruction. One hundred eighteen (26%) new cases of airflow obstruction suggestive of COPD were detected. One-half of these new cases had moderate or severe airflow obstruction. Only 34% of patients with abnormal spirometry results had reported a previous diagnosis of COPD. More than one-half of patients with abnormal spirometry results were current smokers.CONCLUSIONS: Undiagnosed airflow obstruction was detected in a significant number of smokers and ex-smokers through a targeted screening program within a PSS clinic. These patients can be referred for early intervention and secondary preventive strategies.

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Exercise tolerance and dyspnea in patients with chronic obstructive pulmonary disease

Vojnosanitetski pregled ◽

10.2298/vsp1001036c ◽

2010 ◽

Vol 67 (1) ◽

pp. 36-41

Author(s):

Ivan Cekerevac ◽

Zorica Lazic ◽

Ljiljana Novkovic ◽

Marina Petrovic ◽

Vojislav Cupurdija ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Function ◽

Exercise Tolerance ◽

Airflow Limitation ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Diffusion Capacity ◽

Tolerance Level ◽

Lung Hyperinflation ◽

Copd Patients

Background/Aim. Peripheral muscle weakness and nutritional disorders, firstly loss of body weight, are common findings in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to analyse the impact of pulmonary function parameters, nutritional status and state of peripheral skeletal muscles on exercise tolerance and development of dyspnea in COPD patients. Methods. Thirty COPD patients in stable state of disease were analyzed. Standard pulmonary function tests, including spirometry, body pletysmography, and measurements of diffusion capacity were performed. The 6-minute walking distance test (6MWD) was done in order to assess exercise tolerance. Level of dyspnea was measured with Borg scale. In all patients midthigh muscle cross-sectional area (MTCSA) was measured by computerized tomography scan. Nutritional status of patients was estimated according to body mass index (BMI). Results. Statistically significant correlations were found between parameters of pulmonary function and exercise tolerance. Level of airflow limitation and lung hyperinflation had significant impact on development of dyspnea at rest and especially after exercise. Significant positive correlation was found between MTCSA and exercise tolerance. Patients with more severe airflow limitation, lung hyperinflation and reduced diffusion capacity had significantly lower MTCSA. Conclusion. Exercise tolerance in COPD patients depends on severity of bronchoobstruction, lung hyperinflation and MTCSA. Severity of bronchoobstruction and lung hyperinflation have significant impact on dyspnea level.

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