scholarly journals Echocardiographic Evaluation of Patients with Chronic Obstructive Pulmonary Disease

Author(s):  
Shishirakumar A. Goudar ◽  
Virendra Chandrashekhar Patil

There is an overlap of risk factors between heart disease and COPD like cigarette smoking, sedentary lifestyle and old age. The economic burden of COPD is also very high. It is now proven that the only strategy which can reduce COPD incidence is cessation of smoking. The Aim of the present research is to study the Two-dimensional transthoracic Echocardiography (TTE) findings in patients with chronic obstructive pulmonary disease (COPD).The method is that all the enrolled patients were subjected to chest radiography, pulmonary function test, Two-dimensional transthoracic echocardiogram and Doppler study, according to the standard protocol. The findings in our study are consistent with previous studies about the COPD. Total 111(60.7%) of the patients had echocardiographic evidence of pulmonary hypertension and 83(45.4%) of the patients in this study had evidence of cor pulmonale.  We found significant difference between the duration of smoking and severity of the disease based on FEV1 values (p= 0.005). A significant moderate inverse correlation existed between pack years of smoking and FEV1 scores. (r= - 0.379, P < 0.001).

Author(s):  
Elena Jurevičienė ◽  
Greta Burneikaitė ◽  
Laimis Dambrauskas ◽  
Vytautas Kasiulevičius ◽  
Edita Kazėnaitė ◽  
...  

Various comorbidities and multimorbidity frequently occur in chronic obstructive pulmonary disease (COPD), leading to the overload of health care systems and increased mortality. We aimed to assess the impact of COPD on the probability and clustering of comorbidities. The cross-sectional analysis of the nationwide Lithuanian database was performed based on the entries of the codes of chronic diseases. COPD was defined on the code J44.8 entry and six-month consumption of bronchodilators. Descriptive statistics and odds ratios (ORs) for associations and agglomerative hierarchical clustering were carried out. 321,297 patients aged 40–79 years were included; 4834 of them had COPD. A significantly higher prevalence of cardiovascular diseases (CVD), lung cancer, kidney diseases, and the association of COPD with six-fold higher odds of lung cancer (OR 6.66; p < 0.0001), a two-fold of heart failure (OR 2.61; p < 0.0001), and CVD (OR 1.83; p < 0.0001) was found. Six clusters in COPD males and five in females were pointed out, in patients without COPD—five and four clusters accordingly. The most prevalent cardiovascular cluster had no significant difference according to sex or COPD presence, but a different linkage of dyslipidemia was found. The study raises the need to elaborate adjusted multimorbidity case management and screening tools enabling better outcomes.


Author(s):  
Narachai Prasungriyo ◽  
Nungruthai Sooksai

Objective: To investigate the effects of pharmacy counseling on clinical and economic outcomes in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) patients.Material and Methods: The outcomes consisted of 28-day hospital readmissions related to AECOPD, direct costs, medication adherence calculated by proportion of days covered (PDC), and health-related quality of life (HRQoL) measured by chronic obstructive pulmonary disease assessment test (CAT). The data derived from the intervention group, for which pharmacy counseling was provided, was compared with that obtained from the control group provided with usual pharmaceutical care. The study also drew comparisons between the PDC and CAT scores of pre- and postintervention periods.Results: Forty-four patients (23 intervention and 21 control) were included in the analysis. There were no significant differences in the readmission rate (13% vs 19%, p-value>0.050), nor the number of readmitted patients (3 vs 3, p-value >0.050). A decrease in direct costs did not reach statistical significance (p-value>0.050). In addition, no difference between the PDC scores was found (96.67 vs 100.00, p-value>0.050). Intervention patients obtained significantly lower CAT scores than the control patients did (9 vs 19, p-value<0.050). Compared with the pre-intervention period, PDC scores were identical; however, CAT scores measured during the post-intervention period were significantly different.Conclusion: Pharmacy counseling for AECOPD patients could enhance HRQoL. Drug therapy and pulmonary rehabilitation may cause such improvement. Further work, which has adequate participants, is required to detect a significant difference in readmissions between the two groups.


2016 ◽  
Vol 33 (1) ◽  
pp. 8-14 ◽  
Author(s):  
Amber Lanae Smith ◽  
Valerie Palmer ◽  
Nada Farhat ◽  
James S. Kalus ◽  
Krishna Thavarajah ◽  
...  

Background: No systematic evaluations of a comprehensive clinical pharmacy process measures currently exist to determine an optimal ambulatory care collaboration model for chronic obstructive pulmonary disease (COPD) patients. Objective: Describe the impact of a pharmacist-provided clinical COPD bundle on the management of COPD in a hospital-based ambulatory care clinic. Methods: This retrospective cohort analysis evaluated patients with COPD managed in an outpatient pulmonary clinic. The primary objective of this study was to assess the completion of 4 metrics known to improve the management of COPD: (1) medication therapy management, (2) quality measures including smoking cessation and vaccines, (3) patient adherence, and (4) patient education. The secondary objective was to evaluate the impact of the clinical COPD bundle on clinical and economic outcomes at 30 and 90 days post–initial visit. Results: A total of 138 patients were included in the study; 70 patients served as controls and 68 patients received the COPD bundle from the clinical pharmacist. No patients from the control group had all 4 metrics completed as documented, compared to 66 of the COPD bundle group ( P < .0001). Additionally, a statistically significant difference was found in all 4 metrics when evaluated individually. Clinical pharmacy services reduced the number of phone call consults at 90 days ( P = .04) but did not have a statistically significant impact on any additional pre-identified clinical outcomes. Conclusion: A pharmacist-driven clinical COPD bundle was associated with significant increases in the completion and documentation of 4 metrics known to improve the outpatient management of COPD.


2017 ◽  
Vol 5 (6) ◽  
pp. 720-723 ◽  
Author(s):  
Antoaneta Dimitrova ◽  
Nikolay Izov ◽  
Ivan Maznev ◽  
Danche Vasileva ◽  
Milena Nikolova

BACKGROUND: Physiotherapy is an essential for the treatment of patients with chronic respiratory non-inflammatory diseases especially for chronic obstructive pulmonary disease (COPD).AIM: To assess the effect of six months physiotherapy (PT) program on functional status in patients with COPD.МАTERIAL AND METHODS: The patients were divided into two groups according to the severity of the disease. Group A included 33 patients (mean age 68.6 ± 7.3; GOLD II – III stages). Group B included 32 patients (mean age 71.7 ± 6.9; GOLD I –II). They were referred to supervised PT program performed three times weekly for a half a year. All the patients were on standard medical care. At entry and after PT, six minutes walking test (6 MWT), Borg scale and modified Medical Research Council (mMRC) scale were assessed.RESULTS: Significant changes in 6 MWT (р < 0.001) and mMRC scale (р < 0.001) were found after applied physical therapy program in patients of group A. Exertional dyspnoea decreased significantly in patients with group A (р < 0.001). Positive changes were found in physical tolerance in the patients of group B (р < 0.001).CONCLUSIONS: The present study revealed the positive effect of six months physiotherapy in physical tolerance and dyspnoea in patients with COPD at different stages of the disease.


2021 ◽  
Vol 26 (3) ◽  
pp. 34-36
Author(s):  
Nicoleta-Alina Popa ◽  
Adina-Marieta Sipos ◽  
Mircea Ioachim Popescu

Abstract Chronic obstructive pulmonary disease (COPD) is a chronic disease of the respiratory airways due to the partially reversible obstruction of the airflow caused by an abnormal inflammatory response to toxic substances, most often to cigarette smoke.(1) COVID-19 is a mild to severe respiratory disease caused by a coronavirus from the genus Betacoronavirus.(2) Patients with COPD have a major risk of COVID-19 infection. Treating patients with COPD, chronic cor pulmonale and COVID-19 is a current challenge.


Author(s):  
Sarang Patil ◽  
Suresh Patil

Background: Chronic obstructive pulmonary disease (COPD) is a common respiratory condition involving the airways and characterized by airflow limitation. Pulmonary hypertension (PH) is a well-known predictor of increased morbidity and mortality in COPD. The present study was done to assess the cardiac changes in patients diagnosed with COPD in this department using two-dimensional echocardiography.Methods: This observational study was conducted on fifty patients admitted with signs and symptoms suggestive of COPD in the Department of Pulmonary Medicine, Dr. DY Patil Medical College, Navi Mumbai from January 2018 to December 2018. Pulmonary function tests (PFT) were done in all and patients were graded according to the severity of COPD with guidelines given by Global initiative for Obstructive Lung Disease (GOLD). Comprehensive two-dimensional echocardiography was performed.Results: The most common age group was 60 to 69 years. There were 68% males and 32% females. Mean body mass index of the patients included in the study was 27.8±8.13 kg/m2. COPD according to the GOLD classification was mild, moderate, severe and very severe in 12%, 36%, 30% and 22% of the patients. PH was diagnosed in 56% of the patients, Cor pulmonale in 54%, right ventricular dilatation in 48%, right atrial dilatation in 38%, inter-ventricular septal wall motion abnormality in 18% and right ventricular failure in 14% of the patients.Conclusions: Echocardiography examination is a reliable method in COPD patient to assess PH and helps in early detection of cardiac complications in COPD cases giving time for early interventions.


2019 ◽  
Vol 5 (3) ◽  
pp. 69 ◽  
Author(s):  
K.A. Tymruk-Skoropad ◽  
Iu.O. Pavlova ◽  
M.A. Mazepa

<p><strong>The aim</strong><strong>: </strong>to substantiate the structural components of the control system aimed at improving the physical therapist’s work during pulmonary rehabilitation (PR) of COPD persons.</p><p><strong>Materials and methods. </strong>Analysis and generalization of the data of the special scientific and methodological literature on the issues of physical therapy of patients with chronic obstructive pulmonary disease; method of analysis of medical records; elaboration of Internet sources, including databases of evidence based medical literature.<strong></strong></p><p><strong>Results. </strong>The control system, which is reasonable to be implemented at three stages (preliminary, current, final) of the process of physical therapy (PT) and PR of patients with COPD, is substantiated.</p><p>The control system within the competence of the physical therapist provides for rehabilitation examination (preliminary control), monitoring (current control) and final evaluation of certain indicators. There were 5 groups of main indicators: quality of life/ activity and participation, disease course, body functions, body structures, educational competence. For the selected groups of indicators, the selection of measuring instruments was made, the features of their application at different stages were outlined, the values of the minimum clinically significant difference for the selected indicators were given.</p><p><strong>Conclusions. </strong>The process of pulmonary rehabilitation of people with COPD needs to be evaluated and monitored for its effectiveness in accordance with the expected results.</p><p>The monitoring system allows to track all changes in the patient's health and functioning, regulate the intervention and its intensity, evaluate both the individual physical therapy session and the effectiveness of the entire program.</p><p>One of the criteria of the control system is the effectiveness of PT and PR, which is evaluated on the basis of the dynamics and direction of changes of the studied indicators, their compliance with the expected result and taking into account the values of the minimal clinically significant difference for the evaluated indicators.</p>


2019 ◽  
Vol 6 ◽  
Author(s):  
Francesco G. Salerno ◽  
Mauro Carone

Chronic obstructive pulmonary disease (COPD) is a lung disease associated with chronic systemic in- flammatory syndrome. COPD is often associat- ed with comorbidities that need to be evaluated be- cause they affect the severity of the disease. [...]


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