Herz

, Volume 39, Issue 1, pp 53–57 | Cite as

COPD und Herzerkrankung

Schwerpunkt

Zusammenfassung

Kardiovaskuläre Begleiterkrankungen sind häufig bei Patienten mit chronisch-obstruktiver Lungenerkrankung („chronic obstructive pulmonary disease“, COPD). Ungefähr ein Drittel der Patienten mit COPD verstirbt aufgrund der kardiovaskulären Begleiterkrankungen. Overlap-Syndrom (COPD und obstruktive Schlafapnoe), pulmonale Hypertonie und Lungenüberblähung sind weitere Einflussfaktoren der kardiovaskulären Funktion von Patienten mit COPD.

Schlüsselwörter

Chronisch-obstruktive Lungenerkrankung Kardiovaskuläres Risiko Kardiale Dysfunktion Pulmonale Hypertonie Overlap-Syndrom 

COPD and heart disease

Abstract

Cardiovascular diseases are highly prevalent in patients with chronic obstructive pulmonary disease (COPD). Approximately one out of three patients with COPD dies of cardiovascular disease. Overlap syndrome (COPD and obstructive sleep apnea), pulmonary hypertension and lung hyperinflation have a further impact on cardiovascular function in patients with COPD.

Keywords

Chronic obstructive pulmonary disease Cardiovascular risk Cardiac dysfunction Pulmonary hypertension Overlap syndrome 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt. H. Watz und M. Arzt geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

Literatur

  1. 1.
    Wrobel JP, Thompson BR, Williams TJ (2012) Mechanisms of pulmonary hypertension in chronic obstructive pulmonary disease: a pathophysiologic review. J Heart Lung Transplant 31:557–564PubMedCrossRefGoogle Scholar
  2. 2.
    Minai OA, Chaouat A, Adnot S (2010) Pulmonary hypertension in COPD: epidemiology, significance, and management: pulmonary vascular disease: the global perspective. Chest 137:39S–51SPubMedCrossRefGoogle Scholar
  3. 3.
    Hilde JM, Skjorten I, Hansteen V et al (2013) Haemodynamic responses to exercise in patients with COPD. Eur Respir J 41:1031–1041PubMedCrossRefGoogle Scholar
  4. 4.
    Scharf SM, Iqbal M, Keller C et al (2002) Hemodynamic characterization of patients with severe emphysema. Am J Respir Crit Care Med 166:314–322PubMedCrossRefGoogle Scholar
  5. 5.
    Chaouat A, Bugnet AS, Kadaoui N et al (2005) Severe pulmonary hypertension and chronic obstructive pulmonary disease. Am J Respir Crit Care Med 172:189–194PubMedCrossRefGoogle Scholar
  6. 6.
    Hurdman J, Condliffe R, Elliot CA et al (2013) Pulmonary hypertension in COPD: results from the ASPIRE registry. Eur Respir J 41:1292–1301PubMedCrossRefGoogle Scholar
  7. 7.
    Stolz D, Rasch H, Linka A et al (2008) A randomised, controlled trial of bosentan in severe COPD. Eur Respir J 32:619–628PubMedCrossRefGoogle Scholar
  8. 8.
    Blanco I, Gimeno E, Munoz PA et al (2010) Hemodynamic and gas exchange effects of sildenafil in patients with chronic obstructive pulmonary disease and pulmonary hypertension. Am J Respir Crit Care Med 181:270–278PubMedCrossRefGoogle Scholar
  9. 9.
    Fisher MR, Criner GJ, Fishman AP et al (2007) Estimating pulmonary artery pressures by echocardiography in patients with emphysema. Eur Respir J 30:914–921PubMedCrossRefGoogle Scholar
  10. 10.
    Iyer AS, Wells JM, Vishin S et al (2013) CT measured pulmonary artery to aorta ratio and echocardiography for detecting pulmonary hypertension in severe COPD. Chest [Epub ahead of print]Google Scholar
  11. 11.
    Wells JM, Washko GR, Han MK et al (2012) Pulmonary arterial enlargement and acute exacerbations of COPD. N Engl J Med 367:913–921PubMedCentralPubMedCrossRefGoogle Scholar
  12. 12.
    Butler J, Schrijen F, Henriquez A et al (1988) Cause of the raised wedge pressure on exercise in chronic obstructive pulmonary disease. Am Rev Respir Dis 138:350–354PubMedCrossRefGoogle Scholar
  13. 13.
    Boussuges A, Pinet C, Molenat F et al (2000) Left atrial and ventricular filling in chronic obstructive pulmonary disease. An echocardiographic and Doppler study. Am J Respir Crit Care Med 162:670–675PubMedCrossRefGoogle Scholar
  14. 14.
    Funk GC, Lang I, Schenk P et al (2008) Left ventricular diastolic dysfunction in patients with COPD in the presence and absence of elevated pulmonary arterial pressure. Chest 133:1354–1359PubMedCrossRefGoogle Scholar
  15. 15.
    Criner GJ, Scharf SM, Falk JA et al (2007) Effect of lung volume reduction surgery on resting pulmonary hemodynamics in severe emphysema. Am J Respir Crit Care Med 176:253–260PubMedCentralPubMedCrossRefGoogle Scholar
  16. 16.
    Jorgensen K, Houltz E, Westfelt U et al (2003) Effects of lung volume reduction surgery on left ventricular diastolic filling and dimensions in patients with severe emphysema. Chest 124:1863–1870PubMedCrossRefGoogle Scholar
  17. 17.
    Jorgensen K, Muller MF, Nel J et al (2007) Reduced intrathoracic blood volume and left and right ventricular dimensions in patients with severe emphysema: an MRI study. Chest 131:1050–1057PubMedCrossRefGoogle Scholar
  18. 18.
    Barr RG, Bluemke DA, Ahmed FS et al (2010) Percent emphysema, airflow obstruction, and impaired left ventricular filling. N Engl J Med 362:217–227PubMedCentralPubMedCrossRefGoogle Scholar
  19. 19.
    Grau M, Barr RG, Lima JA et al (2013) Percent emphysema and right ventricular structure and function: the Multi-Ethnic Study of Atherosclerosis-Lung and Multi-Ethnic Study of Atherosclerosis-Right Ventricle Studies. Chest 144:136–144PubMedCrossRefGoogle Scholar
  20. 20.
    Smith BM, Prince MR, Hoffman EA et al (2013) Impaired left ventricular filling in COPD and emphysema: is it the heart or the lungs? The Multi-Ethnic Study of Atherosclerosis COPD Study. Chest 144:1143–1151PubMedCrossRefGoogle Scholar
  21. 21.
    Watz H, Waschki B, Meyer T et al (2010) Decreasing cardiac chamber sizes and associated heart dysfunction in COPD: role of hyperinflation. Chest 138:32–38PubMedCrossRefGoogle Scholar
  22. 22.
    Watz H, Waschki B, Boehme C et al (2008) Extrapulmonary effects of chronic obstructive pulmonary disease on physical activity: a cross-sectional study. Am J Respir Crit Care Med 177:743–751PubMedCrossRefGoogle Scholar
  23. 23.
    Travers J, Laveneziana P, Webb KA et al (2007) Effect of tiotropium bromide on the cardiovascular response to exercise in COPD. Respir Med 101:2017–2024PubMedCrossRefGoogle Scholar
  24. 24.
    Nojiri T, Yamamoto K, Maeda H et al (2012) Effects of inhaled tiotropium on left ventricular diastolic function in chronic obstructive pulmonary disease patients after pulmonary resection. Ann Thorac Cardiovasc Surg 18:206–211PubMedCrossRefGoogle Scholar
  25. 25.
    Sin DD, Anthonisen NR, Soriano JB, Agusti AG (2006) Mortality in COPD: role of comorbidities. Eur Respir J 28:1245–1257PubMedCrossRefGoogle Scholar
  26. 26.
    Sin DD, Man SF (2005) Chronic obstructive pulmonary disease as a risk factor for cardiovascular morbidity and mortality. Proc Am Thorac Soc 2:8–11PubMedCrossRefGoogle Scholar
  27. 27.
    Mannino DM, Thorn D, Swensen A, Holguin F (2008) Prevalence and outcomes of diabetes, hypertension and cardiovascular disease in COPD. Eur Respir J 32:962–969PubMedCrossRefGoogle Scholar
  28. 28.
    Vestbo J, Hurd SS, Agusti AG et al (2013) Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 187:347–365PubMedCrossRefGoogle Scholar
  29. 29.
    Anthonisen NR, Skeans MA, Wise RA et al (2005) The effects of a smoking cessation intervention on 14.5-year mortality: a randomized clinical trial. Ann Intern Med 142:233–239PubMedCrossRefGoogle Scholar
  30. 30.
    Calverley PM, Anderson JA, Celli B et al (2007) Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease. N Engl J Med 356:775–789PubMedCrossRefGoogle Scholar
  31. 31.
    Tockman MS, Comstock GW (1989) Respiratory risk factors and mortality: longitudinal studies in Washington County, Maryland. Am Rev Respir Dis 140:S56–S63PubMedCrossRefGoogle Scholar
  32. 32.
    MacNee W, Maclay J, McAllister D (2008) Cardiovascular injury and repair in chronic obstructive pulmonary disease. Proc Am Thorac Soc 5:824–833PubMedCentralPubMedCrossRefGoogle Scholar
  33. 33.
    McNicholas WT (2009) Chronic obstructive pulmonary disease and obstructive sleep apnea: overlaps in pathophysiology, systemic inflammation, and cardiovascular disease. Am J Respir Crit Care Med 180:692–700PubMedCrossRefGoogle Scholar
  34. 34.
    Decramer M, Janssens W (2013) Chronic obstructive pulmonary disease and comorbidities. Lancet Respir Med 1:73–83PubMedCrossRefGoogle Scholar
  35. 35.
    Waschki B, Kirsten A, Holz O et al (2011) Physical activity is the strongest predictor of all-cause mortality in patients with COPD: a prospective cohort study. Chest 140:331–342PubMedCrossRefGoogle Scholar
  36. 36.
    Jorres RA, Welte T, Bals R et al (2010) Systemic manifestations and comorbidities in patients with chronic obstructive pulmonary disease (COPD) and their effect on clinical state and course of the disease – an overview of the cohort study COSYCONET. Dtsch Med Wochenschr 135:446–449PubMedCrossRefGoogle Scholar
  37. 37.
    Bednarek M, Plywaczewski R, Jonczak L, Zielinski J (2005) There is no relationship between chronic obstructive pulmonary disease and obstructive sleep apnea syndrome: a population study. Respiration 72:142–149PubMedCrossRefGoogle Scholar
  38. 38.
    Larsson LG, Lindberg A, Franklin KA, Lundbäck B (2001) Obstructive sleep apnoea syndrome is common in subjects with chronic bronchitis. Report from the Obstructive Lung Disease in Northern Sweden studies. Respiration 68:250–255PubMedCrossRefGoogle Scholar
  39. 39.
    Chaouat A, Weitzenblum E, Krieger J et al (1995) Association of chronic obstructive pulmonary disease and sleep apnea syndrome. Am J Respir Crit Care Med 151:82–86PubMedCrossRefGoogle Scholar
  40. 40.
    Resta O, Foschino Barbaro MP, Brindicci C et al (2002) Hypercapnia in overlap syndrome: possible determinant factors. Sleep Breath 6:11–18PubMedCrossRefGoogle Scholar
  41. 41.
    Shepard JW Jr, Garrison MW, Grither DA et al (1985) Relationship of ventricular ectopy to nocturnal oxygen desaturation in patients with chronic obstructive pulmonary disease. Am J Med 78:28–34PubMedCrossRefGoogle Scholar
  42. 42.
    Weitzenblum E, Krieger J, Apprill M et al (1988) Daytime pulmonary hypertension in patients with obstructive sleep apnea syndrome. Am Rev Respir Dis 138:345–349PubMedCrossRefGoogle Scholar
  43. 43.
    Bradley TD, Rutherford R, Grossman RF et al (1985) Role of daytime hypoxemia in the pathogenesis of right heart failure in the obstructive sleep apnea syndrome. Am Rev Respir Dis 131:835–839PubMedGoogle Scholar
  44. 44.
    Marin JM, Soriano JB, Carrizo SJ et al (2010) Outcomes in patients with chronic obstructive pulmonary disease and obstructive sleep apnea: the overlap syndrome. Am J Respir Crit Care Med 182:325–331PubMedCrossRefGoogle Scholar
  45. 45.
    Hansson GK (2005) Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med 352:1685–1695PubMedCrossRefGoogle Scholar
  46. 46.
    Sheifer SE, Rathore SS, Gersh BJ et al (2000) Time to presentation with acute myocardial infarction in the elderly: associations with race, sex, and socioeconomic characteristics. Circulation 102:1651–1656PubMedCrossRefGoogle Scholar
  47. 47.
    Kjoller E, Kober L, Iversen K, Torp-Pedersen C (2004) Importance of chronic obstructive pulmonary disease for prognosis and diagnosis of congestive heart failure in patients with acute myocardial infarction. Eur J Heart Fail 6:71–77PubMedCrossRefGoogle Scholar
  48. 48.
    Campo G, Guastaroba P, Marzocchi A et al (2013) Impact of COPD on long-term outcome after ST-segment elevation myocardial infarction receiving primary percutaneous coronary intervention. Chest 144:750–757PubMedCrossRefGoogle Scholar
  49. 49.
    Short PM, Lipworth SI, Elder DH et al (2011) Effect of beta blockers in treatment of chronic obstructive pulmonary disease: a retrospective cohort study. BMJ 342:d2549PubMedCentralPubMedCrossRefGoogle Scholar
  50. 50.
    Quint JK, Herrett E, Bhaskaran K et al (2013) Effect of beta blockers on mortality after myocardial infarction in adults with COPD: population based cohort study of UK electronic healthcare records. BMJ 347:f6650PubMedCentralPubMedCrossRefGoogle Scholar
  51. 51.
    Nussbaumer-Ochsner Y, Rabe KF (2011) Systemic manifestations of COPD. Chest 139:165–173PubMedCrossRefGoogle Scholar

Copyright information

© Urban & Vogel 2014

Authors and Affiliations

  1. 1.Pneumologisches ForschungsinstitutLungenClinic Grosshansdorf GmbHGroßhansdorfDeutschland
  2. 2.Klinik und Poliklinik für Innere Medizin IIUniversitätsklinikum RegensburgRegensburgDeutschland

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