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Komorbiditäten bei COPD

Comorbidities of COPD

Der Internist volume 47, pages 895–900 (2006)Cite this article

Zusammenfassung

Die chronisch obstruktive Bronchitis und das Lungenemphysem (COPD) gehen häufig mit Begleiterkrankungen (Komorbiditäten) einher. Kardiovaskuläre Erkrankungen, Gewichtsverlust, Verlust der fettfreien Masse verbunden mit Muskeldysfunktion, Osteoporose und Depression sind die häufigsten Komorbiditäten bei COPD. Kardiovaskuläre Komorbiditäten, Gewichtsverlust und der Verlust an fettfreier Masse sind Prädiktoren für die Mortalität von Patienten mit chronisch obstruktiver Lungenerkrankung. Dementsprechend sind die extrapulmonalen Manifestationen der COPD für die klinische Einschätzung bedeutsam. Die systemische Inflammation ist möglicherweise der Schlüssel zum Verständnis dieser extrapulmonalen Manifestationen.

Abstract

Chronic obstructive pulmonary disease (COPD) is often associated with comorbidities. Cardiovascular diseases, weight loss, loss of fat free mass combined with muscle dysfunction, osteoporosis and depression are the main comorbidities in COPD. Cardiovascular comorbidities, weight loss and loss of fat free mass are predictors of mortality of patients with COPD. Thus, the extrapulmonary manifestations are meaningful parameters of clinical assessment. Systemic inflammation is probably the key to the extrapulmonary signs of COPD.

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Literatur

  1. Agusti AG, Noguera A, Sauleda J et al. (2003) Systemic effects of chronic obstructive pulmonary disease. Eur Respir J 21: 347–360

    Article  PubMed  Google Scholar 

  2. Anthonisen NR, Connett JE, Enright PL, Manfreda J (2002) Hospitalizations and mortality in the Lung Health Study. Am J Respir Crit Care Med 166: 333–339

    Article  PubMed  Google Scholar 

  3. ATS/ERS (1999) Skeletal muscle dysfunction in chronic obstructive pulmonary disease. A statement of the American Thoracic Society and European Respiratory Society. Am J Respir Crit Care Med 159: S1–40

    PubMed  Google Scholar 

  4. Berger JS, Sanborn TA, Sherman W, Brown DL (2004) Effect of chronic obstructive pulmonary disease on survival of patients with coronary heart disease having percutaneous coronary intervention. Am J Cardiol 94: 649–651

    Article  PubMed  Google Scholar 

  5. Bolton CE, Ionescu AA, Shiels KM et al. (2004) Associated loss of fat-free mass and bone mineral density in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 170: 1286–1293

    Article  PubMed  Google Scholar 

  6. Brenes GA (2003) Anxiety and chronic obstructive pulmonary disease: prevalence, impact, and treatment. Psychosom Med 65: 963–970

    Article  PubMed  Google Scholar 

  7. Buch P, Friberg J, Scharling H et al. (2003) Reduced lung function and risk of atrial fibrillation in the Copenhagen City Heart Study. Eur Respir J 21: 1012–1016

    PubMed  Google Scholar 

  8. Burnett D, Chamba A, Hill SL, Stockley RA (1987) Neutrophils from subjects with chronic obstructive lung disease show enhanced chemotaxis and extracellular proteolysis. Lancet 2: 1043–1046

    Article  PubMed  Google Scholar 

  9. Celli BR, Macnee W (2004) Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J 23: 932–946

    PubMed  Google Scholar 

  10. Chaouat A, Bugnet AS, Kadaoui N et al. (2005) Severe pulmonary hypertension and chronic obstructive pulmonary disease. Am J Respir Crit Care Med 172: 189–194

    Article  PubMed  Google Scholar 

  11. Dahl M, Tybjaerg-Hansen A, Vestbo J et al. (2001) Elevated plasma fibrinogen associated with reduced pulmonary function and increased risk of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 164: 1008–1011

    PubMed  Google Scholar 

  12. de Vries F, van Staa TP, Bracke MS et al. (2005) Severity of obstructive airway disease and risk of osteoporotic fracture. Eur Respir J 25: 879–884

    Article  PubMed  Google Scholar 

  13. de Godoy I, Donahoe M, Calhoun WJ et al. (1996) Elevated TNF-alpha production by peripheral blood monocytes of weight-losing COPD patients. Am J Respir Crit Care Med 153: 633–637

    PubMed  Google Scholar 

  14. Di Francia M, Barbier D, Mege JL, Orehek J (1994) Tumor necrosis factor-alpha levels and weight loss in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 150: 1453–1455

    PubMed  Google Scholar 

  15. Eid AA, Ionescu AA, Nixon LS et al. (2001) Inflammatory response and body composition in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 164: 1414–1418

    PubMed  Google Scholar 

  16. Engstrom G, Lind P, Hedblad B et al. (2002) Lung function and cardiovascular risk: relationship with inflammation-sensitive plasma proteins. Circulation 106: 2555–2560

    Article  PubMed  Google Scholar 

  17. Engstrom G, Wollmer P, Hedblad B et al. (2001) Occurrence and prognostic significance of ventricular arrhythmia is related to pulmonary function: a study from „men born in 1914,“ Malmo, Sweden. Circulation 103: 3086–3091

    PubMed  Google Scholar 

  18. Gan WQ, Man SF, Senthilselvan A, Sin DD (2004) Association between chronic obstructive pulmonary disease and systemic inflammation: a systematic review and a meta-analysis. Thorax 59: 574–580

    Article  PubMed  Google Scholar 

  19. Gudmundsson G, Gislason T, Janson C et al. (2005) Risk factors for rehospitalisation in COPD: role of health status, anxiety and depression. Eur Respir J 26: 414–419

    Article  PubMed  Google Scholar 

  20. Hogg JC, Chu F, Utokaparch S et al. (2004) The nature of small-airway obstruction in chronic obstructive pulmonary disease. N Engl J Med 350: 2645–2653

    Article  PubMed  Google Scholar 

  21. Hole DJ, Watt GC, Davey-Smith G et al. (1996) Impaired lung function and mortality risk in men and women: findings from the Renfrew and Paisley prospective population study. BMJ 313: 711–715

    PubMed  Google Scholar 

  22. Incalzi RA, Caradonna P, Ranieri P et al. (2000) Correlates of osteoporosis in chronic obstructive pulmonary disease. Respir Med 94: 1079–1084

    Article  PubMed  Google Scholar 

  23. Ionescu AA, Schoon E (2003) Osteoporosis in chronic obstructive pulmonary disease. Eur Respir J 46 [Suppl]: 64s–75s

    Google Scholar 

  24. Kessler R, Faller M, Weitzenblum E et al. (2001) „Natural history“ of pulmonary hypertension in a series of 131 patients with chronic obstructive lung disease. Am J Respir Crit Care Med 164: 219–224

    PubMed  Google Scholar 

  25. Landbo C, Prescott E, Lange P et al. (1999) Prognostic value of nutritional status in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 160: 1856–1861

    PubMed  Google Scholar 

  26. Lee TA, Weiss KB (2004) Fracture risk associated with inhaled corticosteroid use in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 169: 855–859

    Article  PubMed  Google Scholar 

  27. Maccallum PK (2005) Markers of hemostasis and systemic inflammation in heart disease and atherosclerosis in smokers. Proc Am Thorac Soc 2: 34–43

    Article  PubMed  Google Scholar 

  28. Macnee W (2005) Pulmonary and systemic oxidant/antioxidant imbalance in chronic obstructive pulmonary disease. Proc Am Thorac Soc 2: 50–60

    Article  PubMed  Google Scholar 

  29. Mador MJ, Bozkanat E (2001) Skeletal muscle dysfunction in chronic obstructive pulmonary disease. Respir Res 2: 216–224

    Article  PubMed  Google Scholar 

  30. Mapel DW, Dedrick D, Davis K (2005) Trends and cardiovascular co-morbidities of COPD patients in the veterans administration medical system, 1991–1999. J COPD 2: 35–41

    Google Scholar 

  31. McEvoy CE, Ensrud KE, Bender E et al. (1998) Association between corticosteroid use and vertebral fractures in older men with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 157: 704–709

    PubMed  Google Scholar 

  32. Naeije R (2005) Pulmonary hypertension and right heart failure in chronic obstructive pulmonary disease. Proc Am Thorac Soc 2: 20–22

    Article  PubMed  Google Scholar 

  33. Noguera A, Batle S, Miralles C et al. (2001) Enhanced neutrophil response in chronic obstructive pulmonary disease. Thorax 56: 432–437

    Article  PubMed  Google Scholar 

  34. Pauwels RA, Lofdahl CG, Laitinen LA et al. (1999) Long-term treatment with inhaled budesonide in persons with mild chronic obstructive pulmonary disease who continue smoking. European Respiratory Society Study on Chronic Obstructive Pulmonary Disease. N Engl J Med 340: 1948–1953

    Article  PubMed  Google Scholar 

  35. Pinto-Plata VM, Mullerova H, Toso JF et al. (2006) C-reactive protein in patients with COPD, control smokers and non-smokers. Thorax 61: 23–28

    Article  PubMed  Google Scholar 

  36. Ridker PM, Rifai N, Rose L et al. (2002) Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events. N Engl J Med 347: 1557–1565

    Article  PubMed  Google Scholar 

  37. Scanlon PD, Connett JE, Wise RA et al. (2004) Loss of bone density with inhaled triamcinolone in Lung Health Study II. Am J Respir Crit Care Med 170: 1302–1309

    Article  PubMed  Google Scholar 

  38. Schols AM, Soeters PB, Dingemans AM et al. (1993) Prevalence and characteristics of nutritional depletion in patients with stable COPD eligible for pulmonary rehabilitation. Am Rev Respir Dis 147: 1151–1156

    PubMed  Google Scholar 

  39. Schunemann HJ, Dorn J, Grant BJ et al. (2000) Pulmonary function is a long-term predictor of mortality in the general population: 29-year follow-up of the Buffalo Health Study. Chest 118: 656–664

    Article  PubMed  Google Scholar 

  40. Sin DD, Man JP, Man SF (2003) The risk of osteoporosis in Caucasian men and women with obstructive airways disease. Am J Med 114: 10–14

    Article  PubMed  Google Scholar 

  41. Sin DD, Man SF (2003) Why are patients with chronic obstructive pulmonary disease at increased risk of cardiovascular diseases? The potential role of systemic inflammation in chronic obstructive pulmonary disease. Circulation 107: 1514–1519

    Article  PubMed  Google Scholar 

  42. Sin DD, Man SF (2005) Chronic obstructive pulmonary disease as a risk factor for cardiovascular morbidity and mortality. Proc Am Thorac Soc 2: 8–11

    Article  PubMed  Google Scholar 

  43. Sin DD, Man SF (2006) Skeletal muscle weakness, reduced exercise tolerance, and COPD: is systemic inflammation the missing link? Thorax 61: 1–3

    Article  PubMed  Google Scholar 

  44. Sin DD, Wu L, Man SF (2005) The relationship between reduced lung function and cardiovascular mortality: a population-based study and a systematic review of the literature. Chest 127: 1952–1959

    Article  PubMed  Google Scholar 

  45. Thabut G, Dauriat G, Stern JB et al. (2005) Pulmonary hemodynamics in advanced COPD candidates for lung volume reduction surgery or lung transplantation. Chest 127: 1531–1536

    Article  PubMed  Google Scholar 

  46. Tockman MS, Comstock GW (1989) Respiratory risk factors and mortality: longitudinal studies in Washington County, Maryland. Am Rev Respir Dis 140: S56–S63

    PubMed  Google Scholar 

  47. van Manen JG, Bindels PJ, Dekker FW et al. (2002) Risk of depression in patients with chronic obstructive pulmonary disease and its determinants. Thorax 57: 412–416

    Article  PubMed  Google Scholar 

  48. Vermeeren MA, Creutzberg EC, Schols AM et al. in behalf of the COSMIC Study Group (2006) Prevalence of nutritional depletion in a large out-patient population of patients with COPD. Respir Med [epub ahead of print]

  49. Vestbo J, Prescott E, Almdal T et al. (2006) Body mass, fat-free body mass, and prognosis in patients with chronic obstructive pulmonary disease from a random population sample: findings from the Copenhagen City Heart Study. Am J Respir Crit Care Med 173: 79–83

    Article  PubMed  Google Scholar 

  50. Wagena EJ, Arrindell WA, Wouters EF, van Schayck CP (2005) Are patients with COPD psychologically distressed? Eur Respir J 26: 242–248

    Article  PubMed  Google Scholar 

  51. Walsh LJ, Lewis SA, Wong CA et al. (2002) The impact of oral corticosteroid use on bone mineral density and vertebral fracture. Am J Respir Crit Care Med 166: 691–695

    Article  PubMed  Google Scholar 

  52. Weitzenblum E, Sautegeau A, Ehrhart M et al. (1984) Long-term course of pulmonary arterial pressure in chronic obstructive pulmonary disease. Am Rev Respir Dis 130: 993–998

    PubMed  Google Scholar 

  53. Workshop Report (2005) Global Initiative for Chronic Obstructive Lung Disease (GOLD) Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease NHLBI/WHO Workshop Report. NIH Publication 2701 2001 http://www.gold.com

  54. Wouters EF (2005) Local and systemic inflammation in chronic obstructive pulmonary disease. Proc Am Thorac Soc 2: 26–33

    Article  PubMed  Google Scholar 

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Affiliations

  1. Krankenhaus Großhansdorf, Zentrum für Pneumologie und Thoraxchirurgie und Pneumologisches Forschungsinstitut am Krankenhaus Großhansdorf

    H. Watz &  H. Magnussen

  2. Krankenhaus Großhansdorf, Zentrum für Pneumologie und Thoraxchirurgie, Wöhrendamm 80, 22927, Großhansdorf

    H. Magnussen

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  1. H. Watz
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  2. H. Magnussen
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Correspondence to H. Magnussen.

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Watz, H., Magnussen, H. Komorbiditäten bei COPD. Internist 47, 895–900 (2006). https://doi.org/10.1007/s00108-006-1675-y

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  • DOI: https://doi.org/10.1007/s00108-006-1675-y

Schlüsselwörter

  • Chronisch obstruktive Bronchitis
  • Lungenemphysem
  • Komorbiditäten
  • Kardiovaskuläre Mortalität

Keywords

  • COPD
  • Chronic obstructive pulmonary disease
  • Comorbidities
  • Cardiovascular mortality