AN ASSESSMENT ON RELATIONSHIP OF FEV1 WITH CARDIAC COMPLICATION IN PATIENTS WITH COPD EXACERBATION - A RETROSPECTIVE STUDY

Shahanaz M.* and Sreeja P. A.

ABSTRACT

Objective: To assess the prevalence and various risk factors for COPD, to categorize the COPD patients using dyspnea scale and to identify the various cardiac complications among COPD exacerbative patients.Also to assess the relationship of FEV1 with cardiac complication in patients with COPD exacerbation. Method: Subjects agedbetween 30 to 65 yrs (n=420) were included in the analysis. The clinical examination data’s and patient history was collected in a predesigned data entry form. The percentage was calculated by using MS excel. Result: Out of 420 COPD patients, about 49.5%(n=99) were without CVDs and about 50.5%(n=101) were with CVDs. Male gender(66%) is more susceptible to COPD than female gender(34%). Age group between 61-65(62%) and 56-60 (29%) are more prone to COPD.Results shows that, cigarette smoking is one of the major risk factor in both subject categories, it is of about 69.7% and 52.5% respectively. Other major risk factors are smoke exposure (16.2% & 31.6% respectively).Patients with COPD had significantly higher incidence of grade-2(29.3%) and grade-3(40.4%).Also COPD patients with CVD had significantly higher incidence of Mmrc dyspnea scale 4 (49.5%) and 5 (50.4%). In COPD patients with CVD, most commonly symptom assosiated CVD is systemic hypertension(HTN), 41.50%. Followed by coronary artery disease(CAD) 25.70% patients. Other assosiated CVDs were pulmonary arterial hypertension(PAH) (20.70%), corpulmonale(6.93%), cardiac arrhythmias(2.97%) and atherosclerosis(1.98%). Conclusion: These findings support the conclusion that the risk of COPD and assosiated cardiac comorbidites was more in elder patients above age 50 and it was prominent in males comparing to females. COPD and cardiac comorbidites was more prevalent among smokers. Most of the COPD patients without CVD belongs to Mmrcdyspnea scale 2 and 3 i.e; mild to moderate where as COPD patients with CVD belongs to grade 4 and 5. From this study it is found that the risk of cardiac complication is high in COPD patients having lower FEV1. In this particular study the common cardiac comorbidity associated CVD is systemic hypertension (HTN). Followed by coronary artery disease and the other associated CVDs were pulmonary arterial hypertension (PAH), corpulmonale, cardiac arrhythmias and atherosclerosis. The study concluded that patients with COPD with dyspnea scale grading IV and V and FEV1 ˂ 50 were more prone to show CVD complication and thus dyspnea scale and FEV1 can be used as predictor for such COPD patients. This will help the physician to be aware while treating patients with COPD. By understanding the association between the two disease entities may enable improved CVD risk prediction in patients with COPD by identifying those individuals at higher risk of CVD morbidity and mortality.

Keywords: Cardiovascular Disease(CVD), Forced expiratory volume(FEV1), Chronic Obstructive Pulmonary Disease(COPD), Coronary Artery Disease(CAD), Congestive Cardiac Failure(CCF), Systemic hypertension(HTN), Pulmonary artery hypertension(PAH), Peripheral vascular di