Terapevticheskii arkhiv · 2025
[Prognostic significance of pulmonary ventilation disorders in the development of arrhythmia recurrence in patients with chronic obstructive pulmonary disease and paroxysmal atrial fibrillation].
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Podzolkov V I, Tarzimanova A I, Kazantseva E V
Аннотация
AIM: To evaluate the prognostic value of pulmonary ventilation disorders in the development of arrhythmia recurrence in patients with chronic obstructive pulmonary disease (COPD) and paroxysmal atrial fibrillation (AF).
MATERIALS AND METHODS: The study included 387 patients with COPD, who were divided into two groups: group 1 consisted of 54 (13.9%) patients with COPD and paroxysmal AF, who had AF paroxysm during hospitalization; group 2 (comparison group) - 333 (86.1%) patients with COPD without arrhythmia.
RESULTS: Significantly more severe bronchial obstruction was found in group 1 patients than in group 2 patients. A one-factor regression analysis revealed that a decrease in forced exhalation volume in 1st second of less than 35% increased the risk of AF recurrence in patients with COPD by 2.49 times (odds ratio 0.401, 95% confidence interval 0.218-0.856; p=0.012). According to the results of bodyplethysmography, patients in group 1 showed a significant decrease in the diffusion capacity of the lungs for carbon monoxide, an increase in aerodynamic and specific bronchial resistance compared with group 2, a decrease in the diffusion capacity of the lungs of less than 8 ml/min/mm. Mercury increased the risk of AF paroxysm in COPD patients by 1.297 times (odds ratio 0.771, 95% confidence interval 0.53-0.92; p=0.013). To assess the risk of arrhythmia recurrence in patients with COPD and paroxysmal AF, we developed a mathematical model (sensitivity - 73.8%, specificity - 70.3%).
CONCLUSION: Decreased ventilation capacity of the lungs increases the risk of arrhythmia recurrence in patients with COPD and paroxysmal AF.
MATERIALS AND METHODS: The study included 387 patients with COPD, who were divided into two groups: group 1 consisted of 54 (13.9%) patients with COPD and paroxysmal AF, who had AF paroxysm during hospitalization; group 2 (comparison group) - 333 (86.1%) patients with COPD without arrhythmia.
RESULTS: Significantly more severe bronchial obstruction was found in group 1 patients than in group 2 patients. A one-factor regression analysis revealed that a decrease in forced exhalation volume in 1st second of less than 35% increased the risk of AF recurrence in patients with COPD by 2.49 times (odds ratio 0.401, 95% confidence interval 0.218-0.856; p=0.012). According to the results of bodyplethysmography, patients in group 1 showed a significant decrease in the diffusion capacity of the lungs for carbon monoxide, an increase in aerodynamic and specific bronchial resistance compared with group 2, a decrease in the diffusion capacity of the lungs of less than 8 ml/min/mm. Mercury increased the risk of AF paroxysm in COPD patients by 1.297 times (odds ratio 0.771, 95% confidence interval 0.53-0.92; p=0.013). To assess the risk of arrhythmia recurrence in patients with COPD and paroxysmal AF, we developed a mathematical model (sensitivity - 73.8%, specificity - 70.3%).
CONCLUSION: Decreased ventilation capacity of the lungs increases the risk of arrhythmia recurrence in patients with COPD and paroxysmal AF.