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Kellerer, C.* ; Kahnert, K.* ; Trudzinski, F.C.* ; Lutter, J. ; Berschneider, K.* ; Speicher, T.* ; Watz, H.* ; Bals, R.* ; Welte, T.* ; Vogelmeier, C.F.* ; Jörres, R.A.* ; Alter, P.*

COPD maintenance medication is linked to left atrial size: Results from the COSYCONET cohort.

Respir. Med. 185:106461 (2021)
Publ. Version/Full Text Research data DOI
Open Access Gold (Paid Option)
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BACKGROUND: Lung function impairment in COPD is known to be related to reductions of left heart size, while short-term interventional trials with bronchodilators showed positive effects on cardiac parameters. We investigated whether COPD maintenance therapy has analogous long-term effects. METHODS: Pooled data of GOLD grade 1-4 patients from visits 1 and 3 (1.5 y apart) of the COSYCONET cohort were used. Medication was categorized as use of ICS, LABA + ICS, LABA + LAMA and triple therapy (LABA + LAMA + ICS), contrasting "always" versus "never". Echocardiographic parameters comprised left ventricular end-diastolic and -systolic diameter (LVEDD, LVESD), ejection fraction (LVEF) and left atrial diameter (LA). Associations were identified by multiple regression analysis, as well as propensity score analysis. RESULTS: Overall, 846 patients (mean age 64.5 y; 41% female) were included, 53% using ICS at both visits, 51% LABA + ICS, 56% LABA + LAMA, 40% LABA + LAMA + ICS (triple) therapy. Conversely, 30%, 32%, 28% and 42% had no ICS, LABA + ICS, LABA + LAMA or triple therapy, respectively, at both visits. Among echocardiographic measures, only LA showed statistically significant associations (increases) with medication, whereby significant effects were linked to ICS, LABA + ICS and LABA + LAMA (p < 0.05 each, "always" versus "never") and propensity score analyses underlined the role of LABA + LAMA. CONCLUSIONS: In this observational study, COPD maintenance therapy, especially LABA + LAMA, was linked to left atrial size, consistent with the results of short-term interventional trials. These findings suggest that maintenance medication for COPD does not only improve lung function and patient reported outcomes but may also have an impact on the cardiovascular system. TRIAL REGISTRATION: NCT01245933.
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Publication type Article: Journal article
Document type Scientific Article
Keywords Copd ; Cardiac Size ; Ics ; Laba ; Lama ; Left Atrium ; Maintenance Medication; Ventricular-wall Stress; Lung-function; Airway-obstruction; Percent Emphysema; Pressure-volume; Heart-failure; Hyperinflation; Comorbidities; Deflation; Disease
ISSN (print) / ISBN 0954-6111
e-ISSN 1532-3064
Quellenangaben Volume: 185, Issue: , Pages: , Article Number: 106461 Supplement: ,
Publisher Elsevier
Publishing Place 32 Jamestown Rd, London Nw1 7by, England
Reviewing status Peer reviewed