Noninvasive Assessment and Correlation of Cardiovascular Changes among COPD Patients with Its Prognosis | Chapter 7 | Disease and Health Research: New Insights Vol. 5

Background: Chronic obstructive pulmonary disease (COPD) often co-exists with other co-morbidities or diseases that have an enormous impact on its prognosis. A complex systemic disease with both pulmonary and extrapulmonary manifestations that are causally related or have shared risk factors. Cardiovascular changes on ECG and Echocardiography are one of the common comorbidities of COPD accounting for a 25% rise in major adverse cardiac events (like AMI, and stroke) and mortality. Hence acute cardiac abnormalities across all severity of COPD patients clearly contribute to the overall mortality and morbidity, so an understanding of their role noninvasively through this study holds potential for early intervention.

 

Objectives: This study aimed at noninvasive assessment and correlation of cardiovascular manifestation in COPD patients with its outcome.

 

Materials and Methods: A cross-sectional study was done in the Department of Respiratory Medicine of a rural tertiary care center on patients during the period from January 2015 to June 2016 visiting our OPD or IPD. A total of 350 study subjects were screened and those fulfilling the inclusion and exclusion criteria that were 200 consenting to participate were included in the study. COPD was diagnosed based on clinical history, clinical examination, X-ray chest, and spirometry. All patients were further subjected to electrocardiogram (ECG) and two- dimensional echocardiography (2D-ECHO) for cardiac evaluation. Data collection was done and analyzed.

 

Results: On ECG evaluation: arrhythmia was found in 99 (49.5%) cases, right ventricular hypertrophy (RVH) in 61(30.5%) cases, and right atrial enlargement (RAE) in 52(26%) cases. Right bundle branch blocking in 20(10%) cases poor progression of R wave in 24(12%) cases and right axis deviation was found in 30 (15%) cases.

 

On 2DECHO evaluation: Tricuspid regurgitation was found in 117(58.5%) cases, pulmonary hypertension in 116 (58%) cases, RAE in 79(39.5%) cases, RVH in74 (37%) cases, RV enlargement in 55(27.5%) cases, and left ventricular diastolic dysfunction in 113(56.05%) cases.

 

Conclusion: Cardiovascular comorbidities are highly prevalent in moderate to very severe COPD patients who need early diagnosis and treatment. Hence ECG and ECHO are simple non-invasive bedside tools for cardiac evaluation of COPD patients during acute exacerbation as well as during the follow-up of the disease.

 

 

Author (s) Details

Prashant Yadav
Department of Respiratory Medicine, U.P. University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India.

 

Somnath Bhattacharya
Department of Respiratory Medicine, U.P. University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India.

 

Adesh Kumar
Department of Respiratory Medicine, U.P. University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India.

 

Ashish Kumar Gupta
Department of Respiratory Medicine, U.P. University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India.

 

Aditya Kumar Gautam
Department of Respiratory Medicine, U.P. University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India.

 

Bal Krishna Kushwah
Department of Respiratory Medicine, U.P. University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/dhrni/v5/2074

Mathematical Modeling of Different Heart Rhythms to Diagnose Chronic Heart Disease | Chapter 13 | Current Progress in Medicine and Medical Research Vol. 6

 In this episode, it is explored that the possibility that ECG records belong to class of multifractal process for which a a lot of scaling exponents are necessary to characterize their scaling forms. There are many recent studies which confirmed that the healthy heartbeat shows regular cardiac beat based on Homeostasis principals since physiologically, our physique system tries to reduce soul rate variability (HRV). We use the BIDMC Congestive Heart Failure database containing long term ECG recordings from 11 brothers, aged 22 to 71, and 4 wives, aged 54 to 63 with harsh congestive heart failure and the MIT-BIH Arrhythmia database that holds 48 half-hour excerpts of two-channel ambulatory ECG records, obtained from 47 cases studied by the BIH Arrhythmia Laboratory middle from two points 1975 and 1979. We compare these two chronic soul diseases with the control folk in the MIT-BIH Normal Sinus Rhythm database that includes 18 long-term ECG records of 5 men, aged 26 to 45, and 13 mothers, aged 20 to 50 without important arrhythmia. The vibration analysis in the way that power ghostly densities (PSD) analysis has been acted for differentiating the time order. Multifractal spectrum analysis has judged the multifractal dynamics of pulse interval signals to distinguish between subjects with severe heart attack and normal signals with arrhythmia. The fractal complicatedness of each heart beat is determined utilizing the Higuchi algorithm, and the signals are therefore contrasted over various opportunity intervals [1]. According to our analysis, when multifractal study and scaling exponent were secondhand as a classifier, the three classes were well separated. In addition, multifractal study revealed that we have a narrow range of exponents for arrhythmia and congestive heart failure issues and as a result, a clear loss of multifractality for bureaucracy. We continue the analysis of pulse interval time succession by estimating the capacity law scaling exponents for active subjects and compare bureaucracy with scaling exponents of victims with heart attack and arrhythmia. Then we apply multifractal analysis to study the multifractal makeup and complex dynamics of these three groups of signals. Our findings support a comprehensive framework for demonstrative and classifying different subjects with cardiac disease to a degree arrhythmia and congestive heart failure and differentiate bureaucracy with normal crowd without heart disease that is crucial in judgment the best diagnostic and ruling strategy in fight against chronic myocardial infarction.

Author(s) Details:

Tahmineh Azizi,
Department of Mechanical Engineering, Florida State University, Tallahassee, FL, USA.

Please see the link here: https://stm.bookpi.org/CPMMR-V6/article/view/11486