title: Assessment of the presence of occult myocardial infarction in chronic obstructive pulmonary disease using contrast-enhanced cardiac magnetic resonance imaging.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) has been identified as a risk factor for ischaemic heart disease, independent of smoking history, and inflammation is thought to play a role.
  
  
  OBJECTIVE
  We sought to ascertain whether occult myocardial infarction (MI) was present in the COPD population, and to assess its relationship with inflammation and natriuretic peptides.
  
  
  METHODS
  We recruited 25 patients with moderate/severe COPD and 17 control smokers without lung disease. All participants had no known cardiac disease. Contrast-enhanced cardiac magnetic resonance imaging was performed and analysed for delayed contrast enhancement (DE), indicative of previous MI. All participants had venous blood samples taken for assessment of NT-proBNP and inflammatory markers.
  
  
  RESULTS
  DE was not found in any participant. Right ventricular ejection fraction was lower in COPD patients. Other cardiac measurements and NT-proBNP levels were similar in the 2 groups. C-reactive protein, IL-8, GM-CSF, IL-1 beta and TNF-alpha were all significantly higher in the COPD group.
  
  
  CONCLUSIONS
  DE, indicating previous MI, was not found in patients with moderate/severe COPD. Occult MI does not appear to be common in this population, but a larger study would be needed to conclusively test this.
authors.affiliation: Cardiology Department, Western Infirmary, University of Glasgow, Glasgow, UK. aengus_murphy@hotmail.com
authors.forename: C Aengus
authors.initials: CA
authors.lastname: Murphy
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Blyth
authors.forename: Rekha
authors.initials: R
authors.lastname: Chaudhuri
authors.forename: Jane
authors.initials: J
authors.lastname: Lafferty
authors.forename: Eleanor
authors.initials: E
authors.lastname: Hothersall
authors.forename: Tracey
authors.initials: T
authors.lastname: Steedman
authors.forename: Charles
authors.initials: C
authors.lastname: McSharry
authors.forename: Henry J
authors.initials: HJ
authors.lastname: Dargie
authors.forename: Neil C
authors.initials: NC
authors.lastname: Thomson
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000150:complications*; D012907:Smoking / Q000009:adverse effects
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D019786:Gadolinium DTPA