Assessment of the presence of occult myocardial infarction in chronic obstructive pulmonary disease using contrast-enhanced cardiac magnetic resonance imaging.
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.
Murphy
C Aengus
CA
Cardiology Department, Western Infirmary, University of Glasgow, Glasgow, UK. aengus_murphy@hotmail.com
Blyth
Kevin G
KG
Chaudhuri
Rekha
R
Lafferty
Jane
J
Hothersall
Eleanor
E
Steedman
Tracey
T
McSharry
Charles
C
Dargie
Henry J
HJ
Thomson
Neil C
NC
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
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D019786:Gadolinium DTPA