title: Atrial and Ventricular Arrhythmia-Associated Factors in Stable Patients with Chronic Obstructive Pulmonary Disease.
abstract: BACKGROUND
  Supraventricular and ventricular premature complexes (SVPC and VPC, respectively) are associated with chronic obstructive pulmonary disease (COPD) and with increased mortality in COPD patients. However, there are few reports on the causes of arrhythmia in COPD patients.
  
  
  OBJECTIVE
  This study explores the associations between cardiopulmonary dysfunction and COPD by comparing patients with defined arrhythmias (>100 beats per 24 h) and those without, based on 24-hour electrocardiogram (ECG) recordings.
  
  
  METHODS
  Patients with arrhythmia underwent a 24-hour ECG and subsequent pulmonary function tests, computed tomography, ECG, 6-min walk test (6MWT), and BODE (body mass index, airflow obstruction, modified Medical Research Council Dyspnoea Scale, exercise capacity) index calculation.
  
  
  RESULTS
  Of 103 study patients (71 COPD patients and 32 at-risk patients), 36 had VPC, 45 had SVPC, 20 had both, and 42 had neither. The predicted post-bronchodilator forced expiratory volume in 1 s, the proportion of low-attenuation area on computed tomography, and BODE index values were significantly worse in the SVPC and VPC groups compared with the corresponding reference groups. Patients in the VPC group showed significantly increased right ventricular pressure and increased desaturation in the 6MWT compared with the reference group. In the multivariate analyses, bronchodilator use was a significant risk factor in the SVPC group, whereas in the VPC group, all parameters of the BODE index except for the dyspnoea score were identified as risk factors.
  
  
  CONCLUSIONS
  Increased SVPC might be caused by bronchodilator use, whereas increased VPC is likely related to the peculiar pathophysiology of COPD.
authors.affiliation: Respiratory Care Clinic, Nippon Medical School, Tokyo, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kusunoki
authors.forename: Toshie
authors.initials: T
authors.lastname: Nakamura
authors.forename: Kumiko
authors.initials: K
authors.lastname: Hattori
authors.forename: Takashi
authors.initials: T
authors.lastname: Motegi
authors.forename: Takeo
authors.initials: T
authors.lastname: Ishii
authors.forename: Akihiko
authors.initials: A
authors.lastname: Gemma
authors.forename: Kozui
authors.initials: K
authors.lastname: Kida
mesh_terms: D000368:Aged; D018880:Atrial Premature Complexes / Q000453:epidemiology* / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000627:therapeutic use; D015331:Cohort Studies; D015897:Comorbidity; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D005080:Exercise Test; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D016015:Logistic Models; D008168:Lung / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D012129:Respiratory Function Tests; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D018879:Ventricular Premature Complexes / Q000453:epidemiology* / Q000503:physiopathology
chemical_list: D001993:Bronchodilator Agents