Electrocardiographic predictors of five-years mortality in chronic obstructive pulmonary disease patients

Abstract

Introduction/Objective. Cardiovascular disease is one of the most common comorbidities among subjects with chronic obstructive pulmonary disease (COPD). The aim of this study is to evaluate electrocardiogram (ECG) parameters and mortality predictors in COPD patients. Methods. A total of 835 consecutive patients were included. The patients were classified to suffer from COPD if the forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) was < 70% in three consecutive postbronchodilator measurements. The following ECG changes were observed: axis, P wave, low ORS complex, transitional zone, left bundle branch block (LBBB), right bundle branch block (RBBB), incomplete RBBB, S1S2S3 configuration, negative T in V1–V3. The patients were followed up for mortality over a five-year period. Results. Both survivors and non-survivors were of similar age, sex, and COPD status. FVC and FEV1, as well as Global Initiative for Chronic Obstructive Lung Disease stadiums were significantly higher in the survivor group (p < 0.016, p < 0.001, p < 0.001, respectively). Normal axis was in significantly higher percentage in non-survived patients (p = 0.020). RBBB and incomplete RBBB are more frequent findings in patients who died (p < 0.001, p < 0.05, respectively). LBBB, S1S2S3 configuration is in significantly higher percentage present in non-survivors (p < 0.016, p < 0.001, respectively). In the multivariable logistic model, patients with LBBB have two times higher chance of mortality compared to patients without LBBB. In contrast, patients with RBBB have 1.6 times lower chance of having death outcome. Conclusion. The main ECG predictors of COPD patients’ five-year mortality are LBBB and RBBB, but according to statistical model, ECG should be further explored and possibly obligatory involved in a routine clinical practice as an easy and low-cost screening method.

Keywords

• chronic obstructive pulmonary disease
• electrocardiography
• mortality