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Poster Presentations: Wednesday, November 3, 2010 |

Electrocardiographic Abnormalities in Patients With Severe vs Mild or Moderate Chronic Obstructive Pulmonary Disease Followed in an Academic Outpatient Pulmonary Clinic FREE TO VIEW

Dvorah Holtzman, MD; Wilbert S. Aronow, MD; William M. Mellana, MD; Mala Sharma, MD; Nimesh Mehta, MD; John Lim, MD; Dipak Chandy, MD
Author and Funding Information

New York Medical College, Valhalla, NY



Chest. 2010;138(4_MeetingAbstracts):454A. doi:10.1378/chest.10411
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Abstract

PURPOSE: To investigate electrocardiographic (ECG) abnormalities in severe versus mild or moderate chronic obstructive pulmonary disease (COPD).

METHODS: ECGs were obtained in 146 patients with COPD in a pulmonary clinic. A % predicted forced expiratory volume in 1 second of < 50% was severe COPD (group 1) and 50-80% mild or moderate COPD (group 2). The ECGs were analyzed blindly by an experienced electrocardiographer.

RESULTS: Right atrial enlargement (RAE) occurred in 28 of 63 (44%) group 1 versus 12 of 83 (15%) group 2 patients (p< 0.001). Right ventricular hypertrophy (RVH) occurred in 18 of 63 (29%) group 1 versus 3 of 83 (4%) group 2 patients (p< 0.001). Complete right bundle branch block (CRBBB)occurred in 18 of 63 (29%) group 1 versus 9 of 83 (11%) group 2 patients (p< 0.01). Marked clockwise rotation of heart occurred in 25 of 63 (40%) group 1 versus 15 of 83 (18%) group 2 patients (p< 0.005). Low limb lead voltage occurred in 15 of 63 (24%) group 1 versus 9 of 83 (11%) group 2 patients (p< 0.05). A QS pattern in leads III and aVF occurred in 10 of 63 (16%) group 1 versus 3 of 83 (4%) group 2 patients (p< 0.01).Left axis deviation (LAD) occurred in 10 of 63 (16%) group 1 versus 3 of 83 (4%) group 2 patients (p< 0.01). Supraventricular tachyarrhythmias occurred in 10 of 63 (16%) group 1 versus 4 of 83 (5%) group 2 patients (p< 0.025). Right axis deviation (6% versus 1%) and a S1S2S3 pattern (10% versus 4%) were not significantly different between both groups. A normal ECG occurred in 12 of 63 (19%) group 1 versus 33 of 83 (40%) group 2 patients (p< 0.01).

CONCLUSION: RAE, RVH, CRBBB, marked clockwise rotation of heart, a QS pattern in leads III and aVF, LAD, supraventricular tachyarrhythmias, and an abnormal ECG were significantly more prevalent in group 1 than in group 2 patients.

CLINICAL IMPLICATIONS: ECG abnormalities are more prevalent in patients with severe versus moderate or mild COPD.

DISCLOSURE: Dvorah Holtzman, No Financial Disclosure Information; No Product/Research Disclosure Information

12:45 PM - 2:00 PM


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