Lazović Biljana, Svenda Mirjana Zlatković, Mazić Sanja, Stajić Zoran, Delić Marina
Clinical Hospital Center Zemun, Department of Pulmonology and Cardiology, Belgrade.
Med Pregl. 2013 Mar-Apr;66(3-4):126-9. doi: 10.2298/mpns1304126l.
Chronic obstructive pulmonary disease is the fourth leading cause of mortality worldwide. It is defined as a persistent airflow limitation usually progressive and not fully reversible to treatment. The diagnosis of chronic obstructive pulmonary disease and severity of disease is confirmed by spirometry. Chronic obstructive pulmonary disease produces electrical changes in the heart which shows characteristic electrocardiogram pattern. The aim of this study was to observe and evaluate diagnostic values of electrocardiogram changes in chronic obstructive pulmonary disease patients with no other comorbidity.
We analyzed 110 electrocardiogram findings in clinically stable chronic obstructive pulmonary disease patients and evaluated the forced expiratory volume in the first second, ratio of forces expiratory volume in the first second to the fixed vital capacity, chest radiographs and electrocardiogram changes such as p wave height, QRS axis and voltage, right bundle branch block, left bundle branch block, right ventricular hypertrophy, T wave inversion in leads V1-V3, S1S2S3 syndrome, transition zone in praecordial lead and QT interval.
We found electrocardiogram changes in 64% patients, while 36% had normal electrocardiogram. The most frequent electrocardiogram changes observed were transition zone (76.36%) low QRS (50%) and p pulmonale (14.54%). Left axis deviation was observed in 27.27% patients.
Diagnostic values of electrocardiogram in patients with chronic obstructive pulmonary disease suggest that chronic obstructive pulmonary disease patients should be screened electrocardiographically in addition to other clinical investigations.
慢性阻塞性肺疾病是全球第四大致死原因。它被定义为一种持续的气流受限，通常呈进行性发展且对治疗不完全可逆。慢性阻塞性肺疾病的诊断及疾病严重程度通过肺功能测定来确认。慢性阻塞性肺疾病会引起心脏电活动变化，表现出特征性的心电图模式。本研究的目的是观察和评估无其他合并症的慢性阻塞性肺疾病患者心电图变化的诊断价值。
我们分析了临床稳定的慢性阻塞性肺疾病患者的110份心电图结果，并评估了第一秒用力呼气量、第一秒用力呼气量与用力肺活量的比值、胸部X光片以及心电图变化，如P波高度、QRS电轴和电压、右束支传导阻滞、左束支传导阻滞、右心室肥厚、V1 - V3导联T波倒置、S1S2S3综合征、胸前导联过渡区和QT间期。
我们发现64%的患者有心电图变化，而36%的患者心电图正常。观察到的最常见心电图变化是过渡区（76.36%）、低QRS波（50%）和肺型P波（14.54%）。27.27%的患者出现电轴左偏。
慢性阻塞性肺疾病患者心电图的诊断价值表明，除其他临床检查外，还应对慢性阻塞性肺疾病患者进行心电图筛查。
