Faculty of Medicine, University of Zurich, Zurich, Switzerland.
Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
COPD. 2022 Jul 14;19(1):339-344. doi: 10.1080/15412555.2022.2101992.
Approximately, half of COPD patients die from cardiovascular diseases. A prolongation of cardiac repolarization (measured as QTc interval) is associated with cardiovascular events or cardiovascular deaths in populations of older adults and COPD. One way to reduce the QTc could be to increase physical activity (PA). We investigated whether QTc can be reduced by an increase in PA in patients with severe COPD. This is a secondary outcome analysis from a randomized controlled trial investigating the effects of a 3 months pedometer based program to improve PA. 12-lead ECG was assessed at baseline and after 3 months. We measured PA using a validated triaxial accelerometer. Data were analyzed from 59 participants. Multiple regression modeling, including adjustment for baseline QTc, sex, QT prolonging medications, BMI, smoking status and FEV1%, showed no evidence for an association between an improvement of ≥15% PA and QTc reduction. A 15% improvement in PA according to step counts over 3 months seems not to reduce QTc interval by its MCID of 20 ms in patients with severe to very severe COPD.
大约有一半的 COPD 患者死于心血管疾病。在老年人和 COPD 人群中,心脏复极延长(以 QTc 间期测量)与心血管事件或心血管死亡相关。降低 QTc 的一种方法是增加体力活动(PA)。我们研究了严重 COPD 患者 PA 增加是否可以降低 QTc。这是一项随机对照试验的次要结局分析,该试验研究了基于计步器的 3 个月方案对改善 PA 的影响。在基线和 3 个月时评估 12 导联心电图。我们使用经过验证的三轴加速度计测量 PA。对 59 名参与者的数据进行了分析。多变量回归模型,包括对基线 QTc、性别、QT 延长药物、BMI、吸烟状况和 FEV1%的调整,显示 PA 改善≥15%与 QTc 降低之间没有关联。根据 3 个月的步数,PA 改善 15%似乎不会通过其 MCID 20 ms 降低严重至非常严重 COPD 患者的 QTc 间期。