Research Unit of Cardiovascular Science, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy; Cardiology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.
Research Unit of Cardiovascular Science, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy; Cardiology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy; Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy.
J Electrocardiol. 2024 Jul-Aug;85:58-65. doi: 10.1016/j.jelectrocard.2024.05.083. Epub 2024 May 24.
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality, and its incidence has grown within several years, quickly becoming the third leading cause of mortality. The disease is characterized by alveolar destruction, air-trapping, and chronic inflammation due to persistent exposure to a large spectrum of harmful particles. The diagnosis of COPD is made by demonstration of persistent and not fully reversible airflow limitation, and different phenotypes may be recognized based on pathophysiological, clinical, and radiological features. However, COPD is a systemic disease with effects involving several organs. For example, mechanical and functional alterations secondary to COPD involve heart function. Indeed, cardiovascular diseases are highly prevalent in patients affected by COPD and represent the primary cause of mortality in such patients. An electrocardiogram is a simple and cheap test that gives much information about the heart status of COPD patients. Consequently, variations from "normality" can be appreciated in these patients, with the most frequent abnormalities being P-wave, QRS axis, and ventricular repolarization abnormalities, in addition to conduction alterations and a vast number of arrhythmias. As a result, ECG should be routinely performed as a valuable tool to recognize alterations due to COPD (i.e., mechanical and functional) and possible associated heart diseases. This review aims to describe the typical ECG features in most COPD patients and to provide a systematic summary that can be used in clinical practice.
慢性阻塞性肺疾病（COPD）是发病率和死亡率的主要原因，其发病率在数年内有所上升，迅速成为第三大致死原因。该疾病的特征是由于持续暴露于大量有害颗粒而导致的肺泡破坏、空气滞留和慢性炎症。COPD 的诊断是通过证明持续存在且不完全可逆的气流受限来做出的，并且可以根据病理生理、临床和影像学特征来识别不同的表型。然而，COPD 是一种全身性疾病，对多个器官都有影响。例如，由于 COPD 引起的机械和功能改变会影响心脏功能。事实上，心血管疾病在 COPD 患者中非常普遍，是此类患者死亡的主要原因。心电图是一种简单而廉价的测试，可以提供有关 COPD 患者心脏状况的大量信息。因此，这些患者的心电图可能会出现“正常”以外的变化，最常见的异常是 P 波、QRS 轴和心室复极异常，此外还有传导改变和大量心律失常。因此，心电图应作为一种有价值的工具常规进行，以识别由于 COPD（即机械和功能）引起的改变以及可能伴发的心脏病。本综述旨在描述大多数 COPD 患者的典型心电图特征，并提供一个可用于临床实践的系统总结。
