Alam Mohammad Ajaz, Mangapuram Padmavathi, Fredrick Fremita Chelsea, Singh Bhupinder, Singla Amishi, Kumar Avi, Jain Rohit
Avalon University School of Medicine, Willemstad, Curacao.
Icahn School of Medicine at Mount Sinai, NYC Health+Hospitals, Queens, NY, USA.
Ther Adv Pulm Crit Care Med. 2024 Dec 9;19:29768675241300808. doi: 10.1177/29768675241300808. eCollection 2024 Jan-Dec.
Bronchiectasis-Chronic Obstructive Pulmonary Disease Overlap Syndrome (BCOS) is a complex pulmonary condition that merges bronchiectasis and chronic obstructive pulmonary disease (COPD), presenting unique clinical challenges. Patients with BCOS typically exhibit a range of symptoms from both conditions, including a chronic productive cough, reduced lung function, frequent exacerbations, and diminished exercise tolerance. The etiology of BCOS involves multiple factors such as genetic predisposition, respiratory infections, tobacco smoke, air pollutants, and other inflammatory mediators. Accurate diagnosis requires a comprehensive approach, incorporating pulmonary function tests to evaluate airflow limitation, radiographic imaging to identify structural lung abnormalities, and blood eosinophil counts to detect underlying inflammation. Treatment strategies are tailored to individual symptom profiles and severity, potentially including bronchodilators, inhaled corticosteroids, and pulmonary therapy to improve lung function and quality of life. Patients with BCOS are also at an increased risk for cardiovascular complications, such as stroke, ischemic heart disease, and cor pulmonale. Additionally, medications like beta-agonists and muscarinic antagonists used in COPD treatment can further affect cardiac risk by altering heart rate. This paper aims to provide a thorough understanding of BCOS, addressing its development, diagnosis, treatment, and associated cardiovascular complications, to aid healthcare providers in managing this multifaceted condition and improving patient outcomes.
支气管扩张 - 慢性阻塞性肺疾病重叠综合征(BCOS)是一种复杂的肺部疾病,它合并了支气管扩张和慢性阻塞性肺疾病(COPD),带来了独特的临床挑战。BCOS患者通常表现出这两种疾病的一系列症状,包括慢性咳痰、肺功能下降、频繁急性加重和运动耐力下降。BCOS的病因涉及多种因素,如遗传易感性、呼吸道感染、烟草烟雾、空气污染物和其他炎症介质。准确诊断需要综合方法,包括进行肺功能测试以评估气流受限情况、进行影像学检查以识别肺部结构异常,以及检测血液嗜酸性粒细胞计数以发现潜在炎症。治疗策略根据个体症状特征和严重程度进行调整,可能包括使用支气管扩张剂、吸入性糖皮质激素以及肺部治疗,以改善肺功能和生活质量。BCOS患者发生心血管并发症的风险也会增加,如中风、缺血性心脏病和肺心病。此外,COPD治疗中使用的β受体激动剂和毒蕈碱拮抗剂等药物可通过改变心率进一步影响心脏风险。本文旨在全面介绍BCOS,阐述其发病机制、诊断、治疗及相关心血管并发症,以帮助医疗保健人员管理这一复杂病症并改善患者预后。