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dc.contributor.authorLagan, Jakub
dc.contributor.authorSchelbert, Erik B
dc.contributor.authorNaish, Josephine H
dc.contributor.authorVestbo, Jørgen
dc.contributor.authorFortune, Christien
dc.contributor.authorBradley, Joshua
dc.contributor.authorBelcher, John
dc.contributor.authorHearne, Edward
dc.contributor.authorOgunyemi, Foluwakemi
dc.contributor.authorTimoney, Richard
dc.contributor.authorPrescott, Daniel
dc.contributor.authorBain, Hamish D C
dc.contributor.authorBangi, Tasneem
dc.contributor.authorZaman, Mahvash
dc.contributor.authorWong, Christopher
dc.contributor.authorAshworth, Anthony
dc.contributor.authorThorpe, Helen
dc.contributor.authorEgdell, Robin
dc.contributor.authorMcIntosh, Jerome
dc.contributor.authorIrwin, Bruce R
dc.contributor.authorClark, David
dc.contributor.authorDevereux, Graham
dc.contributor.authorQuint, Jennifer K
dc.contributor.authorBarraclough, Richard
dc.contributor.authorSchmitt, Matthias
dc.contributor.authorMiller, Christopher A; email: christopher.miller@manchester.ac.uk
dc.date.accessioned2021-06-06T01:05:22Z
dc.date.available2021-06-06T01:05:22Z
dc.date.issued2021-05-12
dc.date.submitted2020-09-24
dc.identifierpubmed: 34023272
dc.identifierpii: S1936-878X(21)00340-5
dc.identifierdoi: 10.1016/j.jcmg.2021.03.026
dc.identifier.citationJACC. Cardiovascular imaging
dc.identifier.urihttp://hdl.handle.net/10034/624853
dc.descriptionFrom PubMed via Jisc Publications Router
dc.descriptionHistory: received 2020-09-24, revised 2021-03-17, accepted 2021-03-19
dc.descriptionPublication status: aheadofprint
dc.description.abstractThe purposes of this study were to determine why chronic obstructive pulmonary disease (COPD) is associated with heart failure (HF). Specific objectives included whether COPD is associated with myocardial fibrosis, whether myocardial fibrosis is associated with hospitalization for HF and death in COPD, and whether COPD and smoking are associated with myocardial inflammation. COPD is associated with HF independent of shared risk factors. The underlying pathophysiological mechanism is unknown. A prospective, multicenter, longitudinal cohort study of 572 patients undergoing cardiac magnetic resonance (CMR), including 450 patients with COPD and 122 age- and sex-matched patients with a median: 726 days (interquartile range: 492 to 1,160 days) follow-up. Multivariate analysis was used to examine the relationship between COPD and myocardial fibrosis, measured using cardiac magnetic resonance (CMR). Cox regression analysis was used to examine the relationship between myocardial fibrosis and outcomes; the primary endpoint was composite of hospitalizations for HF or all-cause mortality; secondary endpoints included hospitalizations for HF and all-cause mortality. Fifteen patients with COPD, 15 current smokers, and 15 healthy volunteers underwent evaluation for myocardial inflammation, including ultrasmall superparamagnetic particles of iron oxide CMR. COPD was independently associated with myocardial fibrosis (p < 0.001). Myocardial fibrosis was independently associated with the primary outcome (hazard ratio [HR]: 1.14; 95% confidence interval [CI]: 1.08 to 1.20; p < 0.001), hospitalization for HF (HR: 1.25 [95% CI: 1.14 to 1.36]); p < 0.001), and all-cause mortality. Myocardial fibrosis was associated with outcome measurements more strongly than any other variable. Acute and stable COPD were associated with myocardial inflammation. The associations between COPD, myocardial inflammation and myocardial fibrosis, and the independent prognostic value of myocardial fibrosis elucidate a potential pathophysiological link between COPD and HF. [Abstract copyright: Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.]
dc.languageeng
dc.sourceeissn: 1876-7591
dc.subjectcardiac magnetic resonance
dc.subjectchronic obstructive pulmonary disease
dc.subjectheart failure
dc.subjectmortality
dc.subjectmyocardial fibrosis
dc.subjectmyocardial inflammation
dc.titleMechanisms Underlying the Association of Chronic Obstructive Pulmonary Disease With Heart Failure.
dc.typearticle
dc.date.updated2021-06-06T01:05:21Z
dc.date.accepted2021-03-19


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