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Concomitant diseases: Chronic lung disease beats on the heart
In Germany alone, up to five million people are affected by the chronic obstructive pulmonary disease COPD. The disease, popularly known as smoker's cough, not only affects the respiratory tract, but also beats the heart.
Up to five million German citizens suffer from COPD
According to the German Respiratory League, three to five million people in Germany alone suffer from COPD ("chronic obstructive pulmonary disease"). According to health experts, chronic obstructive pulmonary disease, popularly known as smoker's cough or smoker's lung, is the third leading cause of death worldwide. Doctors now report that the disease also beats on the heart. They also complain that those affected rarely use non-drug therapy options.
Patients often develop comorbidities
Patients with the chronic lung disease COPD not only suffer from frequent coughing, breathing difficulties and inflammation in the area of the respiratory tract, but they often also develop concomitant diseases that affect other organs.
The German Society for Internal Medicine e. V. in a message.
The Germany-wide COSYCONET study is intended to clarify how often such comorbidities occur and how they can be recognized.
Current results of the extensive study, in which more than 2,700 COPD patients from 29 care centers participate, will be presented at the 125th Internist Congress, which will take place in Wiesbaden from May 4 to 7, 2019.
Smoking is the main trigger for the disease
COPD patients suffer from narrowed airways, increased mucus production and chronic cough.
Sometimes non-smokers are also affected, but in the majority of all cases in Germany the main cause is quite clearly determined: smoking.
"80 percent of COPD patients are smokers or have smoked earlier in life," explains Professor Dr. med. Claus F. Vogelmeier, director at the Clinic for Internal Medicine at the University Medical Center Marburg and this year's congress president.
However, other air pollutants such as particulate matter or occupational exposure to coal or grain dust are also possible triggers for COPD.
Variety of new knowledge
As the communication says, the COSYCONET cosortium is now looking at the consequences of the disease.
As part of the study program, the COPD patients are intensively examined a total of seven times: upon admission to the study, as well as six, 18, 36, 54, 72 and 90 months afterwards.
According to the information, lung function, height, weight and blood values are measured at each of these appointments, examined for comorbidities such as cardiovascular diseases and metabolic disorders and physical performance is tested.
In addition, basic demographic data are collected via questionnaires and aspects such as activity, mental state, subjective quality of life and medication are recorded.
"So far, Germany has lacked such a large and comprehensive database on COPD," says Vogelmeier.
A great deal of knowledge has been gained from the wealth of data collected in recent years and published in specialist journals.
Influence on the heart
A current evaluation, which will also be presented at the DGIM Congress, deals with the influence that lung disease has on the heart of the patient.
"We observe that the left ventricle of COPD patients is often reduced in size, and the position of the heart in the chest changes due to the bloating of the lungs," explains Vogelmeier, who helped to initiate and lead the COSYCONET study.
The current data show that as the severity of COPD increases, the electrical axis of the heart also shifts, i.e. the direction in which the excitation spreads in the heart muscle.
"This change does not in itself have to have any disease value," says Vogelmeier. However, it is important to consider the shifts that may be caused by COPD when interpreting ECG leads.
Non-drug treatment and prevention offers
Further current COSYCONET evaluations consider the frequency with which patients with COPD take advantage of the non-drug treatment and prevention options recommended in the guidelines.
"There is still room for improvement here," says Vogelmeier. Because while vaccinations to avoid respiratory infections are well received, only ten to 20 percent of COPD patients take part in pulmonary sports groups or physiotherapy.
In addition, while smoking is known to be the most important aspect of smoking cough prevention, smoking cessation programs are attended by only a quarter of COPD patients who smoke.
"Especially patients in early stages of COPD should be made more aware of the prevention options by their doctors," said Vogelmeier - they could significantly slow the progression of the disease. (ad)