Analysis of Electrocardiogram Changes in in COPD Patients and Controls in the Shahrekord City: A Cohort Study Population in 2020

Background: Chronic Obstructive Pulmonary Disease (COPD) is one of the most prevalent and rapidly growing health problems worldwide. It is a progressive disease characterized by limited or obstructed airflow that is irreversible. "COPD is primarily caused by an excessive inflammatory response to inhaled pollutants and irritants, and is often characterized by a chronic cough, with or without mucus production. Chronic bronchitis and emphysema are the two conditions that comprise COPD, and they are not always precisely distinguishable. Due to the high prevalence of COPD among the elderly population, extensive studies have reported various electrocardiogram (ECG) changes in these patients. Examples include alterations in the axis and height of the P wave and a decrease in the height of the QRS complex in limb and precordial leads. Although not all COPD patients undergo routine ECG evaluations, the occurrence of various arrhythmias remains one of the significant and preventable causes of death in this population. Multiple factors, such as impaired autonomic control of cardiac and pulmonary function, may contribute to the development of arrhythmias in COPD patients. Method: A total of 86 individuals diagnosed with COPD were selected through census sampling and considered the case group. For the control group, twice the number of participants (individuals without any obstructive pulmonary disease) were selected from the cohort population. Information on COPD patients were confirmed via spirometry, and their ECGs were analyzed for arrhythmias and abnormal changes.". These included alterations in wave axes, lengthening or shortening of waves, changes in the R wave, and other deviations from the normal ECG pattern. The collected data were then analyzed and compared using statistical tests. Findings: This study included 85 COPD patients and 168 healthy individuals as the control group, comprising a total of 253 participants. The mean age of the study population was 50.8 years, with 54% of the participants being female and 45% of the COPD patients being male. Significant ECG changes observed in COPD patients compared to the control group included weak progression of the R wave, atrial abnormalities (right atrial enlargement [RAE] and left atrial enlargement [LAE]), right ventricular hypertrophy (RVH), decreased QRS duration, and a short QT interval (P-value < 0.05). Conclusion: The observed ECG changes, such as weak R wave progression and atrial abnormalities, emphasize the importance of ECG as a non-invasive diagnostic tool for identifying cardiovascular complications in COPD patients. This highlights the need for regular cardiac monitoring in these individuals. Since certain cardiac complications in COPD patients are preventable or manageable, regular examinations such as ECG and echocardiography are recommended.