Association between RS Time in Electrocardiogram and Right Ventricular Functions in Patients with Chronic Obstructive Pulmonary Disease.

OBJECTIVE: The occurrence of right ventricular (RV) dysfunction in chronic obstructive pulmonary disease (COPD) results in an increased risk of mortality. We aimed to study the diagnostic value of RS time in the recognition of COPD patients with RV dysfunction. METHODS: 120 consecutive COPD patients were divided into two groups, patients with and without RV dysfunction, and compared them in terms of parameters including RS time. RS time was defined as the longest interval from the beginning of the QRS complex to the nadir of the S- or S'-wave in the inferolateral leads on an electrocardiogram. RESULTS: RV dysfunction was observed in 36% of consecutive COPD patients with a mean age of 63.4 ± 9.8 years (83.3% male) and a mean forced expiratory volume in 1 s of 1.51 ± 0.62 lt. The heart rate, right QRS axis deviation frequency, S1S2S3 pattern frequency, and RS time (p < 0.01) were significantly higher in the patients with RV dysfunction than in those without. Body surface area, heart rate, and RS time (p < 0.001) were independent predictors of an RV dysfunction. An ROC analysis showed that the best RS time cutoff value for the prediction of RV dysfunction was 60 ms with a sensitivity of 81.4% and a specificity of 74.0%. CONCLUSION: In patients with COPD, RS time prolongation, which can be easily and quickly determined from the electrocardiogram, may be a marker for RV dysfunction.

[The relation between nitric oxide levels in exhaled breath condensate and asthma control questionnaires in asthma patients]. / Astimli olgularda yogunlastirilmis soluk havasinda nitrik oksit seviyeleri ile astim kontrol ölçekleri arasindaki iliskinin degerlendirilmesi.

The goal of asthma treatment is to achieve clinical control. The aim of this study was to compare the role of measurement of nitric oxide and its products in exhaled breath condensate and asthma control questionnaire (ACQ), level of asthma control (LAC) according to GINA guidelines and bronchial provocation test (BPT) in assessing asthma control in cases with stable asthma. Thus, 47 patients with the diagnosis of stable asthma and 42 individuals in the control group were enrolled in the study. The mean ages of the patient and the control groups were 44 +/- 11 and 47 +/- 11 years, respectively. While there was no significant relation between LAC and levels of nitric oxide, nitrite and nitrate, there was a significant relation between ACQ and mini quality of life questionnaire (p< 0.001). In the group with positive BPT, ACQ scores and absolute serum eosinophil values were significantly higher (p< 0.05), and FEV(1)/FVC and PEF percentages were significantly lower than those of the group with negative BPT (p< 0.05). Reversibility was significantly higher in participants with positive BPT than in those with negative BPT (11.2 +/- 7.4 and 6.9 +/- 6.6, respectively; p< 0.05). There was no significant relationship between nitric oxide, nitrite, nitrate in the exhaled breath condensate and ACQ, LAC, BPT and pulmonary function tests (p> 0.05). In conclusion, it was found that the levels of exhaled breath condensate nitric oxide, nitrite and nitrate were not sufficient for determining the level of asthma control in patients with stable asthma. It was concluded that the currently available asthma control questionnaires may be adequate for assessing asthma control.