Morphological overview of cardiovascular comorbidities in chronic obstructive pulmonary disease: Frank's sign.

OBJECTIVE: Cardiovascular diseases are the most common and important comorbidities in patients with chronic obstructive pulmonary disease (COPD). Literature indicates that there may be a relationship between diagonal earlobe crease (DELC) and coronary artery disease (CAD). Accordingly, the present study aimed to assess the relationship with DELC and cardiac comorbidities in patients with COPD during routine physical examination. MATERIALS AND METHODS: In this prospective cohort study, we evaluated the demographic data, pulmonary function test (PFT) results, lipid profile, oxygen saturation, and the presence of DELC in patients with COPD and control subjects. RESULTS: DELC was diagnosed in 155 (62%) of COPD patients and these patients had a higher prevalence of CAD (p = 0.044). Moreover, DELC was diagnosed in 135 men (68.5%) and 20 (37.7%) women in the COPD group (p<0.001) and in 39 (48.8%) men and 14 (56.0%) women in the control group (p = 0.527). On the other hand, CAD was diagnosed in 18% of patients with early-stage COPD (n = 104) and in 30.8% of patients with late-stage COPD (n = 146) (p = 0.041). The sensitivity and specificity of DELC positivity in predicting CAD were 80.65% and 44.15% in COPD patients, respectively. CONCLUSION: The presence of cardiac comorbidities in COPD patients may play a vital role in the severity of the disease, exacerbations, and may also reduce the treatment response. Accordingly, an earlobe examination of patients with COPD may be useful in predicting the presence of cardiac comorbidities with high sensitivity.

Short-term variations of optic coherence tomography findings in mild and severe chronic obstructive pulmonary disease.

OBJECTIVE: To evaluate the short-term changes in subfoveal choroidal thickness (SFCT), ganglion cell complex (GCC) analysis, and retinal nerve fiber length (RNFL) of patients with chronic obstructive pulmonary disease (COPD) in a 3-month follow-up. MATERIALS AND METHODS: Forty-eight patients with COPD (96 eyes) and 40 control subjects (80 eyes) were enrolled in our study. COPD patients were grouped according to disease severity as Group 1 (mild-moderate) and Group 2 (advanced). GCC, RNFL, and SFCT analysis by Cirrus SD-OCT were obtained for all eyes, in two consecutive examinations with a 3-month interval. RESULTS: SFCT in Group 2 was lower than Group 1 and control group in the initial and 3rd month examination (p < 0.001, respectively). Inferior RNFL in Group 2 were lower than control group in the initial and 3rd month examination (p = 0.002, p < 0.001, respectively) Temporal RNFL were lower in Group 2 than Group 1 in 3rd month examination (p = 0.009). Average, superior, superotemporal, inferior, and inferonasal GCC analyses of the Group 2 were lower than control group both in the initial and 3rd month examination (p = 0.001, p < 0.001, respectively) SFCT, average, and superior GCC of Group 2 were significantly reduced during the 3-month follow-up (p < 0.001). CONCLUSION: Hypoxia is thought to be the underlying mechanism in COPD, which may influence retinal and choroidal OCT parameters. Decrease in blood flow of optic nerve head, increased vascular resistance, and reduced blood flow in choroid may affect the visual ability in these patients, which should be kept in mind during their follow-up.