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Background <p>To analyze the influencing factors of chronic obstructive pulmonary disease (COPD) concomitant with pulmonary heart disease (PHD) and the diagnostic value of myocardial markers.</p> Methods <p>A retrospective study was conducted on 117 COPD patients. According to whether there were concomitant PHD, 117 cases were distinguished as the combined group (45 cases) and uncombined group (72 cases). Independent risk factors were screened using multivariate logistic regression analysis. The levels of serum markers were determined. Pearson correlation analysis was used to evaluate the correlation between myocardial markers and cardiac function indicators. The expression of myocardial markers in different COPD severity groups was analyzed. The receiver operating characteristic curve (ROC) was adopted to evaluate the diagnostic value of serum markers.</p> Results <p>Compared with the uncombined group, patients in the combined group had significantly increased left atrial diameter (LAD), pulmonary artery pressure (PAP), and inducible co-stimulator ligand (ICOSL) levels, with decreased left ventricular ejection fraction (LVEF) levels (<i>P</i> &lt; 0.05). Serum N-terminal pro-B type natriuretic peptide (NT-proBNP), creatine kinase myocardial band (CK-MB), and cardiac troponin I (cTnI) levels were also markedly increased (<i>P</i> &lt; 0.05). CTnI, CK-MB, and NT proBNP were all negatively correlated with LVEF (<i>r</i> = −&#xa0;0.642, −&#xa0;0.587, −&#xa0;0.723, respectively, <i>P</i> &lt; 0.001), and positively correlated with PAP (<i>r</i> = 0.698, 0.634, 0.781, respectively, <i>P</i> &lt; 0.001). In patients with GOLD grades 3–4 even without concomitant PHD, the levels of cTnI, CK-MB, and NT proBNP were significantly higher than those in patients with GOLD grades 1–2 (<i>P</i> &lt; 0.05). The area under the curve (AUC) of combined serum markers for predicting PHD in COPD patients was 0.921, with specificity and sensitivity of 88.89% and 86.11%, respectively.</p> Conclusions <p>PAP, ICOSL, cTnI, CK-MB, and NT proBNP were all independent risk factors relating to the occurrence of COPD concomitant with PHD. The combined detection of cTnI, CK-MB, and NT-proBNP had certain diagnostic reference value for COPD concomitant with PHD. Monitoring these myocardial markers may provide clues for early identification of patients with COPD concomitant with PHD and assist in the clinical development of targeted intervention programs.</p>

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The influencing factors of chronic obstructive pulmonary disease concomitant with pulmonary heart disease and the diagnostic value of myocardial markers

  • 期刊论文

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  • 发表日期：

    2025年11月26日

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  • Jun Sun,
  • TianLong Yang,
  • Yu Sheng

摘要

Background

To analyze the influencing factors of chronic obstructive pulmonary disease (COPD) concomitant with pulmonary heart disease (PHD) and the diagnostic value of myocardial markers.

Methods

A retrospective study was conducted on 117 COPD patients. According to whether there were concomitant PHD, 117 cases were distinguished as the combined group (45 cases) and uncombined group (72 cases). Independent risk factors were screened using multivariate logistic regression analysis. The levels of serum markers were determined. Pearson correlation analysis was used to evaluate the correlation between myocardial markers and cardiac function indicators. The expression of myocardial markers in different COPD severity groups was analyzed. The receiver operating characteristic curve (ROC) was adopted to evaluate the diagnostic value of serum markers.

Results

Compared with the uncombined group, patients in the combined group had significantly increased left atrial diameter (LAD), pulmonary artery pressure (PAP), and inducible co-stimulator ligand (ICOSL) levels, with decreased left ventricular ejection fraction (LVEF) levels (P < 0.05). Serum N-terminal pro-B type natriuretic peptide (NT-proBNP), creatine kinase myocardial band (CK-MB), and cardiac troponin I (cTnI) levels were also markedly increased (P < 0.05). CTnI, CK-MB, and NT proBNP were all negatively correlated with LVEF (r = − 0.642, − 0.587, − 0.723, respectively, P < 0.001), and positively correlated with PAP (r = 0.698, 0.634, 0.781, respectively, P < 0.001). In patients with GOLD grades 3–4 even without concomitant PHD, the levels of cTnI, CK-MB, and NT proBNP were significantly higher than those in patients with GOLD grades 1–2 (P < 0.05). The area under the curve (AUC) of combined serum markers for predicting PHD in COPD patients was 0.921, with specificity and sensitivity of 88.89% and 86.11%, respectively.

Conclusions

PAP, ICOSL, cTnI, CK-MB, and NT proBNP were all independent risk factors relating to the occurrence of COPD concomitant with PHD. The combined detection of cTnI, CK-MB, and NT-proBNP had certain diagnostic reference value for COPD concomitant with PHD. Monitoring these myocardial markers may provide clues for early identification of patients with COPD concomitant with PHD and assist in the clinical development of targeted intervention programs.