The differences in Electrocardiography (ECG) according to the severity of Chronic Obstructive Pulmonary Disease

Chronic strain on the right side of heart resulting in cor pulmonale and the typical finding of ECG in COPD patients are well known. Since the majority of COPD patients are combined with cardiovascular diseases, the characteristics of ECG seen in clinical practice vary from study to study. The aim of this study is to identify the relationship between disease severity and ECG abnormalities in COPD. Data from The Korea COPD Subgroup Study team was analyzed of 1980 patients. All the 1980 patients underwent resting 12-lead ECG (92.1% male [n=1882]; mean age ± standard deviation [SD]: 68.8 ± 8.6 years; GOLD 1-4: 317/1010/510/143). Normal sinus rhythm was the most prevalent ECG finding and decreased as the COPD severity increased (p=0.001). As for ECG abnormalities, sinus tachycardia was the most prevalent, and pulmonary disease pattern was the least. These two findings increased with the severity of pulmonary obstruction. Of the 1980 patients, 360 underwent an ECG follow-up after one year. Heart rate, NT-pro BNP, and symptom scores were not different between the two groups. Whereas the initial FEV1/ FVC ratio was lower in the ECG change group (p=0.025). Patients experienced hospitalization due to COPD exacerbation were more frequently observed in the ECG change group (p=0.042). <bold>Conclusion:</bold> As the severity of COPD patients increased, sinus tachycardia and pulmonary disease patterns increased. When ECG follow-up of the same patient, ECG changes were more frequent in patients with a history of severe COPD exacerbation and in patients with a low FEV1/FVC ratio. In addition to ECG abnormalities, changes in ECG compared to baseline may also predict the disease course in COPD patients.