Oxidative Stress and Inflammatory Cytokines as Drivers of Cardiac Remodeling in COPD Patients

Chronic obstructive pulmonary disease (COPD) is increasingly recognized as a systemic disease characterized by chronic inflammation and oxidative stress, with frequent cardiovascular involvement. This study investigated the associations between oxidative stress-related inflammatory markers and structural and electrical cardiac abnormalities in patients with COPD using a comprehensive multimodal cardiopulmonary assessment. A total of 100 clinically stable patients with COPD underwent inflammatory biomarker evaluation (IL-6, IL-8, IL-1β, and TNF-α), transthoracic echocardiography and 24 h Holter ECG monitoring. Advanced COPD was associated with significant differences in several structural cardiac parameters, including left atrial volume (p = 0.016), left atrial height (p = 0.027), and selected left ventricular parameters, while left ventricular ejection fraction remained preserved. Electrical abnormalities were significantly associated with systemic inflammatory markers. SII showed the highest discriminatory performance for sinus rhythm abnormalities (AUC = 0.736), whereas IL-6 showed the highest discriminatory performance for ventricular premature complexes (AUC = 0.732). Ventricular ectopic activity was also associated with significantly higher SII, SIRI, MLR, NLR, and PLR. Systemic inflammatory markers were associated with structural and electrical cardiac abnormalities in COPD, suggesting that they may provide complementary information regarding cardiovascular involvement. However, given the cross-sectional design and moderate discriminatory performance of these biomarkers, the findings should be considered exploratory and do not establish causal relationships. Prospective studies are needed to determine their potential role in cardiovascular risk stratification.