Evaluation of atrial conduction features in stable chronic obstructive pulmonary disease patients and its relationship with neutrophil to lymphocyte ratio

Aims: Chronic obstructive pulmonary disease (COPD) has been associated with a high frequency of cardiac arrhythmia. While many studies have examined the development of atrial fibrillation (AF) in COPD patients, there is insufficient data about atrial conduction time (ACT) and its relationship with the Neutrophil to Lymphocyte ratio (NLR) in these patients. The aim of the present study was to evaluate atrial conduction features and its relationship with NLR. Materials and methods: The study groups comprised 40 patients with COPD and 40 healthy subjects, who were subjected to pulmonary function tests, 12-lead surface electrocardiograms, echocardiographic examinations and blood sample tests. ACT was measured through tissue Doppler imaging, while NLR was measured by dividing the neutrophil count by the lymphocyte count. Results: Pulmonary function values were significantly lower in COPD patients than in the control group, as would be expected (p<0,001). According to the ACT measurements, tricuspid ACT was significantly longer in COPD patients than in the controls (26.4 ± 11.4 ms vs 17.7 ± 7.7 ms, p<0.001). Also, NLR was higher in COPD patients than in the control group (2.4 ±1.2 vs 1.94 ±0.8 p=0.009). A negative correlation was observed between tricuspid ACT and the percent of forced expiratory volume in one second (FEV1 %) (r = - 0.45; p <0.001), and a significant positive correlation was identified between tricuspid ACT and NLR (r=+0.38; p< 0.001). Conclusion: Our study revealed prolonged tricuspid ACT and increased NLR in COPD patients, and the existence of a relationship between these parameters was identified. Previous studies claim that hypoxia and chronic inflammation may be the underlying mechanisms explaining arrhythmia in patients with COPD, while many studies also show that a prolongation of ACT and increased NLR is associated with atrial arrhythmias. In the light of our findings and previous data, the assessment of ACT and NLR can be considered a clinically useful approach to detecting the risk of AF development in the population.