https://doi.org/10.4081/monaldi.2023.2543

Serum lactate dehydrogenase and its isoenzymes as predictors of clinical outcomes in acute exacerbation of chronic obstructive pulmonary disease: a retrospective analysis of a hospitalized cohort

Early Access
Submitted: February 6, 2023
Accepted: May 25, 2023
Published: June 7, 2023
Lactate dehydrogenase, LDH isoenzymes, COPD acute exacerbation, COPD outcomes
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Authors

Dimitrios Papadopoulos
d.g.papadopoulos@gmail.com
https://orcid.org/0000-0002-5547-6474
2nd Pulmonary Medicine Department, “Sismanogleion” General Hospital of Attica, Marousi, Greece.
Vlasios Skopas
2nd Pulmonary Medicine Department, “Sismanogleion” General Hospital of Attica, Marousi; Respiratory Medicine Department, School of Medicine, University of Thessaly, University Hospital of Larissa , Greece.
Nikolaos Trakas
Clinical Chemistry Department, “Sismanogleion” General Hospital of Attica, Marousi, Greece.
Eleni Papaefstathiou
Clinical Chemistry Department, “Sismanogleion” General Hospital of Attica, Marousi, Greece.
Nikolaos Tzogas
3rd Pulmonary Medicine Department, Henry Dunant Hospital Center, Athens, Greece.
Demosthenes Makris
Critical Care Department, School of Medicine, University of Thessaly, University Hospital of Larissa, Greece.
Zoe Daniil
Respiratory Medicine Department, School of Medicine, University of Thessaly, University Hospital of Larissa, Greece.
Konstantinos Gourgoulianis
Respiratory Medicine Department, School of Medicine, University of Thessaly, University Hospital of Larissa, Greece.

We aimed to test the association between serum lactate dehydrogenase (LDH) and its isoenzymes and treatment outcomes during hospitalization for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Thirty-eight AECOPD patients were recruited from a tertiary hospital from December 2017 to June 2018. Serum LDH and LDH isoenzymes were measured on venous blood collected at admission. Treatment outcomes included duration of hospital stay, initiation of non-invasive (NIV) or mechanical ventilation, initiation of antipseudomonal antibiotics, change in empirical antibiotic treatment, need for intravenous corticosteroids or methylxanthines, and percentage of change in C-reactive protein from admission to the third day. Multivariate linear and binary logistic regression analyses were used to test the study’s objectives. We found that, after adjusting for age, gender, comorbidities, COPD severity, level of hypoxemia, and inflammation markers, each 10 U/L increase in serum LDH was associated with prolongation of the hospital stay by 0.25 (0.03, 0.46) days, 42% higher odds (odds ratio [OR] 1.42 [1.00, 2.03]) for need of NIV, and 25% higher odds (OR 1.25 [1.04, 1.49]) for initiation of antipseudomonal treatment. LDH1 and LDH2 were the LDH isoenzymes that mainly drove these relationships. LDH release in the context of an AECOPD could originate from lung, muscle, or heart tissue damage due to airway inflammation, respiratory muscle recruitment, and myocardial stress. Myocardial injury and aerobic adaptation in respiratory muscles may explain the predominance of LDH1 and LDH2 isoenzymes in these associations.

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Ethics Approval

The study protocol was approved by the Research Committee of the University of Thessaly (protocol number 2800/2017)

How to Cite

Papadopoulos, Dimitrios, Vlasios Skopas, Nikolaos Trakas, Eleni Papaefstathiou, Nikolaos Tzogas, Demosthenes Makris, Zoe Daniil, and Konstantinos Gourgoulianis. 2023. “Serum Lactate Dehydrogenase and Its Isoenzymes As Predictors of Clinical Outcomes in Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Retrospective Analysis of a Hospitalized Cohort”. Monaldi Archives for Chest Disease, June. https://doi.org/10.4081/monaldi.2023.2543.
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