Cardiovascular comorbidity in patients with chronic obstructive pulmonary disease: echocardiography changes and their relation to the level of airflow limitation

Abstract

Objective. To compare frequency of echocardiographic changes in patients with chronic obstructive pulmonary disease (COPD) and non-COPD controls and to assess their relation to the level of airflow limitation.
 Methods. Study population included 120 subjects divided in two groups. Group 1 included 60 patients with COPD (52 male and 8 female, aged 40 to 80 years) initially diagnosed according to the actual recommendations. Group 2 included 60 subjects in whom COPD was excluded serving as a control. The study protocol consisted of completion of a questionnaire , pulmonary evaluation (dyspnea severity assessment, baseline and post-bronchodilator spirometry, gas analyses, and chest X-ray) and two dimensional (2D) Doppler echocardiography.
 Results. We found significantly higher mean right ventricle end-diastolic dimension (RVEDd) in COPD patients as compared to its dimension in controls (28.0 ± 4.8 vs. 24.4 ± 4.3; P = 0.0000). Pulmonary hypertension (PH) was more frequent in COPD patients than in controls (28.0 ± 4.8 vs. 24.4 ± 4.3; P = 0.0000) showing linear relationship with severity of airflow limitation. The mean value of left ventricular ejection fraction (LVEF%) was significantly lower in COPD patients than its mean value in controls (57.4 ± 6.9% vs. 64.8 ± 2.7; P = 0.0000) with no correlation with severity of airflow limitation. 
 Conclusion. Frequency of echocardiographic changes in COPD patients was significantly higher as compared to their frequency in controls in the most cases being significantly associated with severity of airflow limitation. Echocardiography enables early, noninvasive, and accurate diagnosis of cardiac changes in COPD patients giving time for early intervention.
 Key words: airflow limitation, chronic obstructive pulmonary disease, Doppler echocardiography, pulmonary hypertension, ventricular dysfunction.

A correlation between severity of chronic obstructive pulmonary disorders, electrocardiography and echocardiography of patients: a prospective observational study

“…This is finding corroborates with the study of Scott, Spodick et al [20][21][22] Buklioska-Ilievska has reported that Frequency of echocardiographic changes in COPD patients increases with the severity of airflow obstruction which supports our study. 23 In our study right ventricular hypertrophy pulmonary hypertension and right ventricular failure are common in sever COPD patients, which is supported by the work of Freixa et al 24…”

Relationship between RS time and the severity of chronic obstructive pulmonary disease

“…The reduction of FEV1 in COPD patients increases the risk of fatal cardiovascular and non-fatal coronary events 10 . Electrocardiography can be a practical tool for the early diagnosis of any cardiac alterations related to COPD.…”

“…Although the right ventricular dimension and right ventricular dimension index were higher in the severe and very severe COPD group, this difference did not reach statistical significance. This may be due to the adaptive mechanisms in the chronic process in patients with COPD 10,28 .…”

“…The frequency of cardiac abnormalities is significantly related to the severity of airflow limitation in COPD patients 10,11 . Mortality has also been shown to increase with the severity of airflow limitation in COPD patients 12 .…”

Right cardiac involvement in lung diseases: a multimodality approach from diagnosis to prognostication

“…However, the RV evaluation in patients with COPD should not be limited to sPAP evaluation. In fact, increased sPAP values at rest are a sign of advanced pulmonary circulation impairment [22].…”