Clinical and phonocardiographic evaluation of left ventricular function in patients with chronic obstructive pulmonary disease

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a term to describe a group of diseases (chronic bronchitis and emphysema). The status of left ventricular (LV) function in patients with COPD has been a controversial subject. Given the ambiguity in correlation of LV dysfunction and COPD, this study was planned to assess the relationship between LV function and COPD.Methods: This was an observational study done in 40 adult patients with acute exacerbation of COPD. The enrolled patients were divided into 2 major groups. Group A - predominant emphysema and Group B - predominant bronchitis. Phonocardiogram (PCG), carotid pulse tracing and ECG were done to measure LV ejection time (LVET) and pre-ejection period (PEP).Results: FEV1 impairment was greater (severe to very severe grade) in the majority (77%) of patients of group B, whereas the majority (77.2%) of group A patients had lesser degree of FEV1 impairment (mild to moderate). PEPI were observed to be prolonged and LVETI were observed to be shortened. PEP/LVET ratio was observed to be prolonged in 77.5% of patients in stable condition. PEP/LVET ratio was abnormally prolonged (>0.42) to a greater extent in patients of group B than in patients of group A.Conclusions: LV dysfunction is commonly encountered in patients with COPD and was observed to be exaggerated during an acute exacerbation. It was maximum in patients with chronic bronchitis with cor pulmonale with CCF and lesser in patients with chronic bronchitis without cor pulmonale or CCF and least in patients with emphysema.