Echocardiographic evaluation of heart in chronic obstructive pulmonary disease patient and its co-relation with the severity of disease

Abstract

Background:Chronic obstructive pulmonary disease (COPD) has considerable effects on cardiac functions, including those of the right ventricle, left ventricle, and pulmonary blood vessels. Most of the increased mortality associated with COPD is due to cardiac involvement. Echocardiography provides a rapid, noninvasive, portable, and accurate method to evaluate the cardiac changes.Aims:To assess the cardiac changes secondary to COPD by echocardiography and to find out the correlation between echocardiographic findings and severity of COPD, if there is any.Materials and Methods:A total 40 of patients of COPD were selected and staged by pulmonary function test (PFT) and evaluated byechocardiography.Results:On echocardiographic evaluation of COPD, 50% cases had normal echocardiographic parameters. Measurable tricuspid regurgitation (TR) was observed in 27/40 cases (67.5%). Pulmonary hypertension (PH), which is defined as systolic pulmonary arterial pressure (sPAP)> 30 mmHg was observed in 17/27 (63%) cases in which prevalence of mild, moderate, and severe PH were 10/17 (58.82%), 4/17 (23.53%), and 3/17 (17.65%), respectively. The frequencies of PH in mild, moderate, severe, and very severe COPD were 16.67%, 54.55%, 60.00%, and 83.33%, respectively. Right atrial pressure was 10 mmHg in 82.5% cases and 15 mmHg in 17.5% cases. Cor pulmonale was observed in 7/17 (41.17%) cases; 7.50% cases had left ventricle (LV) systolic dysfunction and 47.5% cases had evidence of LV diastolic dysfunction defined as A ≥ E (peak mitral flow velocity of the early rapid filling wave (E), peak velocity of the late filling wave caused by atrial contraction (A) on mitral valve tracing) Left ventricle hypertrophy was found in 22.5% cases.Conclusion:Prevalence of PH has a linear relationship with severity of COPD and severe PH is almost associated with cor pulmonale. Echocardiography helps in early detection of cardiac complications in COPD cases giving time for early interventions.

Association between left ventricular diastolic dysfunction and severity of chronic obstructive pulmonary disease

“…(21,22). In addition, a recent study showed evidence of diastolic dysfunction in 47.5% (24) of COPD patients. However, Freixa et al found a lower frequency of this echocardiographic alteration (12%) in COPD patients in their first hospital admission (25).…”

Impact of chronic obstructive pulmonary diseases on left ventricular diastolic function in hospitalized elderly patients

“…Therefore, the difference in the frequency of LVDD in patients with COPD between the present and previous studies might be due to different distribution of COPD stages, age, sex, and comorbidities. In addition, a recent study 12 showed diastolic dysfunction in 47.5% of patients with COPD, and only 27.5% of their patients had severe/very severe COPD.…”

Pulmonary Artery Enlargement Is Associated With Right Ventricular Dysfunction and Loss of Blood Volume in Small Pulmonary Vessels in Chronic Obstructive Pulmonary Disease

“…1-4 Functional decline is often associated with concomitant pulmonary hypertension (PH) and right ventricular (RV) dysfunction 2, 5-10 . Cardiac magnetic resonance imaging (cMRI) is the gold standard for the assessment of both the morphological and functional characteristics of the RV particularly in patients with COPD in whom echocardiographic assessment is often not possible 11-14 .…”