Echocardiographic right heart study in patients with chronic obstructive pulmonary disease

Abstract

Background and Aims: : Chronic obstructive pulmonary disease (COPD) is highly prevalent in the Nepalese population. It is associated with significant extrapulmonary effects among which cardiovascular complications are most common . Echocardiography evaluation mainly focused on effects on the right heart function is a salient tool to evaluate the presence of degree of pulmonary hypertension and also identify those group of patients who need more early aggressive therapy for the underling lung disease . We aimed to prospectively study the patients with diagnosed COPD with echocardiogram for evaluating the right heart . Methods: An observational , cross sectional study was done on 50 patients with COPD who were admitted at Bir Hospital and underwent echocardiographic evaluation from Dec 2015 -Dec 2016 . All echocardiogaphic parameters focused on right heart and its function were assessed . Results: Out of total 50 COPD patients studied , majority of them were female (32 patients ,64%). The mean age group of the studied patients was 60.9 ±11.4 years . Pulmonary hypertension defined as sPAP>30 mmHg was evident in all of the patients ; with 30 patients (60% ), 14 (28 %) and 6(12 %) patients having severe, moderate and mild pulmonary hypertension respectively . RV dysfunction was evident with reduced average TAPSE values (1.59± 0.38 cm) and elevated RIMP values (0.58±0.16). Conclusion: Majority of COPD patients had evidence of pulmonary hypertension. Echocardiogram can be a helpful tool to assess early changes on the right heart size and function in patients with COPD and also monitor these patients for rapid progression of the illness .

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

“…In one of them, the 5-year survival rates were 50% in patients with mild PH (20-30 mmHg), 30% in those with moderate to severe PH (30-50 mmHg), and 0% in the small group of patients with severe PH (> 50 mmHg) [30]. As a conclusion, the high level of PH is associated with poor prognosis in COPD patients [7].…”

“…The difference can be explained by several factors like the type of equipment used, the experience of the operator, the quality of the image obtained or the body habitus. Impairment of RV function and alteration of pulmonary blood vessels complicate the clinical course of COPD and correlates inversely with the survival of these patients [7].…”

“…Furthermore, cardiovascular comorbidities are considered as a major cause for hospitalization and mortality in COPD patients [1], [2], [3], [4], [5], [6]. COPD affects pulmonary blood vessels, right ventricle and left ventricle leading to right ventricular dysfunction, left ventricular dysfunction, pulmonary hypertension (PH) and cor pulmonale [7].…”

Kronik Obstrüktif Akciğer Hastalığı Akut Alevlenmelerinde Sağ Kalp Fonksiyonlarının Ekokardiyografi İle Değerlendirilmesi

“…RV fonksiyonunda bozulma ve pulmoner kan damarlarında değişiklik olması KOAH' ın klinik seyrini zorlaştırır ve bu hastaların sağ kalımı ile ters orantılıdır 28 . KOAH hastalarında RV' nin hem sistolik hem de diyastolik fonksiyonlarının bozulduğu iyi bilinmektedir.…”

The burden of chronic respiratory diseases in adults in Nepal: A systematic review

“…Most of the studies were either of low (n ¼ 13) or moderate (n ¼ 12) quality, with two classed as high quality. Some studies reported on more than one condition, with the major diseases identified being: COPD (22 studies), 31,32,[34][35][36][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] asthma (8 studies), 20,32,36,37,49,[52][53][54] bronchiectasis (2 studies and as a co-morbidity in one), 30,40,52 restrictive lung diseases (3 studies), 49,51,52 and 'chronic bronchitis' (1 study). 29 Symptoms reported included chronic cough, phlegm or sputum production, breathlessness or shortness of breath, chest tightness, wheezing, dyspnoea and sore throat.…”