Right Ventricular Contractility is Preserved and Preload Increased in Patients with Chronic Obstructive Pulmonary Disease and Pulmonary Artery Hypertension

Burghuber, Otto Chris

doi:10.1007/978-1-4471-3853-2_11

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…In addition heart failure per se is associated with both restrictive and obstructive changes in pulmonary function [ 18 , 19 ]. Presence of COPD in the medical history was not related to TAPSE in the present study, and earlier studies have shown that RV dysfunction only occur at advances stages of the disease [ 20 , 21 ].…”

Section: Discussionsupporting

confidence: 75%

Predictors of right ventricular function as measured by tricuspid annular plane systolic excursion in heart failure

Kjærgaard

Iversen

Akkan

et al. 2009

Cardiovasc Ultrasound

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Section: Discussionsupporting

confidence: 75%

Predictors of right ventricular function as measured by tricuspid annular plane systolic excursion in heart failure

Kjærgaard

Iversen

Akkan

et al. 2009

Cardiovasc Ultrasound

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“…The association between COPD and TAPSE was explored in an earlier study, which showed that TAPSE was decreased only in COPD patients with co‐existing pulmonary hypertension [11]. The relationship between RV ejection fraction and COPD is complex, and RV contractility is well preserved in COPD [30], although measures of RV ejection fraction may be slightly reduced in patients with COPD, especially in end‐stage pulmonary disease [12]. The present study suggests that RV ejection fraction is an independent predictor of death in patients with HF, regardless of co‐existing COPD.…”

Section: Discussionmentioning

confidence: 99%

Right ventricular dysfunction as an independent predictor of short‐ and long‐term mortality in patients with heart failure

Kjærgaard

Akkan

Iversen

et al. 2007

European J of Heart Fail

232

153

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Background: The prognostic importance of right ventricular (RV) dysfunction in heart failure (HF) has been suggested in patients with severe systolic heart failure. Tricuspid annular plane systolic excursion (TAPSE) is a simple echocardiographic measure of RV ejection fraction, but may be affected by co-existing chronic obstructive pulmonary disease (COPD). Aims: To examine the prognostic information from TAPSE adjusted for the potential confounding effects of co-existing cardiovascular and COPD in a large series of patients admitted for new onset or worsening HF. Methods and results: Eight hundred and seventeen patients screened for participation in a large clinical trial by trans-thoracic echocardiography, including measurement of TAPSE, were followed for a median of 4.1 years (maximum 5.5 years). Decreased TAPSE as well as presence of COPD were independently associated with adverse short-and long-term survival, hazard ratio was 0.74 (p = 0.004) for every doubling of TAPSE; and 2.4 ( p < 0.0001) for the presence of COPD. Conclusion: Decreased RV systolic function as estimated by TAPSE is associated with increased mortality in patients admitted for HF, and is independent of other risk factors in HF including left ventricular function. The co-existence of COPD is also associated with an adverse prognosis independent of the RV systolic function.

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“…Other studies have also shown that RV contractility was identical and within normal limits in COPD patients, both with and without PH, whereas patients with PH exhibited a lower RV ejection fraction. 67,72 Thus it appears that RV contractility is generally well preserved in COPD patients, even in those with PH in the face of a low RVEF.…”

Section: Right Ventricular Function In Copdmentioning

confidence: 99%

Right Heart Function in COPD

MacNee

2010

Semin Respir Crit Care Med

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Pulmonary hypertension is a common complication in patients with severe hypoxic COPD, but the elevation in pulmonary arterial pressure (PAP) is usually relatively mild, although its presence indicates a poor prognosis. A minority of patients have severe pulmonary hypertension, whose prognosis is very poor with the development of right heart failure. Pulmonary hypertension in COPD is thought to result from hypoxic pulmonary vasoconstriction leading to structural remodeling of all layers of the pulmonary arterial walls. The simple hypothesis that hypoxemia in patients with chronic lung disease results in pulmonary hypertension, which adversely affects right ventricular function and hence increases morbidity and decreases exercise tolerance, leading to the development of peripheral edema and increased mortality, is still somewhat controversial. Whether therapeutic interventions that directly affect PAP or right ventricular function have a significant effect on long-term survival in patients with pulmonary hypertension secondary to hypoxic lung disease is still a matter of debate. Furthermore, whether such interventions will have an effect on symptoms or exercise tolerance remains unproven. Present therapies are limited to the correction of hypoxemia over the long term, which has been shown to have proven benefits on survival. Further studies are required of more specific pulmonary vasodilators or therapies to improve right ventricular function in these patients.

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Right Ventricular Contractility is Preserved and Preload Increased in Patients with Chronic Obstructive Pulmonary Disease and Pulmonary Artery Hypertension

Cited by 3 publications

References 9 publications

Predictors of right ventricular function as measured by tricuspid annular plane systolic excursion in heart failure

Predictors of right ventricular function as measured by tricuspid annular plane systolic excursion in heart failure

Right ventricular dysfunction as an independent predictor of short‐ and long‐term mortality in patients with heart failure

Right Heart Function in COPD

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