Use of Ecg and Other Clinical Variables for Detecting Pulmonary Hypertension in Copd Patients- A Cross-Sectional Observational Study

Abstract

BACKGROUND Chronic Obstructive Pulmonary Disease (COPD) has emerged as a leading cause of mortality worldwide. Pulmonary Hypertension (PH) is a frequent complication associated with COPD and it is prevalent among 10% -30% of the COPD patients with moderateto-severe disease. However, PH-associated with COPD is poorly diagnosed due to the lack of specific clinical investigations and sensitive markers. Despite being the most common techniques, the use of non-invasive techniques like echocardiography and electrocardiography for diagnosing PH in COPD is controversial. MATERIALS AND METHODSThe cross-sectional observational study was conducted for a period of two years in a super speciality hospital in south India. The subjects were classified based on the status of PH. Apart from routine laboratory investigations, pulmonary function test, transthoracic 2D-echo with colour Doppler and electrocardiography were performed for all the participants. Different clinical and demographic variables were compared between COPD subjects with and without PH and their significance were studied. RESULTSThe study included a total of 44 subjects with a mean age of 61.3 ± 10.84. PH was detected in 11 subjects based on the 2D ECHO Doppler findings. On comparison of the various ECG findings between the two groups, only P axis > 60 0 (P= 0.0336) showed a significant variation and V1-R/ S > 1 (0.0507) showed a trend towards significance. CONCLUSION ECG may not be an accurate non-invasive tool for diagnosing PH in COPD patients. KEYWORDSCOPD, Pulmonary Hypertension, Electrocardiography, Right Ventricular Hypertrophy. HOW TO CITE THIS ARTICLE: Rangadham A, Gangaiah VD. Use of ECG and other clinical variables for detecting pulmonary hypertension in COPD patients-a cross-sectional observational study. J. Evolution Med. Dent. Sci. 2018;7(02):167-170, DOI: 10.14260/jemds/2018/37 BACKGROUND Chronic obstructive pulmonary disease (COPD) is the most prevailing cause of mortality worldwide. 1 According to the 2013 report by World Health Organisation, 65 million people have moderate-to-severe COPD globally. The disease is estimated to cause more than 30% total deaths by the next 10 years and it is projected to become the third leading cause of death worldwide by 2030. 2 Reports indicate that 90% of the COPD deaths occur in the low-and middle-income countries. 3 A population-based survey has reported an overall prevalence of 8.2 in the Chinese population and the disease was found to be prevalent among individuals of 40 years of age. 4 Studies based on Indian population have reported that 30 million Indians suffer from COPD. 5 A review of the Indiabased population studies by Jindal et al have reported that the estimated prevalence of COPD is 5% in men and 2.7% in women. 6 A systemic review has found that the prevalence of chronic bronchitis in the rural Indian population ranges between 6.5% and 7.7%. 7