Value of Two-Dimensional Echocardiography in the Identification of Pulmonary Hypertension in Chronic Obstructive Lung Disease

Abstract

Thirty-three patients suffering from chronic obstructive lung disease (COLD) were submitted to right heart two-dimensional echocardiographic (2D-ECHO) and hemodynamic study. By the subcostal approach, the right ventricle outflow tract including the pulmonary vessels was visualized in 85% of the patients. Most parameters measured on the right ventricle and pulmonary vessels were significantly higher than those recorded in the healthy control group. Very significant correlations were observed between the mean pulmonary artery pressure (PAP) and the following 2D-ECHO parameters: diameter of the pulmonary artery at valve level (r = 0.62; p < 0.001); supravalvular diameter of the pulmonary artery (r = 0.44; p < 0.03); diameter of the left branch of the pulmonary artery (r = 0.48; p < 0.05); diameter of the right branch of the pulmonary artery (r = 0.39; p < 0.05), and between the PAP and PaO₂ (r = -0.66; p < 0.001). Furthermore, the sensitivity, specificity, and accuracy of 2D-ECHO measurements were calculated to assess the presence of pulmonary hypertension. Overall sensitivity was 65%, specificity 75%, and accuracy 67%. However, by combining the value of PaO₂ with that of the pulmonary valve by means of the multiple regression analysis, sensitivity increased to 84% in identifying pulmonary hypertension. Such data demonstrate that the 2D-ECHO study of the right heart in COLD patients has to carefully measure the dimensions of the pulmonary valve and the great pulmonary vessels, as their modification are mainly linked with the presence of pulmonary hypertension. Hence, it can be concluded that 2D-ECHO if associated with PaO₂ measurement allows the physician to diagnose pulmonary hypertension in COLD with a good degree of probability.

Correlative Study of Ecg and Echocardiographic Findings in Copd Patients

“…There was good correlation between echocardiographic parameters, hemodynamics and pulmonary function parameters. 9 the authors concluded that echocardiography may be a useful technique in the non-invasive assessment of pulmonary hypertension on right heart in COPD.…”