DOI: http://dx.doi.org/10.18203/2349-3933.ijam20171045

Echocardiographic findings in chronic obstructive pulmonary disease and correlation of right ventricular dysfunction with disease severity

Vinod Singh Jatav, S. R. Meena, Shivcharan Jelia, Pankaj Jain, Devendra Ajmera, Vinit Agarwal, Chirangee L. Dayma, Mohd. Arif

Abstract


Background: COPD is a powerful and independent risk factor for cardiovascular morbidity and mortality which includes right ventricular (RV) dysfunction and cor pulmonale secondary to pulmonary arterial hypertension (PAH), left ventricular dysfunction. Echocardiography provides a rapid, noninvasive, portable, and accurate method to evaluate cardiac functions. Early diagnoses and intervention for cardiac comorbidities would reduce mortalities in COPD patients. The aim of this study is to find echocardiographic changes in COPD patients and to assess RV dysfunction by echocardiography and correlate with the disease severity.

Methods: 100 patients of COPD fulfilling the inclusion criteria coming to OPD/wards of NMCH, Kota were recruited. They were staged by pulmonary function test (PFT) and evaluated by echocardiography. Statistical analysis of correlation was done with chi square test and statistical significance was taken p<0.05.

Results: Most common echocardiographic finding was cor pulmonale, which was present in 62% of cases, other echocardiographic findings were PAH in 44% cases, RA/RV dilatation (43%), RVH (42%), LVDD (46%), RVSD (14%) and LVH in 11% of cases. Echocardiographic signs of RV dysfunction observed are PAH, cor pulmonale and RVSD which are correlated with the severity of the disease (p<0.05).

Conclusions: Echocardiographic examination is reliable in following COPD patients with PAH instead of repeated cardiac catheterization. The incidence of RV dysfunction is more common as the severity of COPD increases and there is a significant correlation between the degree of air flow limitation (FEV1) and RV dysfunction.


Keywords


Chronic obstructive pulmonary disease, Cor pulmonale, Echocardiography, RV dysfunction

Full Text:

PDF

References


J. Reilly, Silverman. chronic obstructive pulmonary disease. In: Kasper Dennis,Hauser Stephen, Jameson J. Larry, S. Fauci anthony, Longo, Loscalzo. Harrison's principles of internal medicine 19th edition, from New York, NY:McGraw Hill. 2015;2:1700.

Chen JC, Mannino DM. Worldwide epidemiology of chronic obstructive pulmonary disease. Curr Opin Pulm Med. 1999;5:93-9.

Murray CJ, Lopez AD. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet. 1997;349:1436-42.

Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease. Executive summary. Medical Communications Resources, Inc; 2007:1-43.

Krishnan RD and Srihari B. A study on the severity of right ventricular dysfunction in correlation with the severity of Lung dysfunction in chronic obstructive pulmonary disease patients- COPD. Am J Sci Med Res. 2015;1(1):112-9.

Sekhar CG, Sammaiah P, Bookya K, Balaji B. Study of cardiovascular complications in chronic obstructive pulmonary disease with reference to ECG and 2D echocardiography findings. Am J Pharm Health Res. 2016;4(1):97-111.

Suma KR, Srinath PS. Electrocardiographic and echocardiographic changes in chronic obstructive pulmonary disease (COPD) of different grades of severity. J Evol Med Dent Sci. 2015;4(30):5093-101.

Vikhe VB, Shende PS, Patil RS, Tamakuwala KK, Patil AS, Gupta AP. Cardiovascular complications in chronic obstructive pulmonary disease with reference to 2D echocardiography findings. Natl J Med Res. 2013;3(4):385-8.

Dave L, Dwivedi P, Srivastava N, Yadav BS, Dohre R. A study of cardiovascular manifestations of COPD. Int J Res Health Sci[Internet]. 2014;2(3):812-7.

Kaushal M, Shah PS, Shah AD, Francis SA, Patel NV, Kothari KK. Chronic obstructive pulmonary disease and cardiac comorbidities: A cross-sectional study. Lung India. 2016;33:404-9.

Freixa X, Portillo K. Echocardiographic abnormalities in patients with COPD at their first hospital admission. Eur Respir J. 2013;41:784-91.

Gupta R, Mann S. Correlation between COPD and echocardiographic features with severity of disease. Natl J Integr Res Med. 2016;7(1):26-30

Gupta NK, Agrawal RK, Srivastav AB, Ved ML. Echocardiographic evaluation of heart in chronic obstructive pulmonary disease patient and its co-relation with the severity of disease. Lung India. 2011;28:105-9.

Vizza CD, Lynch JP, Ochoa LL, Richardson G, Trulock EP. Right and left ventricular dysfunction in patients with severe pulmonary disease. Chest. 1998;113;576-83.

Burrows B, Kettel LJ, Niden AH, Rabinowitz M, Diener CF. Patterns of cardiovascular dysfunction in COPD. N Engl J Med. 1972;286:912-8.

Higham MA, Dawson D, Joshi J, Nihoyannopoulos P, Morrell NW. Utility of echocardiography in assessment of pulmonary hypertension secondary to COPD. Eur Respir J. 2001;17:350-5.

Vonk-Noordegraaf A, Marcus JT, Holverda S. Early changes of cardiac structure and function in COPD patients with mild hypoxemia. Chest. 2005;127:1898-903.

Curkendall SM, DeLuise C, Jones JK. Cardiovascular disease in patients with chronic obstructive pulmonary disease, Saskatchewan Canada cardiovascular disease in COPD patients. Ann Epidemiol. 2006;16:63-70.

Klinger JR, Hill NS. Right ventricular dysfunction in chronic obstructive pulmonary disease, evaluation and management. Chest. 1991;99:715-23.