DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20190952

Echocardiographic findings in patients with chronic obstructive pulmonary disease

Sarang Patil, Suresh Patil

Abstract


Background: Chronic obstructive pulmonary disease (COPD) is a common respiratory condition involving the airways and characterized by airflow limitation. Pulmonary hypertension (PH) is a well-known predictor of increased morbidity and mortality in COPD. The present study was done to assess the cardiac changes in patients diagnosed with COPD in this department using two-dimensional echocardiography.

Methods: This observational study was conducted on fifty patients admitted with signs and symptoms suggestive of COPD in the Department of Pulmonary Medicine, Dr. DY Patil Medical College, Navi Mumbai from January 2018 to December 2018. Pulmonary function tests (PFT) were done in all and patients were graded according to the severity of COPD with guidelines given by Global initiative for Obstructive Lung Disease (GOLD). Comprehensive two-dimensional echocardiography was performed.

Results: The most common age group was 60 to 69 years. There were 68% males and 32% females. Mean body mass index of the patients included in the study was 27.8±8.13 kg/m2. COPD according to the GOLD classification was mild, moderate, severe and very severe in 12%, 36%, 30% and 22% of the patients. PH was diagnosed in 56% of the patients, Cor pulmonale in 54%, right ventricular dilatation in 48%, right atrial dilatation in 38%, inter-ventricular septal wall motion abnormality in 18% and right ventricular failure in 14% of the patients.

Conclusions: Echocardiography examination is a reliable method in COPD patient to assess PH and helps in early detection of cardiac complications in COPD cases giving time for early interventions.

Keywords


Cardiovascular diseases, COPD, Cor pulmonale, Echocardiography, Pulmonary hypertension, Right ventricular failure

Full Text:

PDF

References


Gershon AS, Warner L, Cascagnette P, Victor JC, To T. Lifetime risk of developing chronic obstructive pulmonary disease: a longitudinal population study. Lancet. 2011;378(9795):991-6.

Centers for Disease Control and Prevention (CDC). Chronic obstructive pulmonary disease among adults-United States, 2011. MMWR Morb Mortal Wkly Rep. 2012;61:938.

Global Initiative for Chronic Obstructive Lung Disease (GOLD). GOLD 2017 Global Strategy for the Diagnosis, Management and Prevention of COPD, 2017. Available at: https://goldcopd.org/gold-2017-global-strategy-diagnosis-management-prevention-copd/. Accessed December 2, 2018.

McDonough JE, Yuan R, Suzuki M, Seyednejad N, Elliott WM, Sanchez PG, et al. Small-airway obstruction and emphysema in chronic obstructive pulmonary disease. New Eng J Med. 2011 Oct 27;365(17):1567-75.

Cosio MG, Saetta M, Agusti A. Immunologic aspects of chronic obstructive pulmonary disease. N Eng J Med. 2009;360:2445.

Ourředník A, Susa Z. How long does the pulmonary hypertension last in chronic obstructive bronchopulmonary disease? Pulmonary Hypertension. 1975;9:24-8.

Bredikis AJ, Liebson PR. The echocardiogram in COPD: estimating right heart pressures. J Resp Dis. 1998;19:191-8.

Miller MR, Crapo R, Hankinson J, Brusasco V, Burgos F, Casaburi R, et al. General considerations for lung function testing. Euro Res J. 2005;26(1):153-61.

Arcasoy SM, Christie JD, Ferrari VA, Sutton MS, Zisman DA, Blumenthal NP, et al. Echocardiographic assessment of pulmonary hypertension in patients with advanced lung disease. Am J Respir Crit Care Med. 2003;167:735-40.

Groenewegen KH, Schols AM, Wouters EF. Mortality and mortality-related factors after hospitalization for acute exacerbation of COPD. Chest. 2003;124(2):459-67.

Oswald-Mammosser M, Weitzenblum E, Quoix E, Moser G, Chaouat A, Charpentier C, et al. Prognostic factors in COPD patients receiving long-term oxygen therapy: importance of pulmonary artery pressure. Chest. 1995;107(5):1193-8.

Higham MA, Dawson D, Joshi J, Nihoyannopoulos P, Morrell NW. Utility of echocardiography in assessment of pulmonary hypertension secondary to COPD. Eur Res J. 2001;17(3):350-5.

Blanco I, Gimeno E, Munoz PA, Pizarro S, Gistau C, Rodriguez-Roisin R, et al. Hemodynamic and gas exchange effects of sildenafil in patients with chronic obstructive pulmonary disease and pulmonary hypertension. Am J Res Crit Care Med. 2010;181:270-8.

Joppa P, Petrasova D, Stancak B, Tkacova R. Systemic inflammation in patients with COPD and pulmonary hypertension. Chest. 2006;130(2):326-33.