CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS AND ITS CLINICAL EFFECTS ON THE LEFT VENTRICULAR FUNCTION
*Dr. Gaude Gajanan, Dr. Gautam S, Dr. Mahishale Vinay, Dr. Chaudhury Alisha
ABSTRACT
Background: In chronic obstructive pulmonary disease (COPD)
patients, left ventricular (LV) systolic dysfunction is rare. However,
abnormal LV diastolic dysfunction has been frequently reported in
patients with COPD. Objectives: To evaluate the prevalence of left
ventricular systolic or diastolic dysfunction in patients with COPD.
Materials and Methods: A total of 102 patients diagnosed with
COPD as per GOLD guidelines were enrolled. These patients
underwent physical examination and standard two-dimensional
echocardiographic views, and peak flow velocity of early diastolic filling (Emax), peak flow
velocity of late atrial filling (Amax) and early flow velocity peak/late flow velocity peak
(E/A) ratio were measured according to the criteria’s of American Society of
Echocardiographers. Results: Of the 102 COPD patients, the maximal atrial filling velocity
(A-Max) was increased and early filling velocity (E-Max) was decreased in 76 patients
(74.5%) (p < 0.001). The early flow velocity peak/late flow velocity peak (E/A) ratio was
also markedly decreased in these 76 patients (p < 0.001) indicating left ventricular
dysfunction. The atrial contribution to total left diastolic filling was increased in patients with
COPD. This was also observed in COPD patients with normal PAP (p < 0.001). Grade IV COPD (p-0.000), duration of illness (p<0.001), smoking >10 pack years (p<0.001) were the
risk factors which were associated with development of LV diastolic dysfunction in COPD
patients. Conclusion: In the present study, the prevalence of left ventricular diastolic
dysfunction was 74.5%. As the severity of COPD increased, the risk of left ventricular
diastolic dysfunction increased. The screening of severe COPD patients for left ventricular
function will improve the outcome in these cases.
Keywords: COPD, left ventricular dysfunction, pulmonary arterial pressure.
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