EARLY ECHOCARDIOGRAPHIC MARKERS OF STRUCTURAL AND FUNCTIONAL RIGHT VENTRICULAR REMODELLING IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Abstract

Aim. To study right ventricular (RV) structure and function, as well as cardiac and pulmonary hemodynamic parameters, in patients with chronic obstructive pulmonary disease (COPD) of moderate severity. Material and methods. The study included 37 COPD patients and 20 healthy controls. All participants underwent echocardiography (EchoCG) and the assessment of lung function (LF). Results. COPD patients demonstrated an early increase in anterior RV wall thickness and RV chamber volume, already at the stage of moderate elevation in pulmonary artery systolic pressure. Pre-capillary hemodynamic variant of pulmonary hypertension was characterised by a significant increase in pulmonary vascular resistance (р<0,001) and normokinetic hemodynamic type in patients with a longer COPD duration. Conclusion. Disturbed relaxation of RV longitudinal fibres is the initial pathological change, followed by global RV dysfunction and disturbed transverse RV contractility. These markers, which precede RV ejection fraction reduction, could be regarded as early criteria of latent systolic dysfunction in patients with a longer duration of moderately severe COPD.

Keywords

• chronic obstructive pulmonary disease
• echocardiography
• right ventricular function