Systolic function of the left ventricle in patients with pulmonary hypertension on the background of chronic obstructive pulmonary disease

Abstract

Chronic obstructive pulmonary disease (COPD) greatly affects the quality of life, significantly limiting the physical capabilities of people suffering from it. The prevalence of COPD worldwide is about 7,6 %, and it is one of the main causes of morbidity and mortality in today’s society. An urgent medical and social problem of our time is the development of pulmonary hypertension (PH) in patients with COPD. Transthoracic echocardiography is important for PH screening. It has the highest sensitivity and specificity among non-invasive examinations, and unlike catheterization of the right heart, it does not require special equipment and centers for dynamic monitoring of patients with PH. When pulmonary hypertension, there is a pronounced remodeling of the heart. At the first stage, it occurs in the right parts of the heart, and in the future, as a consequence, it is accompanied by a violation of systolic inter-ventricular interactions. Purpose of the study. To determine the characteristics of left ventricular systolic function in patients with pulmonary hypertension on the background of COPD. Materials and methods. Results of the study are based on data from a comprehensive survey of 170 COPD patients aged 40 to 65 years, 123 of which had pulmonary hypertension and 47 ones had no pulmonary hypertension. Results and discussion. In the group of patients with PH on the background of COPD, the shock volume was 74,72 cm3 (64,60–83,09) and it was significantly lower compared to the level of 82,04 cm3 (75,20–87,76) of the COPD group without PH (p 12 years compared to the subgroup  12 years, 134,17 cm3 (117,00–150,15) versus 125,52 cm3 (105,20–139,60) and 57,37 cm3 (51,70–65,60) versus 51,40 cm3 (43,08–59,84), respectively (p 0,05). The level of LV ejection fraction was significantly lower in the subgroup of COPD duration > 12 years 56,64% (52,65–59,73) against the subgroup  12 years (p 0,05). Correlation analysis revealed significant relationships between the following indicators: duration of COPD and ESV (R = +0,24, p = 0,008); duration of COPD and LV EF (R = –0,25, p = 0,006); MPAP and EDV (R = –0,22, p = 0.02); MPAP and SV (R = –0,26, p = 0,004); MPAP and LV EF (R = –0,21, p = 0,02).

Keywords

• left ventricular systolic function
• pulmonary hypertension
• chronic obstructive pulmonary disease
• mean pulmonary artery pressure