Evaluation of left ventricular function in patients with chronic obstructive pulmonary disease with or without pulmonary hypertension

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a common entity in clinical practice. Development of right ventricular hypertrophy and eventual right side heart failure is also common in such patients. However, some disturbance in left ventricular (LV) function has been observed among such patients. Objectives: The aim of this study was to evaluate LV function in patients with chronic obstructive pulmonary disease (COPD) with or without pulmonary hypertension. Patients and methods: Thirty-six patients with COPD without additional cardiac diseases and 12 age and sex-matched healthy subjects were enrolled into the study. All patients underwent spirometry, standard and tissue Doppler echocardiography. Results: 20 COPD patients (55.6%) had pulmonary hypertension. Left ventricular systolic function did not differ between patient and control groups. However the difference between both groups was significant regarding left ventricular diastolic function and left ventricular global function. Left ventricular diastolic function and global function differed significantly between different COPD grades. Patients with pulmonary hypertension had significantly higher heart rate, less E wave peak velocity (measured by DTI) (P ⩽ 0.05), less E/A ratio (measured by DTI) (P ⩽ 0.01) and E/A ratio (measured by flow) and higher myocardial performance index (P ⩽ 0.05) than normal pulmonary pressure patients. Conclusion: Left ventricular diastolic function and LV global function are affected in COPD patients especially with progression of the disease. COPD patients with pulmonary hypertension are more liable to LV diastolic and global dysfunction than normal pulmonary pressure COPD patients. Doppler tissue echocardiography is a better tool in the assessment of left ventricular function.

Keywords

• Left ventricular function
• Diastolic dysfunction
• COPD
• Pulmonary hypertension