Correlation between Chronic Obstructive Pulmonary Disease and Cardiovascular Abnormality: A Cross-sectional Study

Abstract

Introduction: Cardiovascular manifestation is one of the common co-morbidity and also the complication of Chronic Obstructive Pulmonary Disease (COPD). Electrocardiography and echocardiography are rapid, non-invasive and accurate methods of investigation, to evaluate the cardiac changes. Aim: To evaluate the cardiovascular changes in COPD patients and its correction with the severity of COPD. Materials and Methods: In the present cross-sectional observational study, we analysed the cardiovascular abnormalities in COPD patients at Veer Surendra Sai Medical College, Burla, Odisha, India, from September 2014 to August 2016. Based on medical history, clinical examination and spirometry, stable COPD patients were included in the study. X-ray chest, electrocardiography, echocardiography was done for all patients. Collected data were analysed like continuous variables as mean and categorical variables as proportion. Chi-square test, fisher’s-exact test, kruskal-Wallis test were used as per applicability. Results: Out of 80 COPD patients, on the basis of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, there were two (2.5%) patients in Stage I, 34(42.5%) patients in Stage II, 28 (35%) in Stage III and 16(20%) in Stage IV. ECG changes like; P pulmonale, right axis deviation, right ventricular hypertrophy and low voltage QRS were seen more in GOLD stage IV COPD group than the GOLD III group. Echocardiography finding like; right ventricular dilatation, Left Ventricular Hypertrophy (LVH), Left Ventricular diastolic dysfunction and Pulmonary Hypertension was seen more in GOLD Stage IV than Stage III. Left Ventricular systolic dysfunction was seen in 10% of study group and exclusively in GOLD Stage IV group. Conclusion: Right ventricular pathology is common in severe forms of COPD. Left ventricular pathology is seen in GOLD stage IV COPD. The frequency as well as the severity of Pulmonary Hypertension increases as the severity of COPD increases.

Keywords

• cor-pulmonale
• echocardiography
• electrocardiography
• pulmonary hypertension