Acta Medica Medianae (Dec 2005)
MORPHOLOGICAL CHANGES AND DIASTOLIC CHARACTERISTICS OF RIGHT VENTRICLE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE EVALUATED BY DOPPLER ECHOCARDIOGRAPHY
Abstract
Chronic obstructive pulmonary disease (COPD), which is characterized by significant long-term airway obstruction associated with the impaired inflammatory response, represents a progressive disease disturbing the structure and function of the heart, finally leading to cor pulmonale (CP). Pulmonary vascular reduction - pulmonary hypertension lies in etiopathogenesis of CP. The adaptation process of right ventricle (RV) begins with structural changes, followed by hypertrophy of the free wall and interventricular septum. Such changed myocardium, in the presence of hypoxia of varying intensity, may result in diastolic dysfunction of RV in these patients.The aim of the study was to investigate diastolic dysfunction of RV in patients with COPD, by ascertaining the correlation between diastolic dysfunction and charge model of RV depending of bronchial obstruction level. We have proved that aging influences dyastolic characteristic of RV, mostly disturbances of diastolic relaxation. In the third group of patients with significant remodeled RV, there is not any correlation between age and dyastolic function of RV. Diastolic dysfunction of RV and disturbances in charging according to the model of prolonged relaxation are registered in the second group, while in the third one they are more marked. Flow changes in hepatic vein at the retrograde flow rate in the atrial contraction phase show lower compliance of RV at the end of diastole, while anterograde flow limitation in diastole and rise of speed of PA wave in the second group of patients point to the moderate disturbance of RV relaxation. Diastolic dysfunction of RV begins before systole and patients with COPD must be examinedby ultrasound in an early stage of disease for the presence of diastolic dysfunction, so that the adequate treatment could prevent cardiac failure.
