Airflow obstruction and left ventricular filling pressure in suspected chronic obstructive pulmonary disease

Abstract

Left ventricular (LV) filling impairment is present in patients with chronic obstructive pulmonary disease (COPD). Airflow obstruction is related to reduced LV end-diastolic volume, stroke volume, and cardiac output. The ratio of peak early diastolic filling velocity of the mitral inflow to peak early diastolic velocity of the mitral annulus (E/e′), an echocardiographic parameter, can be applied as a surrogate marker of LV filling pressures. Forty-seven individuals with suspected COPD underwent pulmonary function tests and echocardiography. The ratio of forced expiratory volume in 1s to forced vital capacity (FEV1/FVC) and the E/e′ ratio were determined. Multivariate linear regression analysis showed that the FEV1/FVC ratio (β=0.01; 95% confidence interval, 0.001–0.019; p=0.036) independently predicted the log transformed E/e′ ratio. An increase of FEV1/FVC ratio (in percentage) by 1 unit was associated with an increase of the E/e′ ratio multiplied by 1.01. Airflow obstruction inversely predicts LV filling pressure in suspected COPD cases.