Cardiac structural and functional changes in comorbid chronic coronary syndrome, chronic obstructive pulmonary disease, and obese patients

Abstract

The aim of our study was to assess cardiac structural and functional changes in comorbid chronic coronary syndrome (CCS), chronic obstructive pulmonary disease (COPD), and obese patients.Material and methods. 63 participants were included in the study. They were divided into 3 clinical groups: G1 – 16 СCS and obese patients, G2:16 subjects with CCS, COPD, and 18.5<BMI<24.9, G3: 16 CCS, COPD,and obese patients. 15 healthy individuals with 18.5<BMI<24.9 wereincluded in the control group. We determined spirometry parameters andcardiac structural and functional parameters by echocardiography (ECG)in M- and B-modes using the ultrasound system "EnVisor CHD" (Philips,USA). Doppler echocardiography with measurement of the mitral ratio ofpeak early to late diastolic filling velocity (E/A) was also measured. Wealso calculated the BODE index and the modified BODE index, using bodymass index (BMI), forced expiratory volume in one second (FEV1), modified Medical Research Council (mMRC) Dyspnoea Scale, and 6-minute walk test.Results. In our study, we found a significant increase by 17% left atrium(LA) size, by 15% end-systolic size (ESC) (p<0.05), by 12.7% end-diastolic volume (EDV), by 7% LV posterior wall thicknesses in systole (LVPWs), by 5.9% interventricular wall thickness in diastole (IVSd), by 57.5% systolic pulmonary artery pressure (SPAP), by 36% right ventricle size (RV) and decrease by 7.1% an ejection fraction (EF), by 33.2% E/A ratio in CCS, COPD, and obese patients compared with CCS, and obese patients (p<0.05). A probable increase by 7.8% LA size, by 4.2% posterior left ventricle wall thicknesses in diastole (LVPWd), by 9.3% IVSd, by 42% SPAP, by 21% RV size, and decrease by 6.7% EF, by 31.5% E/A ratio was in the second group compared with the first (p<0.05). There was also a significant increase by 8.6% LA size, by 8.1% ESC, by 10.8% SPAP (p<0.05) and a decrease by 2.5% E/A ratio in CCS, COPD, and obese patients compared with CCS, COPD, and normal body weight patients (p<0.05).Conclusions. We found more pronounced structural and functional changes of left atrium size, end-systolic size, the mitral ratio of peak early to late diastolic filling velocity and systolic pulmonary artery pressure in comorbid chronic coronary syndrome, chronic obstructive pulmonary disease, and obese patients.