Echocardiographic Changes in Patients with Chronic Obstructive Pulmonary Disease in a Study of Indian Population

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a significant risk factor of cardiovascularmorbidity and mortality including tricuspid regurgitation (TR), right ventricular hypertrophy (RVH), leftventricular dysfunction (LVD) and right atrial enlargement (RAE) among others. Echocardiography is arapid, non-invasive, and accurate method to evaluate cardiac functions and used to diagnose cardiac changesin COPD patients. This study aimed to assess the prevalence of echocardiographic changes in COPD patientsand its association with disease severity, duration of disease and smoking.Methods: Two hundred thirty four patients of COPD fulfilling the inclusion criteria coming to RespiratoryClinic and Medicine OPD of Assam Medical College and Hospital were recruited. They were evaluatedby echocardiography. Adjusted odd ratios (ORs) (adjusted to age, gender and BMI) with 95% CIs ofechocardiographic changes were computed for different stages of GOLD standard using multiple logisticregression with GOLD stage I as reference. Test for trend was done using chi-square test and statisticalsignificance was taken p-value<0.01.Results: Most common echocardiographic finding was TR, which was present in 63.25% of cases, followedby RVH (56.84%), LVD (33.33%) and RAE (30.33%). Echocardiographic findings of TR, RVH and RAEincrease with GOLD stage progression of COPD (p-value<0.01). Disease duration was correlated withechocardiographic findings of TR, RVH and RAE. A significant trend of change in LVDD was seen forsmoking status with severity of GOLD. The similar echocardiographic findings were RAE, RVH and LVD.Conclusions: Our study finds that echocardiographic examinations of TR, RVH, LVD and RAE are essentialfor early diagnosis of cardiac screening for COPD patients. The incidence of TR is more common as severityof COPD increases followed by RVH. There is a significant correlation between severity of COPD withechocardiographic findings of TR, RVH and RAE.