Echocardiographic Evaluation of Cardiac Status in Patients with Chronic Obstructive Pulmonary Disease

Muhammad Mohiuddin,Mohammad Gaffar Amin,Akm Fazlul Kader,Kazi Nazrul Islam,Chinmoy Saha,Azizul Haque,Abu Thaher Mohammad Mahfuzul Hoque,Abdul Wadud Chowdhury

doi:10.3329/bmrcb.v46i3.52256

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) is a global health burden having systemic and extrapulmonary manifestations. Among them cardiovascular changes are the major comorbidity associated with COPD, responsible for significant morbidity and mortality. Echocardiography is one of the simplest and noninvasive tools in assessing these changes. Objective: To evaluate the echocardiographic changes in patients with chronic obstruction palmonary disease. Methods: A cross sectional observational study was carried out in Department of Cardiology and Department of Respiratory Medicine, Dhaka Medical College Hospital from July, 2018 to June, 2019. Total 98 COPD patients were included in the study. They underwent spirometry in Department of Respiratory Medicine and echocardiography in Department of Cardiology. Data was collected from the patients and recorded in a structured report form. Results: Significant echocardiographic abnormalities were present in 51.02% patients. Most common echocardiographic change was pulmonary hypertension (43.9%). Other echocardiographic findings were dilated RA & RV (36.7%), RVH (35.7%), LV diastolic dysfunction (30.6%) and RV systolic dysfunction (9.2%). Echocardiographic signs of pulmonary hypertension, dilated RA & RV, RVH, RV systolic dysfunction and LV diastolic dysfunction were correlated with the severity of the disease. Though echocardiographic change of pulmonary hypertension was uncommon in COPD stage 1 & 2, but it was very common in stage 3(45.7%) & stage 4(92.9%). Conclusion: This study showed that echocardiographic changes were very common among the COPD GOLD stage 3 & 4 patients. Though these changes were infrequent among mild COPD patients but their severity increased with increasing stage of COPD. Bangladesh Med Res Counc Bull 2020; 46(3): 204-210

Highlights

Chronic Obstructive Pulmonary Disease (COPD) is a disease of progressive airflow limitation that is not reversible
Though echocardiographic change of pulmonary hypertension was uncommon in COPD stage 1 & 2, but it was very common in stage 3(45.7%) & stage 4(92.9%)
This study showed that echocardiographic changes were very common among the COPD GOLD stage 3 & 4 patients

Summary

Introduction

Chronic Obstructive Pulmonary Disease (COPD) is a disease of progressive airflow limitation that is not reversible. It causes high mortality and morbidity as well as high healthcare costs and a significant burden in the form of disability and impaired quality of life.[1]. The mechanism of abnormal LV systolic performance in COPD patients are unclear but may be due to hypoxemia and acidosis; concurrent coronary artery disease; ventricular interdependence which would in turn increase LV end diastolic pressure, decrease venous return and Mohiuddin M et al diminished LV stroke volume & cardiac output and large swings in intrathoracic pressure.[8]. Chronic Obstructive Pulmonary Disease (COPD) is a global health burden having systemic and extrapulmonary manifestations. Echocardiography is one of the simplest and noninvasive tools in assessing these changes

Methods

Results

Discussion

Conclusion