Evaluation of left ventricular function in patients with chronic obstructive pulmonary disease

Abstract

Patients with right ventricle (RV) pressure overload often have impaired left ventricular (LV) diastolic function. Objectives. The aim of study was to evaluate LV function in patients with chronic obstructive pulmonary disease (COPD). Patients and methods. Thirty-five patients (mean age: 62.1 +/- 7.7 y) with COPD without additional cardiac diseases and 25 age--and sex-matched healthy subjects were enrolled into the study. All patients underwent resting ECG tracing, blood pressure, spirometry, standard and tissue Doppler echocardiography. The mean value of forced expiratory volume in one second (FEV1) in the COPD group was 40 +/- 8.9% of the predicted value. We found no significant differences in LV end-diastolic and systolic diameter and interventricular septum as well between COPD patients and controls. RV end-diastolic diameter and RV wall thickness were significantly larger and right ventricle systolic pressure--RVSP (38 +/- 11.2 vs. 20 +/- 2.5 mm Hg) significantly higher in the COPD group. Both peak early to peak atrial filling velocities ratio--E/A and peak annular velocity during early diastole to peak annular velocity during atrial contraction--Em/Am were significantly lower in COPD compared to controls. Moreover, there was a strong inverse correlation between Em/Am and RVSP (r = -0.75; p < 0.001) and between E/A (r = -0.6; p < 0.001) as well. We found no significant differences in parameters assessing the LV systolic function between both groups. In COPD patients LV diastolic function is significantly impaired and its magnitude is related with increase in pulmonary artery pressure, while systolic LV function is well preserved.