Study on function of left heart of chronic obstructive pulmonary disease

Abstract

Objective To evaluate the left heart function in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) through echocardiography.Methods Echocardiography of 79 patients with COPD and 30 control group were analyzed retrospectively.According to the criteria of chronic pulmonary heart disease and respiratory failure,patients were classified into pulmonary heart disease group vs.non-pulmonary heart disease group,and respiratory failure group vs.non-respiratory failure group.Compare the echocardiography difference of them.Results ①There were 33 patients in pulmonary heart disease group,(63.7±10.3) years old,male 28(85％)compared with 46 patients,(66.4±9.6) years old,male 35(76％)in non-pulmonary heart disease group,There were 34 patients in respiratory failure group,(62.6±10.8) years old,male 26(76％)compared with 45 patients,(67.3 ± 9.2) years old,male 37 (82％) in non-pulmonary heart disease group.There were 30 patients in control group,(63.7 ± 10.3) years old,male 28 (85％).②Left ventricular end diastolic diameter (LVEDD) was lower in pulmonary heart disease group (42.70±4.21) mm than in non pulmonary heart disease group (45.04±4.42) mm and in control group (46.27±5.03) mm,P ＜0.05.Left ventricular end-diastolic volume (LVEDV) was lower in pulmonary heart disease group (85.18 ±19.05) ml than in non-pulmonary heart disease group (96.87±20.32) ml and in control group (102.83±26.62) ml,P ＜0.05.There were no significant differences between non-pulmonary heart disease group and control group in LVEDD and LVEDV.③ Ratio of peak velocity of early E-wave to atrial A wave (E/A) gradually decreased in control group,non-pulmonary heart disease group and pulmonary heart disease group (0.79±0.29 vs.0.93±0.20 vs.1.34± 0.21,respectively,P ＜0.05).④E/A in respiratory failure group(0.87±0.20) and non-respiratory failure group (0.82±0.31) was lower than in control group (1.34±0.21),P ＜0.05.There were no significant differences between respiratory failure group and non pulmonary heart disease group.⑤Right ventricular internal dimension (RVID) showed negative correlation with LVEDD,LVEDV,E/A (r=-0.244,-0.221,0.245,respectively.P ＜0.05).⑥FEV1 ％ pred showed positive correlation with LVEDD and LVEDV,and negative correlation with right ventricular outflow tract (RVOT) and RVID (r =0.337,0.281,-0.276,-0.243,respectively,P ＜0.05).⑦Residual volume/total lung capacity showed negative correlation with RVOT and RVID (r =-0.5,-0.375,respectively,P ＜0.05).Conclusions Patients with COPD have an impaired left ventricular diastolic function.Patients with pulmonary heart disease have a smaller left heart size and an impaired left ventricular diastolic function.An increasing rate of COPD severity is associated with a decreasing left heart size and an increasing right heart size. Key words: Chronic obstructive pulmonary disease; Pulmonary heart disease; Lung Function; Echocardiography; Left heart function