The right ventricular sizes, function and quality of life in patients with very severe COPD

Abstract

Purpose: To evaluate the parameters of right ventricular (RV) size, systolic and diastolic function and quality of life (QOL) in patients with very severe COPD. Materials and Methods: 90 patients (males, mean age 57±8 years, range 43-75) with very severe COPD were studied. Mean FEV1 was 30±8% predicted (range 17-48%). RV wall thickness and RV end-diastolic size were evaluated with 2D-echocardiography. The RV systolic function was measured by pulsed wave Doppler tissue imaging (DTI). The RV diastolic function was measured by pulsed Doppler and DTI. The tricuspid inflow profile (E, A, E/A, DT) and hepatic vein flow velocity (S, D, A) were measured by pulsed Doppler. Peak velocities of the tricuspid annular motion (Sa, Ea, Aa, Ea/Aa) were measured using DTI. QOL was assessed with Clinical COPD Questionnaire score (CCQ). Results: RV remodeling was detected in 100% of patients (mean RV wall thickness 7.0±1.0 mm; mean RV end-diastolic size 42.0±4.0 mm). All the above patients had RV diastolic dysfunction. Impaired relaxation pattern of tricuspid inflow was detected in 71.1% (32 patients), pseudonormal pattern - in 17.8% (8 patients), restrictive pattern - in 11.1% (5 patients). 13.3% (6 patients) had RV systolic dysfunction (Sa Conclusions: Our study confirmed 100% prevalence of RV remodeling and diastolic dysfunction in patients with very severe COPD. QOL score in these patients correlated with RV remodeling and dysfunction markers.