Aim . Determination of the functional state of cardiopulmonary hemodynamics in patients with chronic obstructive pulmonary disease (COPD) with varying severity of bronchial obstruction and respiratory failure using echodopplercardiography. Materials and methods . In 82 patients with COPD, the functional state of cardiopulmonary hemodynamics was evaluated using ultrasound methods. All subjects were divided into 2 groups depending on the severity of COPD (moderate and severe course). Results . It was found that in patients with COPD, impaired diastolic function of the right ventricle (RV) may be preclinical. Thus, in patients with COPD stage 2, compared with control in the P-mode and tissue Doppler sonography (TDI), mild changes in the diastolic function (impaired relaxation) of the RV myocardium were revealed (E/A 0.70±0.13 and 1.56±0.18, E/Em 8.45±0.15 and 6.89±0.19, respectively). In patients with COPD stage 3, the mean values of these RV parameters significantly differed (E/A 0.69±0.04 and E/Em 9.34±0.18) and corresponded to moderately expressed diastolic dysfunction. Conclusions . In severe COPD in stage 3, significant violations of the structure and function of the RV were determined. The compensatory capabilities of both cardiac ventricles were depleted, the interventricular interaction changed, which created the conditions for the progression of heart failure and the development of chronic cor pulmonale.