CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS AND ITS CLINICAL EFFECTS ON THE LEFT VENTRICULAR FUNCTION

*Dr. Gaude Gajanan, Dr. Gautam S, Dr. Mahishale Vinay, Dr. Chaudhury Alisha

ABSTRACT

Background: In chronic obstructive pulmonary disease (COPD) patients, left ventricular (LV) systolic dysfunction is rare. However, abnormal LV diastolic dysfunction has been frequently reported in patients with COPD. Objectives: To evaluate the prevalence of left ventricular systolic or diastolic dysfunction in patients with COPD. Materials and Methods: A total of 102 patients diagnosed with COPD as per GOLD guidelines were enrolled. These patients underwent physical examination and standard two-dimensional echocardiographic views, and peak flow velocity of early diastolic filling (Emax), peak flow velocity of late atrial filling (Amax) and early flow velocity peak/late flow velocity peak (E/A) ratio were measured according to the criteria’s of American Society of Echocardiographers. Results: Of the 102 COPD patients, the maximal atrial filling velocity (A-Max) was increased and early filling velocity (E-Max) was decreased in 76 patients (74.5%) (p < 0.001). The early flow velocity peak/late flow velocity peak (E/A) ratio was also markedly decreased in these 76 patients (p < 0.001) indicating left ventricular dysfunction. The atrial contribution to total left diastolic filling was increased in patients with COPD. This was also observed in COPD patients with normal PAP (p < 0.001). Grade IV COPD (p-0.000), duration of illness (p<0.001), smoking >10 pack years (p<0.001) were the risk factors which were associated with development of LV diastolic dysfunction in COPD patients. Conclusion: In the present study, the prevalence of left ventricular diastolic dysfunction was 74.5%. As the severity of COPD increased, the risk of left ventricular diastolic dysfunction increased. The screening of severe COPD patients for left ventricular function will improve the outcome in these cases.

Keywords: COPD, left ventricular dysfunction, pulmonary arterial pressure.