Evaluation of left ventricular function in patients with chronic obstructive pulmonary disease with or without pulmonary hypertension

Background: Chronic obstructive pulmonary disease [COPD] is a common entity in clinical practice. Development of right ventricular hypertrophy and eventual right side heart failure is also common in such patients. However, some disturbance in left ventricular [LV] function has been observed among such patients

Objectives: The aim of this study was to evaluate LV function in patients with chronic obstructive pulmonary disease [COPD] with or without pulmonary hypertension

Patients and methods: Thirty-six patients with COPD without additional cardiac diseases and 12 age and sex-matched healthy subjects were enrolled into the study. All patients underwent spirometry, standard and tissue Doppler echocardiography

Results: 20 COPD patients [55.6%] had pulmonary hypertension. Left ventricular systolic function did not differ between patient and control groups. However the difference between both groups was significant regarding left ventricular diastolic function and left ventricular global function. Left ventricular diastolic function and global function differed significantly between different COPD grades. Patients with pulmonary hypertension had significantly higher heart rate, less E wave peak velocity [measured by DTI] [P

Conclusion: Left ventricular diastolic function and LV global function are affected in COPD patients especially with progression of the disease. COPD patients with pulmonary hypertension are more liable to LV diastolic and global dysfunction than normal pulmonary pressure COPD patients. Doppler tissue echocardiography is a better tool in the assessment of left ventricular function

Quality of life in COPD patients

Quality of life [QOL] can be severely impaired in patients with COPD. They usually show an accelerated decline in lung function and progressive impairment of physical performance. To study quality of life in patients with COPD and to examine its relationship with the severity of the disease. Quality of life was determined in 40 COPD patients using the St. George's Respiratory Questionnaire for COPD patients [SGRQ-C]. Mild COPD patients differed significantly from other grades of COPD in their total SGRQ-C score, symptoms score, activity score and impact score [p

Clinical probability of pulmonary embolism: comparison of different scoring systems

Pulmonary embolism is one of the greatest diagnostic challenges in emergency medicine and clinical probability assessment is a fundamental step in its diagnosis. To evaluate the role of estimating clinical probability of pulmonary embolism and to compare between different pre-test probability scoring systems as regards their sensitivity and specificity. We used seven scoring systems [original Geneva score, revised Geneva score, simplified Geneva score, Wells score, simplified Wells score, simplified Charlotte rule, Pisa model] to assess the clinical probability of PE in 41 patients with suspected pulmonary embolism for whom the final diagnosis was based on multislice CT pulmonary angiography [CTPA]. Twenty-four patients [58.5%] had pulmonary embolism. The scores with the strongest correlation with the result of CTPA were the Pisa model [P 6

Diagnostic value of von willebrand factor [VWF] in poisoned versus non-poisoned patients suffering from respiratory distress in Minoufiya university hospital in the period from January 2009 till June 2010

Acute respiratory distress syndrome [ARDS] is characterized by an extensive alveolar capillary leak, permitting contact between intro-alveolar factors and the endothelium. Von Willebrand Factor antigen [VWF] is a macromolecular antigen that is produced predominantly by endothelial cells and to a lesser extent by platelets. VWF has been investigated as a biological marker of endothelial injury in patients both at risk for and with established ALI/ARDS caused by different etiologies. However, to our knowledge, VWF was not investigated in ALI/ARDS cases caused by poisoning insults. We aimed to investigate VWF as a possible diagnostic, prognostic and predictive marker for ALI/ARDS in poisoned and non-poisoned patients. VWF antigen was measured [By ELISA] in 52 patients with ALI/ARDS, 13 poisoned patients without ALI/ARDS and 20 age and sex matched control subjects. There was a highly significant difference between VWF in patients and control groups [P