Echocardiographic Evaluation of Right Heart in Patients of Chronic Obstructive Pulmonary Disease

Cardiac involvement in Chronic Obstructive Pulmonary Disease (COPD) is a significant cause of morbidity, mortality, and even death. We aimed to study the echocardiographic evaluation, especially of the right heart, in patients of COPD and to co-relate findings of echocardiography with the clinical profile and severity of COPD of such patients.METHODSWe performed a cross-sectional study for a period of 2 years. The patients were subjected to necessary investigations and transthoracic echocardiography for evaluating the right heart parameters. Data was entered in MS Excel spreadsheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0. A p value of <0.05 was considered statistically significant. RESULTSOf the 50 COPD cases studied, the majority (22) fulfilled GOLD stage IV criteria followed by 14 cases in GOLD stage II. Right atrial pressure was increased in 52% study subjects. Pulmonary artery systolic pressure had values of more than 25 mmHg in 68% of patients. RV thickness was >5 mm in 56% subjects. TAPSE was measured to be <17 mm in 50% COPD cases. A significant association was seen between severity of COPD and RA pressure, RV size, RV pressure/pulmonary artery pressure, RV thickness and TAPSE.CONCLUSIONSSignificant prevalence of right heart dysfunction is found in COPD and there was a significant association of cardiac parameters with severity of COPD. Thus it is recommended that all patients of COPD should undergo right heart evaluation by echocardiography so that treatment modalities can be changed to minimize morbidity and mortality

Supportive Periodontal Therapy- An Important Landmark in Clinical Practice

The long term success of periodontal therapy depends less on the manner in which the case was treated than on vigorous follow-up of the wound healing process immediately after therapy and on how well the case is maintained in subsequent recall (Rosling et al 1976, Nyman et al 1977, Knowles et al 1979, Ramfjord et al 1982, West felt et al 1985) SPT has gone by many names, including recall and maintenance, but the name was changed at the 1989 World Workshop in Clinical Periodontics to reflect the fact that the long-term treatment provided for patients during supportive periodontal treatment is of critical importance to the survival of the dentition. In most cases, this form of therapy is used following the completion of active periodontal therapy, but it can be used in other phases of treatment as well.1