Right and left ventricular dysfunction in patients with severe chronic obstructive pulmonary disease

ABSTRACT

To evaluate the right and left ventricular dysfunction and its relation to air-trapping, 20 cases with severe chronic obstructive pulmonary disease [COPD] were studied. All patients underwent pulmonary function tests and Echo-Doppler examination was made to measure the mPAP, RAD, RVD, LVD and LVEf The patients were classified into two groups according to presence or absence of TR, because it consider as a marker for pulmonary hypertension. This study showed that in cases with TR the mPAP was higher and RVD was larger than cases without TR and the differences were statistically highly significant for both parameters with P value <0.0005. regarding the left ventricular form and function, LVD was larger in diastole in cases with TR than cases without TR and the difference was statistically significant with P value <0.05, LVEF was less in cases with TR than cases without TR and the difference was statistically highly significant with P value <0.0005. LVEF was less than 45% in two cases only [10%] of the total cases examined and these two cases had TR and severe pulmonary hypertension. Residual volume and total lung capacity were used as a marker for air-trapping in the lungs of COPD patients, these two parameters had significant correlation with cases who have TR. Both right and left ventricular form and function appeared to be affected in cases with severe COPDs especially in cases with TR, and left ventricular dysfunction appears to be related to right ventricular dysfunction, perhaps through ventricular interdependence Patients with marked air-trapping had more impairment of both ventricular forms and functions