Cardiac function of patients with chronic obstructive pulmonary disease evaluated by echocardiography / 中华全科医师杂志

ABSTRACT

Objective To evaluate the cardiac function in patients with chronic obstructive pulmonary disease ( COPD) by using echocardiography.Methods Three hundred and twenty eight COPD patients and 60 age and gender-matched healthy subjects ( control group ) were enrolled in the study. According to Global Initiative for Chronic Obstructive Lung Disease ( GOLD ) criteria, patients were as classified as mild (n=102), moderate (n=85), severe (n=80) and very severe (61).All participants underwent conventional echocardiography and two dimensional-speckle tracking echocardiography (2D-STE) to assess cardiac function.Results The LVEF was reduced significantly, while the PASP was increased in severe and very severe COPD patients [(60.9 ±2.0)% and (59.4 ±2.8)%, t value3.358, 4.859 to normal controls, 5.247, 6.641 to mild, 3.280, 4.863 to moderate, respectively, all P<0.001].The LA size was dilated in very severe COPD patients [(3.9 ±0.5) cm, t value -2.407, -2.625, -2.071,-2.186, P<0.05 ] , and the RVEF was significantly less than those of the other patients [ ( 42.8 ± 7.3)%,t value 6.357, 6.832, 5.581, 4.639, P<0.05 ] .The right ventricular FAC of moderate or severe COPD patients and the segmental and global LS of left and right ventricular in COPD patients were significantly lower than those in the normal controls, and which were gradually decreased as GOLD classification rising [ RVFAC, moderate ( 37.7 ±2.0 )%, severe ( 35.5 ±3.2 ) %, very severe(34.0 ±3.1) %, t value -4.616, -5.982, -7.195, respectively; LSLVg, moderate ( -18.62 ± 1.76) %, severe ( -17.15 ±0.73 ) %, very severe ( -16.51 ±0.89 ) %, t value -9.389,-15.494, -16.873, respectively;LSRVg, moderate(-20.52 ±2.27) %, severe(-18.84 ±1.38)%, very severe(-16.82 ±1.10) %, t value-8.555, -13.595, -18.499, respectively, all P<0.001].Besides, the FAC of COPD patients was positively correlated with the RVEF (r =0.676,P <0.05), while the RVLSg was negatively correlated with the FAC and RVEF (r=-0.677, -0.591,all P<0.05) .Conclusions There were left and right ventricular dysfunction in COPD patients, which decreased as GOLD classification upgraded. The FAC and 2D-STE can effectively detect the subtle abnormalities of regional and global ventricular function.