Correlation Between COPD And Echocardiographic Features With Severity Of Disease.

ABSTRACT

Background & Objective: Chronic obstructive pulmonary disease (COPD) is the most common cause of secondary pulmonary hypertension (PH). PH secondary to COPD is associated with a worse prognosis of the disease, a low quality of life, as well as with a higher exacerbation frequency, and consequently with an increase in the healthcare cost of COPD patients. Objective is to assess the cardiac changes secondary to COPD by echocardiography and to find out the correlation between echocardiographic findings and severity of COPD, if there is any Methodology: A total 100 of patients of COPD were selected and staged by pulmonary function test (PFT) and evaluated by echocardiography. Results: On echocardiographic evaluation of COPD, 55% cases had normal echocardiographic parameters. Measurable tricuspid regurgitation (TR) was observed in 24/35 cases (67.5%). Pulmonary hypertension (PH), which is defined as systolic pulmonary arterial pressure (sPAP)> 30 mmHg was observed in 15/25 (63%) cases in which prevalence of mild, moderate, and severe PH were 10/17 (58.82%), 3/16 (23.53%), and 3/17 (17.65%), respectively. The frequencies of PH in mild, moderate, severe, and very severe COPD were 16.67%, 54.55%, 60.00%, and 83.33%, respectively. Right atrial pressure was 10 mmHg in 82.5% cases and 15 mmHg in 17.5% cases. Cor pulmonale was observed in 7/17 (41.17%) cases; 7.50% cases had left ventricle (LV) systolic dysfunction and 47.5% cases had evidence of LV diastolic dysfunction defined as A ≥ E (peak mitral flow velocity of the early rapid filling wave (E), peak velocity of the late filling wave caused by atrial contraction (A) on mitral valve tracing) Left ventricle hypertrophy was found in 22.5% cases. Conclusion: Prevalence of PH has a linear relationship with severity of COPD and severe PH is almost associated with cor pulmonale. Echocardiography helps in early detection of cardiac complications in COPD cases giving time for early interventions.