ABSTRACT
INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is a global health issue with cigarette smoking being an important risk factor. COPD affects pulmonary blood vessels, right ventricle, as well as left ventricle leading to the development of pulmonary hypertension (PH), cor-pulmonale (COR-P), right and left ventricular dysfunction. Echocardiography provides a rapid, noninvasive, portable, and accurate method to evaluate cardiac functions. Early diagnoses and intervention for cardiac comorbidities would reduce mortalities. MATERIALS AND METHODS: A cross-sectional study. Total 50 patients of moderate to severe COPD according to GOLD guidelines were taken from Department of Respiratory Medicine, Smt. B. K. Shah Medical Institute and Research Centre, Vadodara. All patients underwent investigations such as chest X-ray PA view, ECG, and spirometry followed by two-dimensional echocardiography. RESULTS: We investigated 49 males and 1 female patients ranging from 35 to 80 years of age. Twenty-nine individuals were of moderate COPD and twenty-one of severe COPD. Of these cases 29 had left ventricular diastolic dysfunction (LVDD) changes, 24 were diagnosed with PH and 16 had changes of COR-P. The study showed the linear relation between the severity of LVDD, PH, and COR-P with the severity of COPD. CONCLUSION: Our study put emphasis on early cardiac screening of all COPD patients which will be helpful in the assessment of the prognosis and will further assist in identifying the individuals likely to suffer increase morbidity and mortality.
ABSTRACT
Obstructive sleep apnea is a disorder resulting from collapse of the upper airway during sleep. Its etiology is multifactorial, resulting from the interdependence of structurally vulnerable upper airway anatomy interacting with physiologic mechanism of ventilator instability during sleep. The ENT causes for OSA are relatively simple conditions that can be treated by safe and simple medical and/or surgical procedures. To assess the prevalence of ENT disorders in patients presenting to the sleep clinic. Patients presented to sleep clinic were submitted to an assessment protocol including clinical history, otorhinolaryngology examination and a polysomnography. Total 69 patients were included and distributed into two groups according to AHI: patients with sleep disordered breathing only (simple snorer and/or AHI ≤ 5) and patients with obstructive sleep apnea syndrome (AHI > 5). There was significant statistical difference for deviated nasal septum (p = 0.0004) and inferior turbinate hypertrophy (p = 0.03) in both groups. Most patients were in the class III and IV of Mallampati classification. Odds of having OSA increases more than 1.5 folds as the level of Mallampati classification increases by one class. ENT disorders were more common in the patients with OSA than in simple snorers and have impact on pathophysiology of OSA and its treatment modality. Hence, ENT examination in all patients with sleep disordered breathing will be helpful.
