Highlights
- •RV diastolic diameter n is associated with unfavorable prognostic markers in COPD, such as worsening lung function and functional capacity.
- •Echocardiogram may be a useful tool to identify patients who need more aggressive strategies to control the evolution of the disease with potential impact to pulmonary rehabilitation.
Abstract
Background
The echocardiogram is a useful method for monitoring the cardiovascular complications
of chronic obstructive pulmonary disease (COPD), but it is not clear if morphological
and functional cardiac variables are able to identify patients with unfavorable COPD
progression.
Objective
The aim of this study was to investigate morphological and functional echocardiographic
variables associated with exacerbation of the disease, pulmonary function parameters
and functional capacity evaluation in COPD patients.
Method
A longitudinal observational study including 91 patients diagnosed with COPD, who
were stratified in two groups according to their basal right ventricle diastolic diameter
(RVDD) measuring greater and less than 35 mm. They underwent clinical evaluation,
echocardiography, spirometry and 6-minute walking-test (6MWT).
Results
The study found that patients with RVDD greater than 35 mm showed worse functional
capacity in the 6MWT (p = 0.05) and more exacerbation of the disease during the one-year follow-up (p = 0.05). There were correlations of greater RVDD vs forced vital capacity (R = -0.27; p = 0.02) and distance in the 6MWT (R = 0.55; p = 0.03) in patients with exacerbation. In the univariate regression analysis, the
RVDD was responsible for 55% of the variation in distance in the 6MWT (-0.75 m) in
COPD patients.
Conclusion
The RV dilation is associated with unfavorable prognostic markers in COPD, such as
the worsening of the functional capacity and more frequent exacerbations. The echocardiogram
may be a useful tool to identify patients who need more aggressive strategies to control
the evolution of the disease with potential impact in pulmonary rehabilitation.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Heart & Lung: The Journal of Cardiopulmonary and Acute CareAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
GOLD COMMITTEE. GOLD-REPORT-2021-v1.1-25Nov20_WMV.pdf [Internet]. 2021. p. 12–9. Available from: https://goldcopd.org.
- Echocardiographic abnormalities in patients with COPD at their first hospital admission.Eur Respir J. 2013; 41: 784-791
- Association of mild echocardiographic pulmonary hypertension with mortality and right ventricular function.JAMA Cardiol. 2019; 4: 1112-1121
- Predictors of adverse outcome in patients hospitalised for exacerbation of chronic obstructive pulmonary disease.Respiration. 2012; 84 ([Internet]Available from): 17-26
- Acute exacerbation impairs right ventricular function in COPD patients.Hell J Cardiol. 2015; 56: 324-331
- Right ventricular function in cardiovascular disease, part II: pathophysiology, clinical importance, and management of right ventricular failure.Circulation. 2008; 117: 1717-1731
- Evaluation of right ventricular function in patients with COPD.Respir Care. 2013; 58 (May): 816-823
- Echocardiographic predictors of exercise capacity and mortality in chronic obstructive pulmonary disease.BMC Cardiovasc Disord. 2013; ([Internet]Sep 22;13. Available from)
- Utility of echocardiography in assessment of pulmonary hypertension secondary to COPD.Eur Respir J. 2001; 17 (Mar): 350-355
- Deep breathing heart rate variability is associated with respiratory muscle weakness in patients with chronic obstructive pulmonary disease.Clinics. 2010; 65: 369-375
- Noninvasive ventilation acutely modifies heart rate variability in chronic obstructive pulmonary disease patients.Respir Med. 2008; 102 (Aug): 1117-1123
- Pulmonary hypertension and right heart dysfunction in chronic lung disease.Biomed Res Int. 2014; (2014(i))
- Echocardiographic evaluation of heart in chronic obstructive pulmonary disease patient and its co-relation with the severity of disease.Lung India. 2011; 28 ([Internet]AprAvailable from): 105-109
Evaluation of early right ventricular dysfunction in patients with chronic obstructive pulmonary disease by echocardiography/. 2021;(12):712067.
- Right ventricular function in cardiovascular disease, part I: anatomy, physiology, aging, and functional assessment of the right ventricle.Circulation. 2008; 117: 1436-1448
- Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.J Am Soc Echocardiogr. 2015; 28 ([Internet]e14. Available from): 1-39https://doi.org/10.1016/j.echo.2014.10.003
- Am J Respir Crit Care Med. 2002; 166 (Jul): 111-117
- An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease.Eur Respir J. 2014; 44 ([Internet]Dec 1LP –1446. Available from): 1428
- Assessment of left and right ventricular involvement in patients with chronic obstructive pulmonary disease with special reference to echocardiography.Int J Curr Res Rev. 2020; 12: 10-13
- Echocardiographic evaluation of right ventricular function and its role in the prognosis of chronic obstructive pulmonary disease.J Cardiovasc Echogr. 2020; 30: 125-130
- Comparison of echocardiographic markers of right ventricular function in determining prognosis in chronic pulmonary disease.J Am Soc Echocardiogr Off Publ Am Soc Echocardiogr. 2002; 15 (Jun): 633-639
- Right ventricular morphology and function in chronic obstructive pulmonary disease patients living at high altitude.Hear Lung Circ. 2013; 22: 31-37
Article info
Publication history
Published online: April 12, 2022
Accepted:
April 5,
2022
Received in revised form:
March 30,
2022
Received:
November 24,
2021
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
