Right Ventricular Functional Improvement after Pulmonary Rehabilitation Program in Patients with COPD Determined by Speckle Tracking Echocardiography

Abstract

BackgroundAlthough right ventricular (RV) dysfunction in pulmonary diseases has been associated with increased morbidity, tools for RV dysfunction identification are not well defined.ObjectiveThe aim of this study was to evaluate the magnitude of RV dysfunction by means of speckle tracking echocardiography (STE) in patients with chronic obstructive pulmonary disease (COPD) and to investigate whether STE could be used as an index of RV improvement after a pulmonary rehabilitation (PR) program.MethodsForty-six patients with COPD undergoing PR program and 32 age-sex matched healthy subjects were enrolled. RV function was evaluated at admission and after PR program by conventional two-dimensional echocardiography (2DE) and STE. In addition, exercise tolerance of subjects was evaluated using the six-minute walk test (6MWT).ResultsCOPD patients had worse RV function according to STE and 2DE as well. STE was more sensitive than conventional 2DE in determining RV improvement after PR program - RV global longitudinal strain (LS): 20.4 ± 2.4% vs. 21.9 ± 2.9% p < 0.001 and RV free wall LS: 18.1 ± 3.4% vs. 22.9 ± 3.7%, p < 0.001). RV free wall LS was directly related to distance walked at baseline 6MWT (r = 0.58, p < 0.001) and to the change in the 6MWT distance (6MWTD Δ) (r = 0.41, p = 0.04).ConclusionsWe conclude that STE might be as effective as 2DE for evaluation of global and regional RV functions. STE may become an important tool for assessment and follow-up of COPD patients undergoing PR program to determine the relationship between RV function and exercise tolerance.

Effects of a Long-Term Wearable Activity Tracker-Based Exercise Intervention on Cardiac Morphology and Function of Patients with Cystic Fibrosis

“…Notably, the PASP, TAPSE, RVFWLS, and RV4CSL were correlated with the number of steps counted at the end of the study in Group A. Similar evidence of the dose-response relationship between the exercise prescription and the improvement in QoL, aerobic capacity, and cardiac function in chronic cardiac and pulmonary disease patients has previously been reported [34,35].…”

Right cardiac involvement in lung diseases: a multimodality approach from diagnosis to prognostication

“…22.9 AE 3.7%, P < 0.001) and the improvement of the 6MWT distance (6MWTD Δ) (r = 0.41, P = 0.04) after a pulmonary rehabilitation programme [42].…”

“…Furthermore, speckle tracking echocardiography (STE) allows to assess the degree of improvement of RV function (fw RVLS: 18.1 AE 3.4% vs. 22.9 AE 3.7%, P < 0.001) and the improvement of the 6MWT distance (6MWTD Δ) (r = 0.41, P = 0.04) after a pulmonary rehabilitation programme [42].…”

Right Ventricular Evaluation with Speckle Tracking Echocardiography in COPD after a Pulmonary Rehabilitation Program

“… 11 In this issue, Kanar et al evaluated the RV function using 2D-STE with 46 COPD and 32 control patients. 12 The authors compared the 2D-STE values for the two groups and for patients before and after a pulmonary rehabilitation program. The conventional parameters for 2D-echo and 2D-STE showed a similar correlation between COPD and control patients, but RV longitudinal strain showed greater sensitivity in examining the relationship between RV function and exercise tolerance.…”