Evaluation of Cardiac function in COPD patients and correlation with disease severity: A cross sectional study

Abstract

Background: Chronic obstructive pulmonary disease (COPD) has considerable effects on cardiac functions, including those of the right ventricle, left ventricle, and pulmonary blood vessels. Most of the increased mortality associated with COPD is due to cardiac involvement. Echocardiography provides a rapid, non-invasive portable, and almost accurate method to evaluate the right ventricle function, right ventricular filling pressure, tricuspid regurgitation, left ventricular function, and valvular functions. Early diagnosis and intervention for cardiac comorbidities would reduce mortalities in COPD.
 Aims and Objectives: This study was undertaken to evaluate cardiac function with echocardiography in COPD patients which may further help to assess the prognosis and assist in identifying the individuals likely to suffer increase morbidity and mortality.
 Materials and Methods: A hospital based cross sectional study in which 100 patients over a period of 1 year were selected according to inclusion and exclusion criteria and cardiac comorbidities were observed in COPD patients by 2D echocardiography. All patients were studied on the basis of following variables- Demographic evaluation, Clinical evaluation, Pulmonary function test, echocardiography.
 Results: Distribution of the study population showed that a large number of COPD patients developed cardiac complication - Right and left ventricular dysfunction and pulmonary arterial hypertension especially in higher grades of COPD patients which can contribute to increased morbidity and mortality.
 Conclusion: Cardiac dysfunction is quite common in COPD patients, especially in the higher grades of COPD. So, we recommend that echocardiography should be included in routine evaluations of all COPD patients for early diagnosis and management of cardiac complications.

Chronic Obstructive Pulmonary Disease with Incidence of Heart Failure and Its Influencing Factors

“…A decrease in the value of TAPSE was found to be 4.2% in GOLD II, 10.3% in GOLD III, and 37.9% in GOLD IV. 4 Tannus-Silva, et al also found that 16% of 50 stable COPD patients with a mean of FEV1 value of 37.6% (± 19.3) pred had RV dysfunction using TAPSE values. 8 It is undeniable that COPD can cause heart failure, especially in the right heart.…”

“…Basak, et al also found a 16% prevalence of decreased RV systolic function with a distribution of 4.2% in 24 GOLD II subjects, 10.3% in 39 GOLD III subjects, and 37.9% in 29 GOLD IV subjects. 4 Tannus-Silva, et al also found 8 subjects (16%) of 50 stable COPD patients with a mean FEV1 value of 37.6% (±19.3) pred who had RV dysfunction using TAPSE values. 8 Gupta, et al found a decrease in LV systolic function of 7.5% in 40 stable COPD patients and Putrawan found a 5.7% prevalence of LV dysfunction in stable COPD subjects.…”

“…The mortality rate in COPD patients increases due to the involvement of cardiovascular disorders such as ischemic heart disease. 4 Echocardiography examination is a non-invasive examination procedure which can be used to evaluate cardiac changes both anatomically and functionally tricuspid such as assessing right ventricular function, right ventricular filling pressure, tricuspid regurgitation (TR), left ventricular function, and cardiac valve. 5,6 This assessment is very important to determine cardiac changes which occur as early as possible in stable COPD patients, hence the selection and administration of appropriate therapy can be started, can be assessed…”