Huang Ying-Shuo, Feng Ying-Chao, Zhang Jian, Bai Li, Huang Wei, Li Min, Sun Ying
Department of Geriatrics and Gerontology, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China.
Clin Interv Aging. 2014 Dec 19;10:81-7. doi: 10.2147/CIA.S71878. eCollection 2015.
To evaluate the impact of chronic obstructive pulmonary disease (COPD) on left ventricular (LV) diastolic function in hospitalized elderly patients.
This was a case-control observational study of 148 consecutive hospitalized elderly patients (≥65 years old): 73 subjects without COPD as controls and 75 patients with COPD. Mild-to-moderate COPD was defined as stages 1 and 2, while severe and very severe COPD was defined as stages 3 and 4, according to the Global Initiative for Chronic Obstructive Lung Disease guidelines. Clinical characteristics and echocardiographic parameters were analyzed and compared.
Compared with the control group, patients with COPD had a higher frequency of LV diastolic dysfunction and heart failure with preserved ejection fraction. Smoking frequency, frequency of cerebrovascular diseases and diabetes, and serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were higher in the COPD group (all P<0.05). COPD patients showed more abnormalities in diastolic function (E/e': 11.51±2.50 vs 10.42±3.25, P=0.047), but no differences in systolic function and right ventricular function (all P>0.05). Patients with severe/very severe COPD showed no differences in LV diastolic function compared to patients with mild/moderate COPD (P>0.05), but serum NT-proBNP levels were higher in severe/very severe COPD (P<0.05).
Results suggest that early-stage COPD may have an impact on the LV diastolic function. Severe COPD mainly affected right ventricular function. In hospitalized elderly patients with COPD, LV diastolic dysfunction should be taken into account together with right ventricular function.
评估慢性阻塞性肺疾病（COPD）对住院老年患者左心室（LV）舒张功能的影响。
这是一项对148例连续住院的老年患者（≥65岁）进行的病例对照观察性研究：73例无COPD的受试者作为对照组，75例COPD患者。根据慢性阻塞性肺疾病全球倡议指南，轻度至中度COPD定义为1期和2期，重度和极重度COPD定义为3期和4期。分析并比较临床特征和超声心动图参数。
与对照组相比，COPD患者左心室舒张功能障碍和射血分数保留的心力衰竭发生率更高。COPD组的吸烟频率、脑血管疾病和糖尿病发生率以及血清N末端B型利钠肽原（NT-proBNP）水平更高（均P<0.05）。COPD患者舒张功能异常更多（E/e'：11.51±2.50对10.42±3.25，P=0.047），但收缩功能和右心室功能无差异（均P>0.05）。重度/极重度COPD患者与轻度/中度COPD患者相比，左心室舒张功能无差异（P>0.05），但重度/极重度COPD患者血清NT-proBNP水平更高（P<0.05）。
结果表明，早期COPD可能对左心室舒张功能有影响。重度COPD主要影响右心室功能。在住院的老年COPD患者中，应同时考虑左心室舒张功能障碍和右心室功能。
