Nasir Syed Aijaz, Singh Sukhvinder, Fotedar Madhulata, Chaudhari Sai Kiran, Sethi Kamal Kumar
Department of Cardiology, Delhi Heart and Lung Institute, New Delhi, India.
Department of Pulmonary Medicine, Delhi Heart and Lung Institute, New Delhi, India.
J Cardiovasc Echogr. 2020 Jul-Sep;30(3):125-130. doi: 10.4103/jcecho.jcecho_10_20. Epub 2020 Nov 9.
Chronic obstructive pulmonary disease (COPD) is associated with structural and mechanical changes in the pulmonary vascular bed that increase right ventricular (RV) afterload and subsequently right heart failure.
The aim of the study was to elucidate RV dysfunction at rest by echocardiography in a cohort of COPD patients and to study its impact on prognosis.
84 patients of COPD and 40 matching healthy controls were evaluated at baseline. Evaluation included clinical examination, pulmonary function tests; 6 minutes walk test and echocardiography. Patient with COPD were again evaluated after 6 months.
All echocardiographic parameters of RV function were significantly impaired in COPD patients as compared to controls. Clinical deterioration in COPD group was much more in patients with baseline abnormal RV function (89%) and patients with RV systolic pressure ≥35 mmHg ( = 0.018). All the six patients who died had three or more abnormal RV systolic function parameters.
RV myocardial performance index and basal strain showed largest difference between controls and COPD cases. Clinical deterioration was more common in patients with abnormal RV function parameters and pulmonary hypertension.
慢性阻塞性肺疾病（COPD）与肺血管床的结构和力学变化相关，这些变化会增加右心室（RV）后负荷，进而导致右心衰竭。
本研究旨在通过超声心动图阐明一组COPD患者静息时的右心室功能障碍，并研究其对预后的影响。
对84例COPD患者和40例匹配的健康对照者进行基线评估。评估包括临床检查、肺功能测试、6分钟步行试验和超声心动图检查。COPD患者在6个月后再次进行评估。
与对照组相比，COPD患者右心室功能的所有超声心动图参数均显著受损。COPD组中，基线右心室功能异常的患者（89%）和右心室收缩压≥35 mmHg的患者临床恶化更为明显（P = 0.018）。所有6例死亡患者均有三个或更多异常的右心室收缩功能参数。
右心室心肌性能指数和基底应变在对照组和COPD病例之间差异最大。右心室功能参数异常和肺动脉高压的患者临床恶化更为常见。
