COPD 患者的左心室向心性重构：一项横断面观察性研究。

Left ventricular concentric remodeling in COPD patients: A cross-sectional observational study.

机构信息

Department of Physical Therapy, Federal University of Sao Carlos, Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil.

Department of Medicine, Federal University of Sao Carlos (UFSCar), Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil.

出版信息

Med Clin (Barc). 2024 Jul 12;163(1):8-13. doi: 10.1016/j.medcli.2024.01.024. Epub 2024 Apr 12.

DOI:10.1016/j.medcli.2024.01.024

PMID:38614905

Abstract

OBJECTIVE

To investigate the association between left ventricular structure and disease severity in COPD patients.

METHODS

Twenty-eight COPD patients were stratified according to the disease severity, using the BODE index, into L (n=17) and H (n=11) groups, composed of patients with lower severity (BODE <5) and higher severity (BODE ≥5), respectively. Left ventricle (LV) was assessed by 2D-echocardiography. BODE index was calculated using body mass index (BMI); forced expiratory volume in the first second (FEV, %); modified Medical Research Council (mMRC) and distance walked during 6-minute walk test (6MWD).

RESULTS

Patients in the H group showed lower oxygen arterial saturation (p=0.02), FEV (p<0.01) and 6MWD (p=0.02) and higher value of relative posterior wall thickness (RWT) compared to L group (p=0.02). There were significant associations between LV end-systolic diameter (LVESD) and BODE index (r=-0.38, p=0.04), LV end-diastolic diameter (LVEDD) and FEV (r=0.44, p=0.02), LVEDD and BMI (r=0.45, p=0.02), LVESD and BMI (r=0.54, p=0.003) and interventricular septal thickness and 6MWD (r=-0.39, p=0.04).

CONCLUSIONS

More severe COPD patients, BODE score ≥5, may have higher RWT, featuring a possible higher concentric remodeling of LV in this group. Besides that, a greater disease severity may be related to LV chamber size reduction.

摘要

目的

研究慢性阻塞性肺疾病（COPD）患者左心室结构与疾病严重程度的关系。

方法

根据 BODE 指数，将 28 例 COPD 患者分为 L 组（n=17）和 H 组（n=11），分别为低严重程度（BODE<5）和高严重程度（BODE≥5）患者。使用二维超声心动图评估左心室（LV）。BODE 指数采用体重指数（BMI）、第一秒用力呼气量（FEV，%）、改良的医学研究委员会呼吸困难量表（mMRC）和 6 分钟步行试验（6MWD）所走距离计算。

结果

H 组患者的动脉血氧饱和度（p=0.02）、FEV（p<0.01）和 6MWD（p=0.02）较低，相对后壁厚度（RWT）较高（p=0.02）。LV 收缩末期直径（LVESD）与 BODE 指数呈负相关（r=-0.38，p=0.04），LV 舒张末期直径（LVEDD）与 FEV 呈正相关（r=0.44，p=0.02），LVEDD 与 BMI 呈正相关（r=0.45，p=0.02），LVESD 与 BMI 呈正相关（r=0.54，p=0.003），室间隔厚度与 6MWD 呈负相关（r=-0.39，p=0.04）。