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Early changes of cardiac structure and function in COPD patients with mild hypoxemia
Anton Vonk-Noordegraaf1, J Tim Marcus, Sebastiaan Holverda
1Department of Pulmonary Medicine, Institute for Cardiovascular Research, Vrije Universiteit Medical Center, PO Box 7057, 1007 MB Amsterdam, Netherlands. A.Vonk@vumc.nl
Chest
|June 11, 2005
Summary
Chronic obstructive pulmonary disease (COPD) patients show early signs of concentric right ventricular (RV) hypertrophy. This structural change in the heart occurs without affecting RV or left ventricular (LV) systolic function in patients with normal oxygen levels.
Area of Science:
- Cardiology
- Pulmonology
- Medical Imaging
Background:
- Chronic obstructive pulmonary disease (COPD) is linked to cardiac structural and functional changes.
- Right ventricular (RV) dysfunction is documented in COPD with severe hypoxemia, but less is known about normoxic/mildly hypoxemic patients.
Purpose of the Study:
- To evaluate cardiac structural and functional alterations in COPD patients with normal PaO2 and no signs of RV failure.
Main Methods:
- Magnetic resonance imaging (MRI) assessed RV and left ventricular (LV) structure and function in 25 stable COPD patients and 26 controls.
- Pulmonary artery pressure (PAP) was estimated using right pulmonary artery distensibility.
Main Results:
- COPD patients exhibited increased RV mass/end-diastolic volume (0.72 vs. 0.41 g/mL, p < 0.01), indicating concentric RV hypertrophy.
- LV and RV ejection fractions were not significantly different between COPD patients and controls.
- Estimated PAP was not elevated in the COPD group.
Conclusions:
- Concentric RV hypertrophy represents the earliest indicator of RV pressure overload in COPD patients.
- This early cardiac adaptation does not impair RV and LV systolic function in this patient group.