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Decreasing cardiac chamber sizes and associated heart dysfunction in COPD: role of hyperinflation

Henrik Watz1, Benjamin Waschki, Trhorsten Meyer

  • 1Pulmonary Research Institute, Hospital Grosshansdorf, Center for Pneumology and Thoracic Surgery, Woehrendamm 80, D-22927 Grosshansdorf, Germany. h.watz@pulmoresearch.de

Chest
|March 2, 2010
PubMed

Insights

Chronic obstructive pulmonary disease (COPD) severity is linked to smaller heart size and dysfunction. Lung hyperinflation, specifically inspiratory-to-total lung capacity ratio, significantly impacts heart size and function, affecting exercise capacity.

Area of Science:

  • Cardiology
  • Pulmonology
  • Medical Imaging

Background:

  • The relationship between abnormal lung function and cardiac structure/function in COPD patients is poorly understood.
  • Investigating these links is crucial for understanding COPD progression and its systemic effects.

Purpose of the Study:

  • To examine the association between lung function parameters and cardiac chamber sizes in COPD patients.
  • To determine the impact of lung function on cardiac dysfunction and its relation to exercise capacity (6-min walk distance).

Main Methods:

  • Echocardiography was used to assess cardiac chamber sizes and ventricular dysfunction (left ventricular diastolic and right ventricular Tei-index) in 138 COPD patients (GOLD I-IV).
  • Lung function was evaluated using spirometry, body plethysmography, and diffusion capacity.
  • The 6-min walk distance (6MWD) was measured.

Main Results:

  • Cardiac chamber sizes decreased with increasing COPD severity (GOLD stage).
  • Static hyperinflation, particularly the inspiratory-to-total lung capacity ratio (IC/TLC), showed stronger correlations with cardiac chamber sizes than airway obstruction or diffusion capacity.
  • An impaired left ventricular diastolic filling pattern and right ventricular dysfunction (Tei-index) were observed in patients with lower IC/TLC (< or = 0.25), and this diastolic dysfunction was linked to reduced 6MWD.

Conclusions:

  • COPD severity correlates with reduced heart size.
  • Lung hyperinflation, especially reduced IC/TLC, appears to be a significant factor in cardiac remodeling and dysfunction in COPD patients.
  • Impaired left ventricular diastolic function is independently associated with decreased exercise capacity in COPD.
Abstract

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