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Left ventricular diastolic dysfunction in COPD may manifest myocardial ischemia

Parthasarathi Bhattacharyya1, Dipabali Acharjee, Soumendra Nath Ray

  • 1Institute of Pulmocare & Research, Kolkata, India. parthachest@yahoo.com

COPD
|May 10, 2012
PubMed

Insights

In advanced chronic obstructive pulmonary disease (COPD), new-onset left ventricular diastolic dysfunction (LVDD) may stem from underlying ischemia. This study found reversible perfusion defects in 50% of patients lacking typical cardiac risk factors.

Area of Science:

  • Cardiology
  • Pulmonology
  • Medical Imaging

Background:

  • Left ventricular diastolic dysfunction (LVDD) is common in advanced chronic obstructive pulmonary disease (COPD).
  • The pathophysiology of LVDD in COPD patients without traditional cardiovascular risk factors remains unclear.
  • Subclinical myocardial ischemia is hypothesized as a potential cause.

Purpose of the Study:

  • To investigate the prevalence of myocardial ischemia in advanced COPD patients with LVDD.
  • To determine if LVDD in these patients is associated with previously unrecognized ischemia.

Main Methods:

  • Tissue Doppler echocardiography was used to identify LVDD in advanced COPD patients (GOLD III & IV).
  • Patients were screened to exclude common cardiovascular risk factors (hypertension, diabetes, ischemic heart disease, hypothyroidism).
  • 99mTc MIBI stress myocardial perfusion imaging assessed for ischemia in patients with LVDD.

Main Results:

  • 50% (7 out of 14) of advanced COPD patients with LVDD and no conventional risk factors showed reversible perfusion defects.
  • These defects were predominantly located in the inferior wall myocardium (71.43%).
  • Stress electrocardiography (ECG) failed to detect most of these significant perfusion defects.

Conclusions:

  • Reversible myocardial ischemic defects are prevalent in advanced COPD patients with LVDD, even without common risk factors.
  • This suggests a significant association between COPD, LVDD, and subclinical ischemia.
  • Further research is warranted to elucidate this relationship and its clinical implications.
Abstract

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