Left ventricular dysfunction in COPD without pulmonary hypertension

Area of Science:

• Cardiology
• Pulmonology
• Echocardiography

Background:

• Chronic obstructive pulmonary disease (COPD) is associated with cardiovascular complications.
• Left ventricular (LV) function in stable COPD patients requires further investigation, especially in the absence of overt cardiac disease.

Purpose of the Study:

• To evaluate the prevalence of left ventricular (LV) systolic and diastolic dysfunction in stable COPD patients.
• To assess LV function in relation to pulmonary artery pressure in COPD.

Main Methods:

• 100 COPD patients (GOLD II-IV) and 34 controls underwent echocardiography.
• LV myocardial performance index (MPI) and strain assessed systolic function.
• Diastolic function evaluated using E/A ratio, E´, E/E´, isovolumic relaxation time, and left atrium volume.

Main Results:

• Abnormal LV MPI (≥0.51) found in 64.9% and LV strain (≤-15.8%) in 62.2% of COPD-non-PH patients.
• Abnormal LV MPI and strain were also observed in patients with mean pulmonary artery pressure (mPAP) <20 mmHg.
• Standard diastolic echo indices did not significantly differ between COPD-non-PH patients and controls.

Conclusions:

• Subclinical LV systolic dysfunction is frequent in COPD patients, irrespective of pulmonary artery pressure.
• Conventional echocardiographic indices showed minimal evidence of LV diastolic dysfunction in this COPD cohort.