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Eccentric Left Ventricular Hypertrophy and Left and Right Cardiac Function in Chronic Heart Failure with or without

Polliana B Dos Santos1, Rodrigo P Simões1,2, Cássia da L Goulart1

  • 1Cardiopulmonary Physical Therapy Laboratory, Federal University of Sao Carlos, Sao Carlos, Brazil.

International Journal of Chronic Obstructive Pulmonary Disease
|February 11, 2021
PubMed

Insights

Chronic heart failure with COPD significantly worsens exercise capacity compared to heart failure alone. Echocardiography reveals cardiac function links to exercise performance, highlighting a therapeutic target.

Area of Science:

  • Cardiology
  • Pulmonology
  • Exercise Physiology

Background:

  • Eccentric left ventricular hypertrophy (ELVH) impacts exercise performance in chronic heart failure (CHF).
  • The combined burden of CHF and chronic obstructive pulmonary disease (COPD) may further compromise cardiorespiratory fitness.
  • Understanding the interplay between cardiac function, clinical factors, and exercise capacity is crucial for managing these conditions.

Purpose of the Study:

  • To evaluate the effect of ELVH on exercise performance in patients with CHF alone versus those with co-existing CHF and COPD.
  • To investigate the relationship between Doppler echocardiography-derived cardiac function, clinical characteristics, and cardiorespiratory fitness measures.

Main Methods:

  • A cohort of 46 patients (23 CHF, 23 CHF+COPD) underwent pulmonary function tests, echocardiography, and symptom-limited incremental cardiopulmonary exercise testing (CPET).
  • CPET utilized a cycle ergometer to assess cardiorespiratory responses.

Main Results:

  • Patients with CHF+COPD exhibited significantly lower work rate, peak oxygen uptake (VO2), oxygen pulse, rate pressure product (RPP), circulatory power (CP), and ventilatory power (VP) compared to the CHF-only group.
  • Significant correlations were found between ventilatory power and relative wall thickness, and between VE/VCO2 intercept and Mitral E/e' ratio in the CHF group.
  • In the CHF+COPD group, indexed left ventricle mass correlated with RPP, and relative VO2 correlated with right ventricle diameter.

Conclusions:

  • Combined CHF and COPD diagnosis leads to greater impairments in cardiorespiratory fitness than CHF alone.
  • Echocardiographic measures of cardiac function are demonstrably linked to cardiopulmonary exercise performance.
  • Targeting echocardiographic measures of cardiac function may be a key strategy for improving exercise performance and functional capacity in these patients.
Abstract

Keywords:
cardiopulmonary exercise testingchronic obstructive pulmonary diseaseeccentric hypertrophyechocardiographyheart failureventricular dysfunction

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