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Left heart function in chronic obstructive lung disease.

H Seibold, U Roth, R Lippert

    Klinische Wochenschrift
    |May 2, 1986
    PubMed
    Summary
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    Chronic obstructive pulmonary disease (COPD) patients show typical left ventricular ejection fraction (LVEF) responses during exercise. However, some exhibit unexpected ischemia, suggesting potential coronary heart disease in older adults with COPD.

    Area of Science:

    • Cardiology
    • Pulmonology
    • Medical Imaging

    Background:

    • Chronic obstructive pulmonary disease (COPD) can affect cardiovascular function.
    • Left ventricular (LV) function in COPD patients requires further investigation, especially concerning exercise response and comorbidities.

    Purpose of the Study:

    • To simultaneously measure central hemodynamics and LV function using radionuclide ventriculography (RNV) and echocardiography in COPD patients at rest and during exercise.
    • To investigate the relationship between COPD severity, arterial hypertension, and LV function.
    • To identify potential undiagnosed coronary heart disease (CHD) in this population.

    Main Methods:

    • Simultaneous measurements of central hemodynamics and RNV at rest and during exercise.
    • Echocardiograms performed in a subset of patients.

    Related Experiment Videos

  • Assessment of left ventricular ejection fraction (LVEF) and regional wall motion abnormalities.

    • Main Results:

    • COPD patients exhibited a typical resting LVEF in the high normal range with no further increase during exercise.
    • Decreased LV compliance was suspected in COPD patients with coexisting arterial hypertension.
    • Five out of 27 patients showed abnormal LVEF decrease and regional hypokinesis during exercise, suggesting possible CHD.
    • Arterial hypertension was present in at least 30% of patients, and 20% showed exercise-induced ischemia on RNV not detected by ECG.

    Conclusions:

    • The observed LVEF response pattern during exercise is typical for COPD patients and unlikely to be caused by COPD itself.
    • A significant portion of COPD patients have arterial hypertension and/or undiagnosed exercise-induced ischemia.
    • Diagnostic uncertainty regarding CHD remains in older COPD patients due to ventilatory limitations and lack of angina, highlighting the need for further investigation.