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Assessment of Cardiac Dysfunction in Patients With Chronic Obstructive Pulmonary Disease (COPD): A Cross-Sectional
Rehab A Mohammed1,2, Layla A Mohamed3, Eman M Abdelsalam1
1Internal Medicine, Faculty of Medicine for Girls, Al-Azhar University, Cairo, EGY.
Cureus
|June 30, 2023
Summary
Cardiac abnormalities are common in patients with chronic obstructive pulmonary disease (COPD). Echocardiography, pulmonary function tests, arterial blood gas, and brain natriuretic peptide levels can help predict cardiovascular dysfunction in COPD patients.
Area of Science:
- Cardiology
- Pulmonology
- Medical Diagnostics
Background:
- Cardiovascular diseases (CVDs) are prevalent in patients with chronic obstructive pulmonary disease (COPD).
- Comorbid CVDs in COPD patients often go undiagnosed or undertreated due to insufficient guideline-recommended screening.
- This study investigates cardiac function and prognostic indicators in COPD patients without a prior history of heart disease.
Purpose of the Study:
- To evaluate cardiac function in moderate to very severe COPD patients using echocardiography.
- To assess spirometry, arterial blood gas (ABG) analysis, and brain natriuretic peptide (BNP) as prognostic indicators of cardiovascular dysfunction.
- To identify predictors of right ventricular (RV) and left ventricular (LV) dysfunction in this population.
Main Methods:
- One hundred moderate to very severe COPD patients (GOLD guidelines) were recruited from Saudi Arabia.
- Evaluations included electrocardiography (ECG), chest X-ray, BNP, pulmonary function tests, ABG analysis, and transthoracic echocardiography.
- Multiple linear regression analysis was employed to determine predictors of RV and LV dysfunction.
Main Results:
- Pulmonary hypertension (PH) was found in 28% of patients; 25% had abnormal tricuspid annular plane systolic excursion (TAPSE).
- Left ventricular ejection fraction (LVEF) and strain were abnormal in 20%, right ventricular strain in 17%, and fractional area change (FAC) in 9%.
- Age, diabetes, hyperlipidemia, hypoxemia, hypercapnia, forced vital capacity (FVC), and BNP levels were significant predictors of cardiac dysfunction.
Conclusions:
- Cardiac abnormalities are frequent in moderate to very severe COPD patients.
- Echocardiography is a valuable tool for assessing cardiac function in COPD patients, even without a history of heart disease.
- Pulmonary function, ABG, and BNP provide additional predictive information regarding cardiac function in COPD.
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