Two-dimensional echocardiography using a subcostal approach in patients with COPD

Area of Science:

• Cardiology
• Pulmonology
• Medical Imaging

Background:

• Pulmonary artery hypertension (PAH) is a serious complication in patients with chronic obstructive pulmonary disease (COPD).
• Accurate assessment of PAH in COPD is crucial for management and prognosis.
• Non-invasive imaging techniques are valuable for evaluating cardiac involvement in respiratory diseases.

Purpose of the Study:

• To evaluate the efficacy of two-dimensional echocardiography (2-DE) utilizing a subcostal window for assessing pulmonary artery hypertension (PAH) in patients with chronic obstructive pulmonary disease (COPD).
• To determine if specific 2-DE derived parameters can reliably quantify the morphologic changes in the right heart associated with PAH in COPD.

Main Methods:

• A case-control study comparing 15 COPD patients with PAH to 15 healthy controls.
• Two-dimensional echocardiography (2-DE) performed using a subcostal approach.
• Measurements included tricuspid annulus (TA) dimensions, right ventricle (RV) short axis, and right ventricular anterior wall (AW) thickness, normalized to body surface area (2D-index).

Main Results:

• The 2D-index (TA X RV + AW/body surface area) was significantly higher in COPD patients with PAH (871.2 +/- 314.5 mm/m2) compared to controls (378.3 +/- 47.6 mm/m2).
• The 2D-index demonstrated a strong correlation with mean pulmonary artery pressure (MPAP) (r=0.9055, p<0.001).

Conclusions:

• 2-DE parameters derived from the subcostal window can effectively quantify right heart morphologic alterations in COPD patients with PAH.
• These echocardiographic parameters are valuable tools for the non-invasive assessment of pulmonary artery hypertension in the context of COPD.