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Related Experiment Videos

Left ventricular dysfunction in deteriorating patients with chronic obstructive pulmonary disease

M L Render1, A S Weinstein, A S Blaustein

  • 1Medical Service, Veterans Affairs Medical Center, University of Cincinnati.

Chest
|January 1, 1995
PubMed
Summary

Left ventricular dysfunction (LVD) affects 32% of patients with chronic obstructive pulmonary disease (COPD) experiencing worsening symptoms. Standard clinical evaluation is insufficient to distinguish COPD alone from COPD with LVD, necessitating further investigation.

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Area of Science:

  • Cardiology
  • Pulmonology
  • Medical Diagnostics

Background:

  • Chronic obstructive pulmonary disease (COPD) exacerbations can be complicated by coexisting left ventricular dysfunction (LVD).
  • Differentiating isolated COPD from COPD with LVD is crucial as treatment strategies differ.
  • Symptomatic deterioration in COPD patients warrants evaluation for underlying cardiac issues.

Purpose of the Study:

  • To assess the efficacy of clinical variables and radionuclide ventriculography in distinguishing COPD patients with isolated disease from those with concurrent LVD.
  • To identify reliable methods for diagnosing LVD in patients presenting with worsening COPD symptoms.

Main Methods:

  • Retrospective review of 77 veteran patients referred to an outpatient Pulmonary Rehabilitation Program for increasing dyspnea.

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  • Data collected included medical history, physical findings, pulmonary function tests, arterial blood gases, 12-min walk distance, dyspnea score, ECG, chest radiograph, and radionuclide multigated ventriculography.
  • Patients were categorized based on left ventricular ejection fraction (<40% indicating LVD).

    • Main Results:

    • 32% (25/77) of patients with COPD and worsening dyspnea exhibited left ventricular dysfunction (LVD) with reduced ejection fraction and wall motion abnormalities.
    • Patients with LVD demonstrated significantly poorer functional capacity, evidenced by shorter 12-min walk distances and higher dyspnea scores.
    • Standard clinical evaluations and pulmonary function tests were insufficient to reliably differentiate patients with isolated COPD from those with coexisting LVD.

    Conclusions:

    • Left ventricular dysfunction (LVD) is a common comorbidity in COPD patients experiencing symptomatic decline.
    • Accurate identification of LVD in COPD patients is essential for appropriate therapeutic management.
    • Further prospective research is required to determine the most cost-effective diagnostic approaches and evaluate treatment benefits for this dual pathology.