Cardiac evaluation of patients with Chronic Obstructive Pulmonary Disease (COPD) using two-dimensional Doppler echocardiography

We aimed to compare the frequency of echocardiographic changes between COPD patients and non-COPD controls and to assess their relation to COPD severity. Prospective, cross-sectional study of 220 patients with stable COPD as investigated group (IG), aged 40-75 years and 58 controls (CG) in whom COPD was excluded, matched by age, gender, BMI, smoking status. Pulmonary evaluation: dyspnea severity assessment, pre- and post-bronchodilator spirometry, arterial gas analysis, chest X-ray. Resting 2D Doppler Echocardiography was performed according to the recommendations of the American Heart Association. We found statistically significant difference between left ventricle ejection fraction (LVEF) in IG vs. CG 58.67±6.58% vs. 62.74±4.89% (p=0.00003). There was a significant linear positive correlation between LVEF% and FEV1 decline (p=0.00001) and between left ventricle enlargement and FEV1 decline (p=0.0109). With decrease of FEV1(GOLD1→GOLD4), the left atrial dilatation increased significantly (p=0.0021). Results presented statistically significant difference in mean right ventricle end-diastolic dimension in IG vs.CG (28.0±6.01 vs. 23.67±2.44mm; p=0.00001). Pulmonary hypertension was more frequent in COPD patients than in controls (33.3% vs. 0%; p=0.008). Systolic pulmonary arterial pressure significantly increased with FEV1 decline (GOLD1→GOLD4). We found higher prevalence and higher severity of echocardiographic abnormalities in COPD vs. controls. Cardiac findings were significantly related to disease severity and started in the early stages of the disease. Echocardiography should be considered as a tool in the assessment of all patients with COPD.