Abstract 4382: Identification of Subclinical Right Ventricular Systolic and Diastolic Dysfunction in Stable Chronic Obstructive Pulmonary Disease - A Tissue Doppler Study
Introduction: Compared with conventional echocardiographic technologies, tissue Doppler imaging (TDI) is capable of detecting early impairment of myocardial function.
Hypothesis: Subclinical right ventricular (RV) dysfunction can be identified by using TDI in patients with chronic obstructive pulmonary disease (COPD).
Methods: 100 patients (73 ± 8 years, 80% males) with stable COPD (without acute exacerbation in the past 3 months) who had no history of right heart failure were compared with 50 healthy subjects. Color TDI was performed to assess tricuspid annular motion displacement, peak systolic (Sm) and peak early diastolic (Em) velocities in both basal and mid RV segments.
Results: Patients with COPD had a higher pulmonary artery systolic pressure (PASP) and increased RV wall thickness (RVWT), though RV areas and area change were comparable with controls. The tricuspid E velocity was decreased while A velocity was increased resulting in reduced E/A ratio. TDI showed significant reduction in tricuspid annular displacement as well as Sm and Em in both basal and mid segments. The extent of decline in Em (35%) was greater than that of Sm (13%). When the cutoff values were derived from the normal subjects (−2SD from mean) for basal Sm (7.1cm/s) and basal Em (4.8cm/s), the prevalence of systolic and diastolic dysfunction in COPD patients was 20% and 33%, respectively.
Conclusions: By using TDI, early asymptomatic impairment of RV systolic and diastolic function was evident in patients with stable COPD who had no clinical evidence of right heart failure.