Abstract 14626: Evidence of Progressive Subclinical Right Ventricular Dysfunction in Patients with Chronic Obstructive Pulmonary Disease: A Prospective Study by Tissue Doppler Imaging
Background: In patients with chronic obstructive pulmonary disease (COPD), right ventricular (RV) function could be adversely affected as the disease progresses. We hypothesize that subclinical deterioration of RV systolic function may occur in patients with COPD.
Methods: This prospective study enrolled 50 patients (47males, mean age: 70±8 years) with COPD and no history of heart failure. Conventional 2D echocardiography and pulsed wave tissue Doppler imaging were performed at baseline and one-year follow-up to assess RV function. 2D parameters included RV end-diastolic area (RVEDA), end-systolic area (RVESA) and fractional area change (RV-FAC). Peak systolic tricuspid annulus velocity (S') was measured. Pulmonary artery systolic pressure (PASP) was estimated by peak velocity of tricuspid regurgitation (TR) and right atrial pressure.
Results: There was no significant difference in RVEDA (11.8±3.6 vs. 11.0±2.7 cm2, p=0.093), RVESA (6.0±2.2 vs. 5.6±1.7 cm2, p=0.156) and RV-FAC (49.8±8.1 vs. 49.8±7.2%, p=0.977) between baseline and one-year follow up. However, S' showed significant reduction at one-year follow-up (14.6±4.0 vs. 13.0±.5 cm/s, p=0.002), which occurred in 60% of study patients. Furthermore, in patients presented with reduced S', the peak early diastolic velocity of tricuspid annulus (E') was decreased (6.9±2.5 vs. 5.8±2.0 cm/s, p=0.005). There was no change in PASP (27.2±16.2 vs. 24.5±13.8 mmHg, p=0.274) and peak velocity of TR.
Conclusion: This prospective study showed that patients with COPD had evidence of progressive deterioration of RV systolic function which can be detected by the use of more sensitive quantitative echocardiographic tools such as tissue Doppler imaging.
- © 2011 by American Heart Association, Inc.