Evaluation of Left Ventricular Systolic Function by Two-Dimentional Speckle Tracking Echocardiography in Patients With Chronic Obstructive Pulmonary Disease (COPD)
Journal Title: The Egyptian Journal of Hospital Medicine - Year 2018, Vol 72, Issue 1
Abstract
<span>Background: </span><span>Chronic obstructive pulmonary disease (COPD) is characterized by chronic airflow limitation. In addition, COPD presents significant extra-pulmonary effects and is associated with important co-morbidities. The main causes of morbidity and mortality among COPD patients are cardiovascular disease (CVD), lung cancer and osteoporosis. Subclinical changes in LV systolic function that cannot be detected by conventional LV ejection fraction (EF) can be identified by speckle tracking echocardiography for quantification of myocardial strain and is a superior predictor of outcomes to EF. There are different mechanisms that COPD affect LV function as physiologcal stress, ventricular interdependence, chronic hypoxia and left ventricular hypertrophy. </span><span>Aim of the Work: </span><span>to evaluate LV systolic function by means of two-dimentional speckle tracking echocardiography (2D-STE) in patients with COPD and no evidence of CVD. </span><span>Patients and Methods: </span><span>This prospective study was carried out on 50 subjects of both sexes, who were presented to El Hussein University Hospital. Subjects were categorized into two groups; 20 healthy subjects as (control) group and 30 patients with (COPD) group. </span><span>Results: </span><span>The results of the study showed that there were statistically highly significant correlations of FEV1% with GLS, PAPs and smoking pack years (p < 0.001) and significant correlations of FEV1% with PO2 and oxygen saturation (p < 0.05). In addition, there were statistically significant correlations of global longitudinal strain (GLS) with tricuspid annular plane systolic excursion (TAPSI) and PO2 (p < 0.05) and PAPs and smoking pack years (p < 0.001). According to the comparison between both COPD subgroups, group (B) COPD subjects showed higher significant correlation with GLS, FEV1, FEV1/ FVC, PAPs and smoking pack year than group (A) COPD. Therefore, COPD severity is significantly correlated with GLS. </span><span>Conclusion: </span><span>2D-STE is a novel, fast and non invasive technique so, clinicians can use 2D-STE to predict risk of cardiovascular morbidity in COPD patients. </span><span>Recommednations: </span><span>It is recommended to perform larger- scaled study in multi-centers to assess role of 2D-STE in diagnosis LV dysfunction in COPD patients. Other diagnostic modalities as cardiac (MRI) can be helpful for assessment of LV function.<br /> </span>
Authors and Affiliations
Eman Helal
Keywords
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