Chest
Clinical InvestigationsPulmonary Hypertension and Right Ventricular Function in Patients with COPD
Section snippets
Patients
One hundred patients were studied (66 men and 34 women, mean age 62, SD eight years) who had a history of cough and sputum production for three months per year for at least two consecutive years. The patients had airflow limitation (FEV1/FVC <60 percent predicted) which was largely irreversible (<15 percent change in FEV1 in response to two puffs of a β−2 agonist), indicating COPD. Most had severe airflow limitation (although we wished to have a wide range of disability), with hypoxemia, but
RESULTS
In these 100 patients with COPD, there was a wide range of ventilatory function, arterial blood gas values, and RVEF (Table 1). There was no correlation between mean pulmonary arterial pressure and simultaneous measurements of RVEF (Fig 1) (r = –0.07), nor between RVEF and systolic pulmonary arterial pressure (r = –0.02). However, there was a weak but significant correlation between the total pulmonary vascular resistance and the RVEF (r = –0.40, p<0.05, n = 52). In addition, RVEF did
DISCUSSION
We found no correlation between simultaneous measurements of RVEF and the (Fig 1) in 100 patients with COPD who had a wide range of both and RVEF (Table 1). This represents the largest group of patients with COPD where a correlation between these simultaneously measured variables has been made. Previous studies have shown correlation coefficients between and RVEF varying from + 0.23 to –0.86.5, 6, 7, 8, 20, 21, 22, 23, 24 Several factors may account for this
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Cited by (71)
Combined Echocardiographic and Cardiopulmonary Exercise to Assess Determinants of Exercise Limitation in Chronic Obstructive Pulmonary Disease
2021, Journal of the American Society of EchocardiographyCitation Excerpt :The first was an abnormal RV response to exercise, shown by the blunted increase in radial (RV fractional area change) and longitudinal (S′) contraction in patients with COPD. Previous studies of the function of the right ventricle in patients with COPD7,10,26,27 suggested that blunted response is related to increased RV afterload in patients with COPD.7,26,28 Our analyses show that the RV systolic pressure response was entirely different in patients with COPD, with a significant difference from control subjects linking RV afterload to the abnormal RV response.
CT scan-measured pulmonary artery to aorta ratio and echocardiography for detecting pulmonary hypertension in severe COPD
2014, ChestCitation Excerpt :Although the correlation between relative PA enlargement and PA pressures is driven most by changes in PA diameter rather than changes in aortic diameter, relative PA enlargement is only partially explained by intrinsic PH itself, as indicated by the modest r value we report. Other mechanisms could contribute, including changes to pulmonary arterial distensibility,34 redistribution of blood flow from peripheral capillary loss,35 or left ventricular systolic or diastolic dysfunction,36‐38 although we observed no clear correlation with capillary wedge pressures, cardiac output, or left ventricular ejection fraction in those with PA:A > 1 and PA:A < 1. Prior studies have characterized the relationship between CT scan metrics and hemodynamics; however, these have been conducted in heterogeneous populations with various lung diseases and included a small number of patients with COPD.17,39‐41
Right ventricular dysfunction and remodeling in chronic obstructive pulmonary disease without pulmonary hypertension
2013, Journal of the American College of CardiologyHypoxaemia in patients with pulmonary arterial hypertension during simulated air travel
2013, Respiratory MedicineRight Ventricular Dysfunction in Chronic Lung Disease
2012, Cardiology Clinics
Manuscript received February 2; revision accepted April 26.