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Abstract

PROSPECTIVE STUDY OF SPECTRUM OF ECHOCARDIOGRAPHIC PRESENTATIONS IN PATIENTS OF COPD

*Dr. Rakesh Kumar and Dr. P. Nigam

ABSTRACT

Background: Chronic obstructive pulmonary disease (COPD) has noticeable effects on cardiac functions, including those of the right and left ventricles, and pulmonary blood vessels. High incidence of mortality associated with COPD patients is due to cardiac involvement. Echocardiography evaluation provides a rapid, noninvasive, portable, and accurate method to evaluate the cardiac changes. Aims: To evaluate the cardiac changes secondary to COPD by echocardiography and to find out the correlation between echocardiographic determinants and severity of COPD, if there is any. Material and Methods: The present observational study was conducted on 50 cases having history of cough with expectoration of at least 3 months duration in 2 consecutive years in Department of Medicine, BRD Medical College, Gorakhpur from December 2012 to July 2014. A total 50 patients of COPD were selected and staged by pulmonary function test (PFT) using spirometric evaluation of forced expiratory volume in one second (FEV1), Forced vital capacity (FVC) and FEV1 / FVC ratio. The severity of COPD was assessed according to British Thoracic Society guidelines as Mild: FEV1 60-79% of predicted, Moderate: FEV1, 40-59% of predicted, Severe: FEV1 < 40% of predicted. 2-D and M-mode echocardiography was done to observe the presence of pulmonary hypertension, right ventricular hypertrophy, right ventricular dilatation, right ventricular failure and left ventricular systolic or diastolic dysfunction. All the data were expressed in numbers (%) and mean ± SD using SPSS ver. 20. Results: The Present study male: female ratio was 5.25:1 which indicate that COPD is more prevalent among men. The Incidence of COPD is higher (60%) among patients of age group 50-69 years. Study also revealed that most of the patients had symptoms of 1-5 years of duration. The mean FEV1 among study population was 36.01± 12.23 percent of predicted. Most of the patients (60%) had severe airflow obstruction at the time of presentation and only 4% had mild disease. Echocardiographic evaluation of COPD showed that 54% of study population had corpulmonale, 56% were having pulmonary hypertension, 48% had ventricular dilatation and 28% had right ventricular hypertrophy. Conclusion: Present study shows high prevalence of pulmonary hypertension, corpulmonale, left ventricular dysfunction complicating COPD, more so with more severe COPD. We suggest screening of all COPD patients for cardiac complications. Echocardiography helps in early detection of cardiac complications in COPD cases giving time for early interventions.

Keywords: Chronic obstructive pulmonary disease; Cardiac complications, Echocardiography.


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