Echocardiographic features of congestive heart failure in patients with chronic obstructive pulmonary disease

Abstract

Aim. To optimize echocardiographic diagnosis of congestive heart failure in patients with chronic obstructive pulmonary disease (COPD). Methods. Several modes of echocardiography using HD 11XE (Philips, USA) ultrasound scanner, 24-hour ECG monitoring using Microvit MT-101 (Schiller, Switzerland) 3-channel recorder and spirometry using АFD-02-«МFP» (Russia) machine were performed in 157 patients aged 39-76 years (male - 114, female - 43) who were divided into the following subgroups: (1) patients with COPD alone, (2) patients with COPD and concomitant arterial hypertension, (3) patients with COPD and concomitant ischemic heart disease, (4) patients with ischemic heart disease, (5) healthy controls. Results. 55.4% of patients with COPD had clinical signs of congestive heart failure (with signs of isolated diastolic dysfunction in 85.7% of patients with congestive heart failure). Diastolic dysfunction was associated with increase of peak isovolumic velocity (IVV) and even more significant decrease of peak early (Ea) and late (Aa) diastolic annular tricuspid vale velocities ratio at pulsed Doppler tissue imaging compared to patients without congestive heart failure. In patients with isolated COPD and isolated diastolic dysfunction echo signs of right ventricle dilatation, and in patients with COPD and concomitant ischemic heart disease - also of pulmonary artery trunk dilatation and hypertrophy of both ventricles were significantly more frequent. Systolic dysfunction was found only in patients with COPD and concomitant ischemic heart disease, causing longitudinal systolic dysfunction of the right ventricle seen as a reduction of systolic excursion and peak systolic (Sa) annular velocity, increased Myocardial Performance Index (Tei Index) and corrected isovolumic relaxation time, as well as hypertrophy of both ventricles and left ventricular dilatation. Conclusion. Echocardiography (Doppler tissue imaging) can be used for congestive heart failure diagnosis verification in patients with COPD.

Keywords

chronic obstructive pulmonary disease / congestive heart failure / echocardiography / Doppler tissue imaging

References

[1] Батыралиев Т.А., Махмутходжаев С.А., Патарая С.А. Лёгочная гипертензия и правожелудочковая недостаточность. Часть IV. Хронические заболевания лёгких // Кардиология. - 2006. - №5. - С. 77-88.

[2] Национальные рекомендации ВНОК и ОССН по диагностике и лечению ХСН (III пересмотр). - http://medic.ossn.ru/activity/man/

[3] Пульмонология: национальное руководство / Под ред. А.Г. Чучалина. - М: ГЭОТАР-Медиа, 2009. - 960 c.

[4] Рыбакова М.К., Алёхин М.Н., Митьков В.В. Практическое руководство по ультразвуковой диагностике. Эхокардиография. - М.: Видар, 2008. - 512 с.

[5] Curkendall S.M., DeLuise C., Jones J.K. et al. Cardiovascular disease in patients with chronic obstructive pulmonary disease, Saskatchewan Canada cardiovascular disease in COPD patients // Ann. Epidemiol. - 2006. - Vol. 16, N 1. - P. 63-70.

[6] De Rocha N., Stelmach R., Cukier A. et al. Assessment of the ventricular function of patients with advanced chronic obstructive pulmonary disease by using magnetic resonance imaging // Arq. Bras. Cardiol. - 2004. - Vol. 83, N 4. - P. 326-331.

[7] Finkelstein J., Cha E., Scharf S.M. Chronic obstructive pulmonary disease as an independent risk factor for cardiovascular morbidity // Int. J. Chron. Obstruct. Pulmon. Dis. - 2009. - Vol. 4, N 3. - P. 337-349.

[8] Huiart L., Ernst P., Suissa S. Cardiovascular morbidity and mortality in COPD // Chest. - 2005. - Vol. 128, N 4. - P. 2640-2646.

[9] Kjaergaard J., Akkan D., Iversen K.K. et al. Right ventricular dysfunction as an independent predictor of short- and long-term mortality in patients with heart failure // Eur. J. Heart Fail. - 2007. - Vol. 9, N 6-7. - Р. 610-616.

RIGHTS & PERMISSIONS

Akramova E.G.