Echocardiographic Evaluation of Right Heart in Patients of Chronic Obstructive Pulmonary Disease

BACKGROUND Cardiac involvement in Chronic Obstructive Pulmonary Disease (COPD) is a significant cause of morbidity, mortality, and even death. We aimed to study the echocardiographic evaluation, especially of the right heart, in patients of COPD and to co-relate findings of echocardiography with the clinical profile and severity of COPD of such patients. METHODS We performed a cross-sectional study for a period of 2 years. The patients were subjected to necessary investigations and transthoracic echocardiography for evaluating the right heart parameters. Data was entered in MS Excel spreadsheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0. A p value of <0.05 was considered statistically significant. RESULTS Of the 50 COPD cases studied, the majority (22) fulfilled GOLD stage IV criteria followed by 14 cases in GOLD stage II. Right atrial pressure was increased in 52% study subjects. Pulmonary artery systolic pressure had values of more than 25 mmHg in 68% of patients. RV thickness was >5 mm in 56% subjects. TAPSE was measured to be <17 mm in 50% COPD cases. A significant association was seen between severity of COPD and RA pressure, RV size, RV pressure/pulmonary artery pressure, RV thickness and TAPSE. CONCLUSIONS Significant prevalence of right heart dysfunction is found in COPD and there was a significant association of cardiac parameters with severity of COPD. Thus it is recommended that all patients of COPD should undergo right heart evaluation by echocardiography so that treatment modalities can be changed to minimize morbidity and mortality.