Echocardiographic evaluation of right heart in chronic obstructive pulmonary disease patients

Abstract

Background: Chronic obstructive pulmonary disease (COPD), defined by GOLD as a preventable and treatable disease with some significant extrapulmonary effects, is a very common clinical entity in clinical practice. Echocardiography evaluation mainly focused on effects on the right heart function is a salient tool to evaluate the presence of degree of pulmonary hypertension and also identify that group of patients who need more early aggressive therapy for the underling lung disease. We aimed to prospectively study the patients with diagnosed COPD with echocardiogram for evaluating the right heart. Methods: An observational cross sectional, single centre study was done on 100 patients with COPD who were admitted in Mymensingh Medical College Hospital and underwent echocardiographic evaluation from January to December 2022. All echocardiographic parameters focused on right heart and its function were assessed. Results: Total 100 COPD patients studied, majority of patients should be male (64 patients, 64%) with the mean age of 60.9±11.4 years. Ninety Four patients (94%) studied had significant ECG abnormality out of which P ‘pulmonale was the most common (90 patients, 90%) while atrial arrhythmias in the form of Atrial fibrillation (AF) or Multifocal tachycardia (MAT) (12 patients, 12%) being the least common finding. Pulmonary hypertension defined as sPAP>30 mmHg was evident in all of the patients; with 30 patients (30%), 50 (50%) and 20 (20%) patients having severe, moderate and mild pulmonary hypertension respectively. RV dysfunction was evident with reduced average TAPSE values (1.59±0.38 cm) and elevated RIMP values (0.58±0.16). Conclusion: Majority of COPD patients had evidence of pulmonary hypertension. Echocardiogram can be a helpful tool to assess early changes on the right heart size and function in patients with COPD and also monitor these patients for rapid progression of the illness.