Key result
Impaired right ventricular strain in clinically stable patients with group A and B COPD was associated with a significantly higher risk of hospitalizations for acute exacerbation at one year compared to normal strain (55% vs 25%).
Why the study?
COPD-mediated myocardial involvement is a common cause of morbidity and mortality, but conventional TTE parameters perform poorly in detecting subclinical myocardial dysfunction.
Does 2D strain echocardiography detect subclinical myocardial dysfunction and predict hospitalizations in clinically stable group A and B COPD patients?
Cross-Sectional (n=80)
Yes
Does 2D strain echocardiography detect subclinical myocardial dysfunction and predict hospitalizations in clinically stable group A and B COPD patients?
Absolute Event Rate: 55% vs 25%
p-value: p=0.024
In clinically stable COPD patients with normal conventional echocardiographic parameters, 2D speckle tracking echocardiography can detect subclinical right ventricular dysfunction, which is associated with worse functional capacity and a higher risk of exacerbation-related hospitalizations.
RV strain may aid risk stratification in stable COPD with normal conventional echo; leaves open whether it guides interventions to reduce hospitalizations.
Background Myocardial involvement mediated by chronic obstructive pulmonary disease (COPD) is a common cause of morbidity and mortality. Conventional transthoracic echocardiography (TTE) parameters are poor in the detection of subclinical myocardial dysfunction. Aim To investigate the contribution of strain in the early detection of cardiac damage in clinically stable COPD patients. Methods This was a comparative study between COPD patients (classified A or B) with normal and reduced right ventricle (RV) strain. The COPD assessment test (e.g., CAT score), spirometry [e.g., forced expiratory volume in 1 s (FEV1, L)], 6 min walk test [e.g., 6 min walk distance (6MWD, m)], and both conventional TTE [i.e., left ventricular ejection fraction (LVEF), right atrium (RA), RV, left ventricle global longitudinal strain (LV GLS)], and strain (e.g., impaired RV strain is > −19), were performed. Results Eighty COPD patients [mean ± standard deviation (SD): age = 66 ± 9 years, LVEF = 60.1 ± 5%, RA = 25 ± 7%, RV = −19.9 ± 3.7%, LV GLS v −21.1 ± 2, and 48% had impaired RV strain] were included. Compared to COPD patient with normal RV strain, those with reduced RV strain had (i) Lower 6MWD (310 ± 113 vs 470 ± 104 m; p = 0.001), (ii) Lower FEV1 (1.63 ± 0.73 vs 2.18 ± 0.41 L; p = 0.012), and (iii) Higher CAT score (21 ± 10 vs 13 ± 6; p = 0.012). An impaired RV strain was associated with a higher risk of hospitalizations for acute exacerbation in the post inclusion year, (respectively for 55% and 25%; p = 0.024). No death was recorded during the study period. Conclusion Group A and B COPD patients having normal conventional TTE parameters, speckle tracking is a key parameter in the detection of subclinical myocardial dysfunction.
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Kaddoussi et al. (2025) conducted a cross-sectional in Chronic obstructive pulmonary disease (COPD) group A or B (n=80). Impaired right ventricular (RV) strain vs. Normal RV strain was evaluated on Hospitalizations for acute exacerbation at 1 year (p=0.024). Impaired right ventricular strain in clinically stable patients with group A and B COPD was associated with a significantly higher risk of hospitalizations for acute exacerbation at one year compared to normal strain (55% vs 25%).
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