Key result
Severe COPD and lower PaO2 levels were significantly correlated with increased right atrial area, higher pulmonary artery pressures, and right ventricular dysfunction.
Observational (n=56)
No
In patients with acute COPD exacerbations, worsening blood gas parameters correlate with right ventricular dysfunction and right atrial enlargement.
Hypothesis-generating for hypoxia-driven right heart changes in COPD; prospective studies needed before clinical adoption.
OBJECTIVE: To investigate the correlation between respiratory failure and the pulmonary circulation. We focused on anatomical and functional changes of the right heart. Design. Clinical investigation. METHODS: We evaluated 75 patients hospitalized in our respiratory ward for COPD exacerbation. All patients underwent transthoracic echocardiography and measurements of right heart chambers. Moreover all patients underwent blood tests, measurement of blood pressure, evaluation of body mass index (BMI), ECGs, pulmonary function tests, and the Saint George's Respiratory Questionnaire (SGRQ). RESULTS: Among 75 patients consecutively hospitalized, 56 patients with a COPD exacerbation were included in our study. We have emphasized the higher value of PAPs and the increased size of right atrial area in severe COPD patients. Significant correlation was observed between low values of PaO2 and larger area of the right atrium. The measurement of TAPSE showed a right ventricular dysfunction in all patients but especially in severe COPD patients. We have obtained a significant correlation between TAPSE and arterial blood gas. CONCLUSIONS: In patients with chronic respiratory failure, blood gas parameters should be considered as negative prognostic factors of right heart failure. Respiratory failure shows a relationship with pulmonary hypertension and with the anatomy and function of the right heart sections.
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Terzano et al. (2014) conducted an observational in COPD exacerbation (n=56). Respiratory failure was evaluated on Correlation between respiratory failure (arterial blood gas parameters) and right heart anatomical and functional changes. Severe COPD and lower PaO2 levels were significantly correlated with increased right atrial area, higher pulmonary artery pressures, and right ventricular dysfunction.
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