Key result
Pulmonary hypertension affects ~50% of COPD patients and correlates with disease severity and dyspnea.
Observational (n=50)
No
p-value: p=0.029
Echocardiographic abnormalities, particularly pulmonary hypertension and left ventricular diastolic dysfunction, are highly prevalent in COPD patients and correlate with disease severity.
May support echocardiography in advanced COPD; leaves open whether detecting pulmonary hypertension improves outcomes in prospective studies.
BACKGROUNDMild-to-moderate pulmonary hypertension is a common complication of chronic obstructive pulmonary disease (COPD) and is associated with increased rates of exacerbation and decreased survival.The aim of our study was to find the prevalence of pulmonary hypertension and other cardiac abnormalities in patients with COPD and identify any correlation with disease severity, as well as identify any clinical predictors of pulmonary hypertension in these patients. MATERIALS AND METHODSAll patients presenting to our hospital with clinical symptoms suggestive of COPD were subjected to spirometry.For all patients, a detailed clinical history and disease severity assessment by GOLD and CAT were available.Two-dimensional echocardiography was performed for all patients and findings were recorded.Prevalence values for the various echocardiographic findings were calculated and correlation with disease severity was analysed. RESULTSOut of the total of 50 patients studied, 82% were male, 58% were aged above 60 years, 70% were ex-smokers and 88% were symptomatic (mMRC > 2).The majority had high CAT scores (>21, 62%), were in GOLD 3 or 4 (68%), and were predominantly in group D of the Individualised Assessment (IA) of COPD classification (62%) as per the GOLD statement.Right atrium (RA) and right ventricle (RV) dilatation were seen in 28% and 20% of the study group respectively.Tricuspid regurgitation and pulmonary hypertension were seen in 48% and 50% of the study population.Grade 1 left ventricular diastolic dysfunction (LVDD) and left ventricular hypertrophy (LVH) were seen in 86% and 58% of the patients.There was significant correlation between all the three echocardiographic findings and mMRC.There was significant correlation between TR and CAT scores (p=0.041), between PH and Grade 1 LVDD and GOLD stage (p = 0.029 and p = 0.001, respectively), and between PH and Grade 1 LVDD and IA of COPD (p = 0.029 and p = 0.015, respectively). CONCLUSIONPulmonary hypertension is common in patients with COPD and correlates well with symptoms (mMRC) and severity of disease (GOLD).
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Ayub et al. (2017) conducted an observational in Chronic Obstructive Pulmonary Disease (COPD) (n=50). COPD was evaluated on Prevalence of pulmonary hypertension (p=0.029). Pulmonary hypertension was present in 50% of patients with COPD and significantly correlated with disease severity (GOLD stage, p=0.029) and dyspnea symptoms.
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