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Left ventricular dysfunction in COPD without pulmonary hypertension
OBJECTIVES: We aimed to assess prevalence of left ventricular (LV) systolic and diastolic function in stable cohort of COPD patients, where LV disease had been thoroughly excluded in advance. METHODS: 100 COPD outpatients in GOLD II-IV and 34 controls were included. Patients were divided by invasive...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7365599/ https://www.ncbi.nlm.nih.gov/pubmed/32673327 http://dx.doi.org/10.1371/journal.pone.0235075 |
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author | Hilde, Janne M. Hisdal, Jonny Skjørten, Ingunn Hansteen, Viggo Melsom, Morten N. Grøtta, Ole J. Småstuen, Milada C. Seljeflot, Ingebjørg Arnesen, Harald Humerfelt, Sjur Steine, Kjetil |
author_facet | Hilde, Janne M. Hisdal, Jonny Skjørten, Ingunn Hansteen, Viggo Melsom, Morten N. Grøtta, Ole J. Småstuen, Milada C. Seljeflot, Ingebjørg Arnesen, Harald Humerfelt, Sjur Steine, Kjetil |
author_sort | Hilde, Janne M. |
collection | PubMed |
description | OBJECTIVES: We aimed to assess prevalence of left ventricular (LV) systolic and diastolic function in stable cohort of COPD patients, where LV disease had been thoroughly excluded in advance. METHODS: 100 COPD outpatients in GOLD II-IV and 34 controls were included. Patients were divided by invasive mean pulmonary artery pressure (mPAP) in COPD-PH (≥25 mmHg) and COPD-non-PH (<25 mmHg), which was subdivided in mPAP ≤20 mmHg and 21–24 mmHg. LV myocardial performance index (LV MPI) and strain by tissue Doppler imaging (TDI) were used for evaluation of LV global and systolic function, respectively. LV MPI ≥0.51 and strain ≤-15.8% were considered abnormal. LV diastolic function was assessed by the ratio between peak early (E) and late (A) velocity, early TDI E´, E/E´, isovolumic relaxation time, and left atrium volume. RESULTS: LV MPI ≥0.51 was found in 64.9% and 88.5% and LV strain ≤-15.8% in 62.2.% and 76.9% in the COPD-non-PH and COPD-PH patients, respectively. Similarly, LV MPI and LV strain were impaired even in patients with mPAP <20 mmHg. In multiple regression analyses, residual volume and stroke volume were best associated to LV MPI and LV strain, respectively. Except for isovolumic relaxation time, standard diastolic echo indices as E/A, E´, E/E´ and left atrium volume did not change from normal individuals to COPD-non-PH. CONCLUSIONS: Subclinical LV systolic dysfunction was a frequent finding in this cohort of COPD patients, even in those with normal pulmonary artery pressure. Evidence of LV diastolic dysfunction was hardly present as measured by conventional echo indices. |
format | Online Article Text |
id | pubmed-7365599 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-73655992020-08-05 Left ventricular dysfunction in COPD without pulmonary hypertension Hilde, Janne M. Hisdal, Jonny Skjørten, Ingunn Hansteen, Viggo Melsom, Morten N. Grøtta, Ole J. Småstuen, Milada C. Seljeflot, Ingebjørg Arnesen, Harald Humerfelt, Sjur Steine, Kjetil PLoS One Research Article OBJECTIVES: We aimed to assess prevalence of left ventricular (LV) systolic and diastolic function in stable cohort of COPD patients, where LV disease had been thoroughly excluded in advance. METHODS: 100 COPD outpatients in GOLD II-IV and 34 controls were included. Patients were divided by invasive mean pulmonary artery pressure (mPAP) in COPD-PH (≥25 mmHg) and COPD-non-PH (<25 mmHg), which was subdivided in mPAP ≤20 mmHg and 21–24 mmHg. LV myocardial performance index (LV MPI) and strain by tissue Doppler imaging (TDI) were used for evaluation of LV global and systolic function, respectively. LV MPI ≥0.51 and strain ≤-15.8% were considered abnormal. LV diastolic function was assessed by the ratio between peak early (E) and late (A) velocity, early TDI E´, E/E´, isovolumic relaxation time, and left atrium volume. RESULTS: LV MPI ≥0.51 was found in 64.9% and 88.5% and LV strain ≤-15.8% in 62.2.% and 76.9% in the COPD-non-PH and COPD-PH patients, respectively. Similarly, LV MPI and LV strain were impaired even in patients with mPAP <20 mmHg. In multiple regression analyses, residual volume and stroke volume were best associated to LV MPI and LV strain, respectively. Except for isovolumic relaxation time, standard diastolic echo indices as E/A, E´, E/E´ and left atrium volume did not change from normal individuals to COPD-non-PH. CONCLUSIONS: Subclinical LV systolic dysfunction was a frequent finding in this cohort of COPD patients, even in those with normal pulmonary artery pressure. Evidence of LV diastolic dysfunction was hardly present as measured by conventional echo indices. Public Library of Science 2020-07-16 /pmc/articles/PMC7365599/ /pubmed/32673327 http://dx.doi.org/10.1371/journal.pone.0235075 Text en © 2020 Hilde et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Hilde, Janne M. Hisdal, Jonny Skjørten, Ingunn Hansteen, Viggo Melsom, Morten N. Grøtta, Ole J. Småstuen, Milada C. Seljeflot, Ingebjørg Arnesen, Harald Humerfelt, Sjur Steine, Kjetil Left ventricular dysfunction in COPD without pulmonary hypertension |
title | Left ventricular dysfunction in COPD without pulmonary hypertension |
title_full | Left ventricular dysfunction in COPD without pulmonary hypertension |
title_fullStr | Left ventricular dysfunction in COPD without pulmonary hypertension |
title_full_unstemmed | Left ventricular dysfunction in COPD without pulmonary hypertension |
title_short | Left ventricular dysfunction in COPD without pulmonary hypertension |
title_sort | left ventricular dysfunction in copd without pulmonary hypertension |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7365599/ https://www.ncbi.nlm.nih.gov/pubmed/32673327 http://dx.doi.org/10.1371/journal.pone.0235075 |
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