Echocardiographic Evaluation of Right Ventricular Diastolic Function in Patients with Chronic Obstructive Pulmonary Disease

Kim, Tae Hyun; Lee, Seung Uk; Jeong, Jong Pil; Park, Jung Bok; Kim, Chun Ho; Ko, Young Chun; Cho, Sang Ki

Abstract

Pulmonary heart disease is the third common cardiac condition, next to hypertensive heart disease and atherosclerotic heart disease. Chronic obstructive pulmonary disease (COPD) is a common cause of pulmonary parenchymal disease that results in right ventricular dysfunction. In recent years, there have been a few studies suggesting that patient with COPD with pulmonary hypertension have right ventricular diastolic dysfunction. The aim of this study is to evaluate right ventricular diastolic function in a group of patient with COPD. Forty patients with COPD were stuided. They were divided into 3 groups according to cor pulmonale and pulmonary hypertension. Group 1 comprised 10 patients with cor pulmonale, Group 2 consist of 15 patients without cor pulmonale and pulmonary hypertension, 15 patients with pulmonary hypertension formed group 3. COPD was defined by American Thorasic Society classification, and Cor pulmonale defined by ECG. The following variables were measured peak velocity of early diastolic filling (E), late filling with atrial contraction (A), E/A ratio, and deceleration time of the E. The COPD patients with cor pulmonale (group 1) and those with pulmonary hypertension (group 3) had higher tricuspid peak A velocity, lower tricuspid E velocity, lower E/A ratio, than the COPD patients without cor pulmonale and pulmonary hypertension (group 2). It is concluded that in patients with COPD, the development of pulmonary hypertension and cor pulmonale leads to right ventricular diastolic dysfunction, whereas the patients without cor pulmonale and pulmonary hypertension are spared from right ventricular dysfunction.