Korean J Intern Med.  2019 May;34(3):569-578. 10.3904/kjim.2017.366.

Left ventricular dysfunction in relation with systemic inflammation in chronic obstructive pulmonary disease patients

• Gulen ST
• Eryilmaz U
• Yilmaz M
• Karadag F

• KMID: 2448349
• DOI: http://doi.org/10.3904/kjim.2017.366

Abstract

BACKGROUND/AIMS
Most important cause of mortality in chronic obstructive pulmonary disease (COPD) patients is known to be cardiovascular disease (CVD). The objective of the present study was to evaluate the echocardiographic parameters in COPD patients with or without pre-diagnosed CVD and to investigate the relationship between echocardiographic parameters and systemic inflammation markers.
METHODS
A total of 60 stable COPD patients (23 patients with CVD, group 1; 37 patients without CVD, group 2) and 21 healthy controls (group 3) were included in the study. Six-minute walking test (6MWT), COPD assessment test (CAT), and Body mass index, airflow Obstruction, Dyspnea, and Exercise (BODE) index results were recorded. High-sensitivity C-reactive protein (HsCRP), interleukin 8 (IL-8), fetuin-A, Clara cell protein (CCL-16), N-terminal pro-brain natriuretic peptide levels were studied in serum. Parameters of left and right ventricular systolic and diastolic function were measured by echocardiography.
RESULTS
Patients with COPD had higher levels of systemic inflammation markers and lower level of inflammation inhibitor fetuin-A. When three groups were compared, group 1 had lower 6MWT result. HsCRP was highest in group 2 while other inflammatory markers were similar in groups 1 and 2. Regarding echocardiographic parameters, left ventricular ejection fraction (LVEF) was lower and left ventricle end-diastolic diameter (LVED), left ventricle end-systolic diameter (LVES) diameters were higher in group 1. The aortic diameter was higher in COPD patients. Fetuin-A was correlated with diameter of aorta and LVES. LVEF, LVED, and LVES were found to be correlated with functional parameters of COPD cases.
CONCLUSIONS
In COPD, left ventricular functions are affected as well as right ventricle before prominent clinical findings of cardiac disease and these echocardiographic parameters correlate with functional parameters of COPD patients.

Keyword

Pulmonary disease, chronic obstructive; Ventricular function, left; Systemic inflammation

MeSH Terms

alpha-2-HS-Glycoprotein
Aorta
Body Mass Index
C-Reactive Protein
Cardiovascular Diseases
Dyspnea
Echocardiography
Heart Diseases
Heart Ventricles
Humans
Inflammation*
Interleukin-8
Mortality
Pulmonary Disease, Chronic Obstructive*
Stroke Volume
Ventricular Dysfunction, Left*
Ventricular Function, Left
Walking
C-Reactive Protein
Interleukin-8
alpha-2-HS-Glycoprotein