EFFECT OF SEVERITY OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE ON THE RIGHT VENTRICULAR SYSTOLIC FUNCTION
Abstract
According to the World Health Organization, the most common complication of chronic obstructive pulmonary disease (COPD) is chronic pulmonary heart disease (cor pulmonale chronicum). It represents myocardial hypertrophy of the right ventricle, dilatation and insufficiency of the right ventricle occurring as a result of changes in lung function/structure in the absence of left heart disease. The gold standard in detecting changes in right heart function in patients with COPD is an echocardiographic examination. The primary goal of this research was to determine the influence of the severity of COPD on the values of the right ventricular systolic function parameter, and the secondary goal of this research was to determine the frequency of tricuspid regurgitation in relation to the degree of COPD. For a detailed assessment of the systolic function of the right ventricle, which is important for the objectives of the study, the following parameters were performed: The fractional area change (FAC) of the right ventricle and tricuspid annular plane systolic excursion (TAPSE) in 44 patients with COPD which were divided into four groups according to the global initiative for obstructive lung disease (GOLD) criteria. There was no statistically significant difference between the groups for anthropometric indicators and FEV1 values (%) (p > 0.05).
The Kruskal−Wallis test shows that the TAPSE index and FAC values are significantly higher in patients with severe and very severe COPD (p < 0.05). The results of our research show that echocardiographic parameters of the right ventricle such as TAPSE and FAC are very important for assessing its systolic function and that these values decrease proportionally with the progression of the COPD disease.
References
Alerhand S, Hickey SM. Tricuspid annular plane systolic excursion (TAPSE) for risk stratification and prognostication of patients with pulmonary embolism. J Emerg Med 2020; 58(3): 449-56. [CrossRef] [PubMed]
Anavekar NS, Gerson D, Skali H, Kwong RY, Kent Yucel E, Solomon SD. Two-dimensional assessment of RVfunction: an echocardiographic-MRI correlative study. Echocardiography 2007; 24(5): 452-6. [CrossRef] [PubMed]
Barnes PJ, Celli BR. Systemic manifestations and comorbidities of COPD. Eur Respir J 2009; 33(5): 1165–85. [CrossRef] [PubMed]
Brusasco V, Crapo R, Viegi G. Coming together: the ATS/ERS consensus on clinical pulmonary function testing. Eur Respir J 2005; 26(1): 1–2. [CrossRef] [PubMed]
Chen J, Wu X, Su L,Gao S. Echocardiographic evaluation of right ventricular function in aged patients with chronic obstructive pulmonary disease. Chinese J Rehabilitation Med 2019; 6: 90-3.
Chronic respiratory diseases. WHO, 2022. Pristupljeno 13.07.2022. Dostupno na : https://www.who.int/health-topics/chronic-respiratory-diseases#tab=tab_3
Cuttica MJ, Shah SJ, Rosenberg SR, Orr R, Beussink L, Dematte JE, et al. Right Heart Structural Changes Are Independently Associated with Exercise Capacity in Non-Severe COPD. PLoS ONE 2011; 6(12): e29069 [CrossRef] [PubMed]
Dahl M, Vestbo J, Lange P, Bojesen SE, Tybjaerg-Hansen A, Nordestgaard BG. C-reactive protein as a predictor of prognosis in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2007; 175(3): 250–5. [CrossRef] [PubMed]
Fahim O, Fawzi A, Beshay M, Yousif M. Study of the relation between speckle tracking echocardiography and BODE index in patients with chronic obstructive pulmonary disease. The Egyptian Journal of Chest Diseases and Tuberculosis 2020; 69(3): 524-531. [CrossRef] [PubMed]
Foster TS, Miller JD, Marton JP, Caloyeras JP, Russell MW, Menzin J. Assessment of the economic burden of COPD in the US: a review and synthesis of the literature. COPD 2006; 3(4): 211–18. [CrossRef] [PubMed]
Galie N, Hinderliter AL, Torbicki A, Fourme T, Simonneau G, Pulido T, et al. Effects of the oral endothelin-receptor antagonist bosentan on echocardiographic and doppler measures in patients with pulmonary arterial hypertension. J Am Coll Cardiol 2003;41(8):1380–6 [CrossRef] [PubMed]
Galiè N, Hoeper MM, Humbert M, Torbicki A, Vachiery JL, Barbera JA, et al. Guidelines for the diagnosis and treatment of pulmonary hypertension: the Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT). Eur Heart J 2009; 30(20): 2493-537. [CrossRef] [PubMed]
Ghio S, Recusani F, Klersy C, Sebastiani R, Laudisa ML, Campana C, et al. Prognostic usefulness of the tricuspid annular plane systolic excursion in patients with congestive heart failure secondary to idiopathic or ischemic dilated cardiomyopathy. Am J Cardiol 2000;85(7): 837–42. [CrossRef] [PubMed]
Ghosh I, Mahapatra ABS, Tapadar S, Chowdhury SP. "Echocardiographic evaluation of right ventricle in different stages of chronic obstructive pulmonary disease (COPD) and its correlation with severity of the disease." World Journal of Pharmaceutical Research 2017;6(14): 632-43. [CrossRef]
Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease report; 2022.
Juillière Y, Barbier G, Feldmann L, Grentzinger A, Danchin N, Cherrier F. Additional predictive value of both left and right ventricular ejection fractions on long-term survival in idiopathic dilated cardiomyopathy. Eur Heart J 1997; 18(2): 276-80. [CrossRef] [PubMed]
Kaul S, Tei C, Hopkins JM, Shah PM. Assessment of right ventricular function using two-dimensional echocardiography. Am Heart J 1984; 107(3): 526-31. [CrossRef] [PubMed]
Kjaergaard J, Akkan D, Iversen KK, Kober L, Torp-Pedersen C, Hassager C. Right ventricular dysfunction as an independent predictor of short- and long-term mortality in patients with heart failure. Eur J of Heart Fail 2007; 9(6-7): 610-6. [CrossRef] [PubMed]
Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 2005; 18(12):1440-63. [CrossRef] [PubMed]
Martha J W, Pranata R , Wibowo A, Lim MA. Tricuspid annular plane systolic excursion (TAPSE) measured by echocardiography and mortality in COVID-19: a systematic review and meta-analysis. IJID 2021; 105: 351-6. [CrossRef] [PubMed]
Nacionalni vodič dobre kliničke prakse : Hronična opstruktivna bolest pluća. Institut za javno zdravlje “Dr Milan Jovanović Batut”. Beograd, 2013.
Najafian J, Taheri S, Mahaki B, Molavi S, Alami S, Khalesi S, Salehi A. Comparing right ventricular function and pulmonary artery pressure before and shortly after hemodialysis in patients with end-stage renal disease. Adv Biomed Res 2015; 4:197. [CrossRef] [PubMed]
O.C. Burghuber, Right ventricular contractility is preserved and preload increased in patients with chronic obstructive pulmonary disease and pulmonary artery hypertension, in: V. Jezek, M. Morpurgo, R. Tramarin (Eds.), Right Ventricular Hypertrophy and Function in Chronic Lung Disease, Springer-Verlag, Berlin 1992, pp. 135–141. [CrossRef]
Quiñones MA, Otto CM, Stoddard M, Waggoner A, Zoghbi WA; Doppler Quantification Task Force of the Nomenclature and Standards Committee of the American Society of Echocardiography. Recommendations for quantification of Doppler echocardiography: a report from the Doppler Quantification Task Force of the Nomenclature and Standards Committee of the American Society of Echocardiography. J Am Soc Echocardiogr 2002; 15(2): 167-184. [CrossRef] [PubMed]
Raymond RJ, Hinderliter AL, Willis PW, Ralph D, Caldwell EJ, Williams W, et al. Echocardiographic predictors of adverse outcomes in primary pulmonary hypertension. J Am Coll Cardiol 2002; 39(7):1214–9. [CrossRef] [PubMed]
Rennard SI, Drummond MB. Early chronic obstructive pulmonary disease: definition, assessment, and prevention. Lancet 2015; 385(9979): 1778-88. [CrossRef] [PubMed]
Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 2010; 23(7): 685-713. [CrossRef] [PubMed]
Schünemann HJ, Dorn J, Grant BJ, Winkelstein W Jr, Trevisan M. Pulmonary function is a long-term predictor of mortality in the general population: 29-year follow-up of the Buffalo Health Study. Chest 2000; 118(3): 656-64. [CrossRef] [PubMed]
Vizza CD, Lynch JP, Ochoa LL, Richardson G, Trulock EP. Right and left ventricular dysfunction in patients with severe pulmonary disease. Chest 1998; 113(3): 576-83. [CrossRef] [PubMed]
Zile MR, Brutsaert DL. New Concepts in Diastolic Dysfunction and Diastolic Heart Failure: Part I, Diagnosis, Prognosis, and Measurements of Diastolic Function. Circulation 2002; 105(11): 1387–93. [CrossRef] [PubMed]
