Early changes of cardiac structure and function in COPD patients with mild hypoxemia

Anton Vonk-Noordegraaf, J Tim Marcus, Sebastiaan Holverda, Bea Roseboom, Pieter E Postmus

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: COPD is often associated with changes of the structure and the function of the heart. Although functional abnormalities of the right ventricle (RV) have been well described in COPD patients with severe hypoxemia, little is known about these changes in patients with normoxia and mild hypoxemia.

STUDY OBJECTIVES: To assess the structural and functional cardiac changes in COPD patients with normal Pa(O2) and without signs of RV failure.

METHODS: In 25 clinically stable COPD patients (FEV1, 1.23 +/- 0.51 L/s; Pa(O2), 82 +/- 10 mm Hg [mean +/- SD]) and 26 age-matched control subjects, the RV and left ventricular (LV) structure and function were measured by MRI. Pulmonary artery pressure (PAP) was estimated from right pulmonary artery distensibility.

RESULTS: RV mass divided by RV end-diastolic volume as a measure of RV adaptation was 0.72 +/- 0.18 g/mL in the COPD group and 0.41 +/- 0.09 g/mL in the control group (p < 0.01). LV and RV ejection fractions were 62 +/- 14% and 53 +/- 12% in the COPD patients, and 68 +/- 11% and 53 +/- 7% in the control subjects, respectively. PAP estimated from right pulmonary artery distensibility was not elevated in the COPD group.

CONCLUSION: From these results, we conclude that concentric RV hypertrophy is the earliest sign of RV pressure overload in patients with COPD. This structural adaptation of the heart does not alter RV and LV systolic function.

Original languageEnglish
Pages (from-to)1898-903
Number of pages6
JournalChest
Volume127
Issue number6
DOIs
Publication statusPublished - Jun 2005

Cite this

@article{770734066dab46a0858bebbbfb806f75,
title = "Early changes of cardiac structure and function in COPD patients with mild hypoxemia",
abstract = "BACKGROUND: COPD is often associated with changes of the structure and the function of the heart. Although functional abnormalities of the right ventricle (RV) have been well described in COPD patients with severe hypoxemia, little is known about these changes in patients with normoxia and mild hypoxemia.STUDY OBJECTIVES: To assess the structural and functional cardiac changes in COPD patients with normal Pa(O2) and without signs of RV failure.METHODS: In 25 clinically stable COPD patients (FEV1, 1.23 +/- 0.51 L/s; Pa(O2), 82 +/- 10 mm Hg [mean +/- SD]) and 26 age-matched control subjects, the RV and left ventricular (LV) structure and function were measured by MRI. Pulmonary artery pressure (PAP) was estimated from right pulmonary artery distensibility.RESULTS: RV mass divided by RV end-diastolic volume as a measure of RV adaptation was 0.72 +/- 0.18 g/mL in the COPD group and 0.41 +/- 0.09 g/mL in the control group (p < 0.01). LV and RV ejection fractions were 62 +/- 14{\%} and 53 +/- 12{\%} in the COPD patients, and 68 +/- 11{\%} and 53 +/- 7{\%} in the control subjects, respectively. PAP estimated from right pulmonary artery distensibility was not elevated in the COPD group.CONCLUSION: From these results, we conclude that concentric RV hypertrophy is the earliest sign of RV pressure overload in patients with COPD. This structural adaptation of the heart does not alter RV and LV systolic function.",
keywords = "Aged, Analysis of Variance, Case-Control Studies, Female, Heart Function Tests, Humans, Hypertension, Pulmonary/complications, Hypertrophy, Right Ventricular/complications, Hypoxia/complications, Magnetic Resonance Imaging, Male, Middle Aged, Prognosis, Pulmonary Disease, Chronic Obstructive/complications, Pulmonary Emphysema/complications, Regression Analysis, Respiratory Function Tests, Risk Assessment, Severity of Illness Index, Ventricular Function, Left/physiology, Ventricular Function, Right/physiology",
author = "Anton Vonk-Noordegraaf and Marcus, {J Tim} and Sebastiaan Holverda and Bea Roseboom and Postmus, {Pieter E}",
year = "2005",
month = "6",
doi = "10.1378/chest.127.6.1898",
language = "English",
volume = "127",
pages = "1898--903",
journal = "Chest",
issn = "0012-3692",
publisher = "American College of Chest Physicians",
number = "6",

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Early changes of cardiac structure and function in COPD patients with mild hypoxemia. / Vonk-Noordegraaf, Anton; Marcus, J Tim; Holverda, Sebastiaan; Roseboom, Bea; Postmus, Pieter E.

In: Chest, Vol. 127, No. 6, 06.2005, p. 1898-903.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Early changes of cardiac structure and function in COPD patients with mild hypoxemia

AU - Vonk-Noordegraaf, Anton

AU - Marcus, J Tim

AU - Holverda, Sebastiaan

AU - Roseboom, Bea

AU - Postmus, Pieter E

PY - 2005/6

Y1 - 2005/6

N2 - BACKGROUND: COPD is often associated with changes of the structure and the function of the heart. Although functional abnormalities of the right ventricle (RV) have been well described in COPD patients with severe hypoxemia, little is known about these changes in patients with normoxia and mild hypoxemia.STUDY OBJECTIVES: To assess the structural and functional cardiac changes in COPD patients with normal Pa(O2) and without signs of RV failure.METHODS: In 25 clinically stable COPD patients (FEV1, 1.23 +/- 0.51 L/s; Pa(O2), 82 +/- 10 mm Hg [mean +/- SD]) and 26 age-matched control subjects, the RV and left ventricular (LV) structure and function were measured by MRI. Pulmonary artery pressure (PAP) was estimated from right pulmonary artery distensibility.RESULTS: RV mass divided by RV end-diastolic volume as a measure of RV adaptation was 0.72 +/- 0.18 g/mL in the COPD group and 0.41 +/- 0.09 g/mL in the control group (p < 0.01). LV and RV ejection fractions were 62 +/- 14% and 53 +/- 12% in the COPD patients, and 68 +/- 11% and 53 +/- 7% in the control subjects, respectively. PAP estimated from right pulmonary artery distensibility was not elevated in the COPD group.CONCLUSION: From these results, we conclude that concentric RV hypertrophy is the earliest sign of RV pressure overload in patients with COPD. This structural adaptation of the heart does not alter RV and LV systolic function.

AB - BACKGROUND: COPD is often associated with changes of the structure and the function of the heart. Although functional abnormalities of the right ventricle (RV) have been well described in COPD patients with severe hypoxemia, little is known about these changes in patients with normoxia and mild hypoxemia.STUDY OBJECTIVES: To assess the structural and functional cardiac changes in COPD patients with normal Pa(O2) and without signs of RV failure.METHODS: In 25 clinically stable COPD patients (FEV1, 1.23 +/- 0.51 L/s; Pa(O2), 82 +/- 10 mm Hg [mean +/- SD]) and 26 age-matched control subjects, the RV and left ventricular (LV) structure and function were measured by MRI. Pulmonary artery pressure (PAP) was estimated from right pulmonary artery distensibility.RESULTS: RV mass divided by RV end-diastolic volume as a measure of RV adaptation was 0.72 +/- 0.18 g/mL in the COPD group and 0.41 +/- 0.09 g/mL in the control group (p < 0.01). LV and RV ejection fractions were 62 +/- 14% and 53 +/- 12% in the COPD patients, and 68 +/- 11% and 53 +/- 7% in the control subjects, respectively. PAP estimated from right pulmonary artery distensibility was not elevated in the COPD group.CONCLUSION: From these results, we conclude that concentric RV hypertrophy is the earliest sign of RV pressure overload in patients with COPD. This structural adaptation of the heart does not alter RV and LV systolic function.

KW - Aged

KW - Analysis of Variance

KW - Case-Control Studies

KW - Female

KW - Heart Function Tests

KW - Humans

KW - Hypertension, Pulmonary/complications

KW - Hypertrophy, Right Ventricular/complications

KW - Hypoxia/complications

KW - Magnetic Resonance Imaging

KW - Male

KW - Middle Aged

KW - Prognosis

KW - Pulmonary Disease, Chronic Obstructive/complications

KW - Pulmonary Emphysema/complications

KW - Regression Analysis

KW - Respiratory Function Tests

KW - Risk Assessment

KW - Severity of Illness Index

KW - Ventricular Function, Left/physiology

KW - Ventricular Function, Right/physiology

U2 - 10.1378/chest.127.6.1898

DO - 10.1378/chest.127.6.1898

M3 - Article

VL - 127

SP - 1898

EP - 1903

JO - Chest

JF - Chest

SN - 0012-3692

IS - 6

ER -