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 language | English |
|---|---|
| Pages (from-to) | 1898-903 |
| Number of pages | 6 |
| Journal | Chest |
| Volume | 127 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Jun 2005 |
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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 journal › Article › Academic › peer-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 -