Manoj Kumar, S (2015) A Study on Echocardiographic Profile of patients with Chronic Obstructive Pulmonary Disease. Masters thesis, PSG Institute of Medical Sciences and Research, Coimbatore.
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Abstract
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a systemic disease with various extrapulmonary manifestations. Cardiovascular disease is a major comorbidity in COPD and probably the most frequent and most important disease co existing with COPD. Echocardiography is one of the simplest and non invasive tool in assessing the cardiac status. AIM OF THE STUDY: To evaluate the clinico-physiological characteristics of COPD and correlate them with the echocardiographic findings and to identify the predictors of pulmonary hypertension in COPD patients. MATERIALS AND METHODS: Forty COPD patients diagnosed by GOLD criteria who neither has other lung disease which alters spirometry nor has primary cardiac disease were recruited. They were explained about the study and interviewed for socio demographic details. They were subjected for thorough clinical examination and followed by Echocardiography. RESULTS: The frequency of mild, moderate, severe and very severe COPD were 7.5%, 42.5%, 37.5%, 12.5% respectively.Pulmonary hypertension (PH) defined as systolic pulmonary artery pressure (sPAP) > 30 mmHg was found in 35% (n= 14) of study subjects. None of them had s PAP > 50 mmHg. PH was present in 26.7%, 35.3% and 60% of moderate, severe and very severe COPD patients. The occurrence of PH increased with severity of COPD. None of the patients had RV systolic dysfunction documented by TAPSE with mean of 1.96±0.134. RV Hypertrophy based on RV Thickness was present irrespective of PH with mean of 0.68±0.13. LV Diastolic Dysfunction was present in 35% (n=14) of study population. By multivariate logistic regression analysis, BMI showed significant correlation with PH (adjusted odd’s ratio of 0.76, 95% confidence interval 0.59 – 0.98, P’=0.04) Duration of disease, 6MWD, LVDD does not correlate with PH. CONCLUSION: Our study showed that prevalence of pulmonary hypertension increased with severity of COPD. Severe pulmonary hypertension was not observed in our study with stable COPD patients. Right ventricle hypertrophy and diastolic dysfunction of left ventricle were the other common findings in COPD patients. We found that patients with low BMI have 24% less chance for developing pulmonary hypertension. Since cardiovascular disease is the major cause of morbidity and mortality in COPD, it is essential to evaluate the cardiac status at the time of initial diagnosis. The overall survival and quality of life can be improved by addressing this comorbidity.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Chronic Obstructive Pulmonary Disease ; Echocardiographic Profile. |
| Subjects: | MEDICAL > Tuberculosis and Respiratory Medicine |
| Depositing User: | Punitha K |
| Date Deposited: | 06 May 2018 04:35 |
| Last Modified: | 06 May 2018 04:35 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/7527 |
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