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Research Article

A study on the severity of right ventricular dysfunction in correlation with the severity of Lung dysfunction in Chronic Obstructive Pulmonary Disease   patients - COPD

D. Radha Krishnan1* and Barama Srihari2

1-2 Rangaraya Medical College, Kakinada, Andhra Pradesh, India

E-mail:
dr.desarajurk@yahoo.com

Abstract
Background: Chronic Obstructive Pulmonary Disease (COPD) is characterized by airflow limitation that is not fully reversible. COPD is a powerful and independent risk factor for cardiovascular morbidity and mortality which includes right ventricular (RV) dysfunction and corpulmonale secondary to pulmonary arterial hypertension (PAH), coronary artery disease (CAD), and cardiac arrhythmias. The aim of this study is to assess RV dysfunction by utilizing RV parameters obtained by clinical methods, electrocardiography (ECG), and echocardiography and to correlate with the severity of airflow limitation in COPD patients.
Methods:
Analysis of 100 cases of COPD admitted to Government General Hospital, Kakinada during the period of October 2012 to May 2013.
Results: COPD is more common in males than females in the ratio of 5.25:1.Majority of patients (46%) had a mean of 8.4 years of smoking history. Most common symptoms and signs observed are dyspnea (100%), cough (96%) and tachypnoea. Signs suggesting corpulmonale are parasternal heave, loud P2 and elevated JVP. Radiological study revealed emphysema in 52% and prominent right descending pulmonary artery suggesting PAH in 25%.ECG findings are suggestive of RV dysfunction i.e., P-pulmonale, Right axis deviation (RAD), incomplete RBBB and RVH. Echocardiographic signs of RV dysfunction observed are PAH, corpulmonale and RVSD which are correlated with the severity of the disease (p<0.05).PAH, was observed in 40%.Corpulmonale was observed in 45% of patients having PAH. The frequencies of corpulmonale in patients with mild, moderate and severe PAH were 10%, 73.3%, and 100%, respectively. 45% of COPD patients had normal echocardiographic findings.
Conclusions: Echocardiographic examination is reliable in following COPD patients with PAH instead of repeated cardiac catheterization. The incidence of RV dysfunction is more common as the severity of COPD increases and there is a significant correlation between the degree of air flow limitation (FEV1) and RV dysfunction.

Keywords:
Chronic Obstructive Pulmonary Disease, ECG, RV, CAD.


Published online 11th June, 2015
2015 Published by
Global Science Publishing Group, USA

Cite this Article as

D. Radha Krishnan and Barama Srihari (2015). A study on the severity of right ventricular dysfunction in correlation with the severity of Lung dysfunction in Chronic Obstructive Pulmonary Disease   patients - COPD. The Ame J Sci & Med Res, 1(1):112-119. doi:10.17812/ajsmr20151120

Published online  11th June, 2015
The Ame J Scie & Med Res, Volume 1, Issue 1
DOI: http://dx.doi.org/10.17812/ajsmr20151120
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