Echocardiographic Changes in Patients with Chronic Obstructive Pulmonary Disease in a Study of Indian Population
Keywords:COPD, echocardiography, echoabnormalities, odd ratios
Background: Chronic obstructive pulmonary disease (COPD) is a significant risk factor of cardiovascular
morbidity and mortality including tricuspid regurgitation (TR), right ventricular hypertrophy (RVH), left
ventricular dysfunction (LVD) and right atrial enlargement (RAE) among others. Echocardiography is a
rapid, non-invasive, and accurate method to evaluate cardiac functions and used to diagnose cardiac changes
in COPD patients. This study aimed to assess the prevalence of echocardiographic changes in COPD patients
and its association with disease severity, duration of disease and smoking.
Methods: Two hundred thirty four patients of COPD fulfilling the inclusion criteria coming to Respiratory
Clinic and Medicine OPD of Assam Medical College and Hospital were recruited. They were evaluated
by echocardiography. Adjusted odd ratios (ORs) (adjusted to age, gender and BMI) with 95% CIs of
echocardiographic changes were computed for different stages of GOLD standard using multiple logistic
regression with GOLD stage I as reference. Test for trend was done using chi-square test and statistical
significance was taken p-value<0.01.
Results: Most common echocardiographic finding was TR, which was present in 63.25% of cases, followed
by RVH (56.84%), LVD (33.33%) and RAE (30.33%). Echocardiographic findings of TR, RVH and RAE
increase with GOLD stage progression of COPD (p-value<0.01). Disease duration was correlated with
echocardiographic findings of TR, RVH and RAE. A significant trend of change in LVDD was seen for
smoking status with severity of GOLD. The similar echocardiographic findings were RAE, RVH and LVD.
Conclusions: Our study finds that echocardiographic examinations of TR, RVH, LVD and RAE are essential
for early diagnosis of cardiac screening for COPD patients. The incidence of TR is more common as severity
of COPD increases followed by RVH. There is a significant correlation between severity of COPD with
echocardiographic findings of TR, RVH and RAE.