Left Ventricular and Right Ventricular Functional Changes in Cases of COPD and its Corelation with Severity- A Cross-sectional Study

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a global health problem, mainly in developing countries. It affects pulmonary blood vessels, right ventricle, and also left ventricle leading to pulmonary hypertension, cor pulmonale and right and left ventricular dysfunction.

Aim: To assess the cardiac, right and left ventricular changes in subjects with increasing COPD severity staged according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines and to compare Arterial Blood Gases (ABG), St. George’s Respiratory Questionnaire (SGRQ) percentages and BODE (Body-mass index, airflow Obstruction, Dyspnoea, and Exercise) scores to cardiac changes in COPD.

Materials and Methods: The present study was a cross-sectional study conducted at tertiary care hospital in Southern Karnataka, India. The sample size was 60. A structured questionnaire was administered which included demographic, clinical variables followed by a detailed clinical examination, spirometry, Electrocardiograph (ECG), ABG, chest radiograph, echocardiography and a 6-Minute Walk Test (6MWT). Data collected was analysed using Statistical Package for the Social Sciences (SPSS) and Epi Info software for mean, Standard Deviation (SD) and multivariate analysis.

Results: All the patients diagnosed with COPD (using GOLD criteria) were included in study and assessed for right and left ventricular changes. Out of 60 patients, 58 were males and two were females, with mean age being 64.71±28.28 years. Among the study population, 45 (75%) patients had one or the other cardiac condition. Cardiac changes included left ventricular diastolic dysfunction (58.3%), right ventricular dilatation (33.3%), right ventricular hypertrophy, right atrial dilation, tricuspid regurgitation and pulmonary hypertension and left heart changes included left ventricular hypertrophy.

Conclusion: The study highlights the need for early and active cardiac screening of all COPD patients. This will help in early treatment and good prognosis, and will further contribute in reducing the morbidity and mortality.