Cardiopulmonary hemodynamics and respiratory function in patients with chronic obstructive pulmonary disease according to doppler echocardiography data
https://doi.org/10.24884/1682-6655-2020-19-4-39-43
Abstract
Aim. Determination of the functional state of cardiopulmonary hemodynamics in patients with chronic obstructive pulmonary disease (COPD) with varying severity of bronchial obstruction and respiratory failure using echodopplercardiography. Materials and methods. In 82 patients with COPD, the functional state of cardiopulmonary hemodynamics was evaluated using ultrasound methods. All subjects were divided into 2 groups depending on the severity of COPD (moderate and severe course). Results. It was found that in patients with COPD, impaired diastolic function of the right ventricle (RV) may be preclinical. Thus, in patients with COPD stage 2, compared with control in the P-mode and tissue Doppler sonography (TDI), mild changes in the diastolic function (impaired relaxation) of the RV myocardium were revealed (E/A 0.70±0.13 and 1.56±0.18, E/Em 8.45±0.15 and 6.89±0.19, respectively). In patients with COPD stage 3, the mean values of these RV parameters significantly differed (E/A 0.69±0.04 and E/Em 9.34±0.18) and corresponded to moderately expressed diastolic dysfunction. Conclusions. In severe COPD in stage 3, significant violations of the structure and function of the RV were determined. The compensatory capabilities of both cardiac ventricles were depleted, the interventricular interaction changed, which created the conditions for the progression of heart failure and the development of chronic cor pulmonale.
About the Authors
O. N. Titova
Pavlov University
Russian Federation
Russian Federation
Titova Olga N. – M. D., professor, Director of the Research Institute of Pulmonology
6-8, L’va Tolstogo str., Saint Petersburg, 197022
N. A. Kuzubova
Pavlov University
Russian Federation
Russian Federation
Kuzubova Nataliya A. – M. D., Deputy Director of the Research Institute of Pulmonology
6-8, L’va Tolstogo str., Saint Petersburg, 197022
A. L. Aleksandrov
Pavlov University
Russian Federation
Russian Federation
Aleksandrov Albert L. – M. D., professor, Director of the Research Institute of Pulmonology
6-8, L’va Tolstogo str., Saint Petersburg, 197022
V. E. Perley
Pavlov University
Russian Federation
Russian Federation
Perley Vitaly E. – M. D., professor, Director of the Research Institute of Pulmonology
6-8, L’va Tolstogo str., Saint Petersburg, 197022
A. Y. Gichkin
Pavlov University
Russian Federation
Russian Federation
Gichkin Aleksey Y. – Ph. D., Research Institute for Surgery and Emergency Medicine
6-8, L’va Tolstogo str., Saint Petersburg, 197022
References
1. Chronic obstructive pulmonary disease: monograph / ed. prof. Chuchalina A.G. - Moscow: Atmosphere, 2011: 568 p. (In Russ.)
2. Gorelik I.L., Kalmanova E.N., Aisanov Z.R., Chuchalin A.G. Diagnostics of early signs of heart remodeling in patients with COPD // Practical Medicine. 2011; 3 (51): 72-77 (In Russ.)
3. Menshikova I.G. et al. Predictors of progression of circulatory failure in patients with chronic obstructive pulmonary disease // Far Eastern Medical Journal. 2012; 3: 21-24. (In Russ.)
4. Noordegraaf A.V. and Galie N. The role of the right ventricle in pulmonary arterial hypertension. Eur. Respir. Rev. 2011; 20: 122, 243–253
5. Borskaya E.N., Kutuzova A.B., Lelyuk V.G. Stages of formation of structural changes in the heart in patients with chronic pulmonary pathology // Ultrasonic and functional diagnostics. 2003; 4: 82-87. (In Russ.)
6. AlterP, WatzH, KahnertK, PfeiferM, RanderathW.J, AndreasS, WaschkiB, KleibrinkB.E, WelteT, BalsR, SchulzH, BiertzF, YoungD, VogelmeierC.F, JörresR.A.Airway obstruction and lung hyperinflation in COPD are linked to an impaired left ventricular diastolic filling.Respir Med. 2018 Apr;137:14-22. doi: 10.1016/j.rmed.2018.02.011.
7. Howard L.S., Grapsa J., Dawson D., Bellamy M. Echocardiographic assessment of pulmonary hypertension: standard operating procedure. Eur. Respir. Rev. 2012; 21: 125, 239–248
8. Rabe K.F., Beghe B., Luppi F., Fabbri L.M. Update in Chronic Obstructive Pulmonary Disease 2006 // Am. J. Respir. Crit. Care Med. 2007; 175(12): 1222 - 1232.
9. Singh D, Agusti A, Anzueto A, Barnes PJ, Bourbeau J, Celli BR, Criner GJ, Frith P, Halpin DMG, Han M, López Varela MV, Martinez F, Montes de Oca M, Papi A, Pavord ID, Roche N, Sin DD, Stockley R, Vestbo J, Wedzicha JA, Vogelmeier C.Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease: the GOLD science committee report 2019. EurRespir J. 2019 May 18; 53(5):1900164. doi: 10.1183/13993003.00164-2019.
10. Badano L.P., Ginghina C., Easaw J. et.al. Right ventricle in pulmonary arterial hypertension: haemodynamics, structural changes, imaging, and proposal of a study protocol aimed to assess remodelling and treatment effects. European Journal of Echocardiography; 2010; 11: 27–37.
11. Tannus-Silva DG, Rabahi MF. State of the Art Review of the Right Ventricle in COPD Patients: It is Time to Look Closer. Lung. 2017 Feb; 195(1): 9-17. doi: 10.1007/s00408-016-9961-5.
12. Meluzin J., Spinarova L., Bakala J., Toman J., Krejc J. Pulsed Doppler tissue imaging of the velocity of tricuspid annular systolic motion. A new, rapid, and non-invasive method of evaluating right ventricular systolic function.European Heart Journal (2001); 22: 340–348
13. Mocan M, MocanHognogi LD, Anton FP, Chiorescu RM, Goidescu CM, Stoia MA, Farcas AD.Biomarkers of Inflammation in Left Ventricular Diastolic Dysfunction. Dis Markers. 2019 Jun 2; 2019: 758,36-90. doi: 10.1155/2019/7583690.
14. Wan SH, Vogel MW, Chen HH.J. Pre-clinical diastolic dysfunction.J Am CollCardiol. 2014 Feb 11; 63(5): 407-16. doi: 10.1016/j.jacc.2013.10.063.
15. Brett E.F., Kristen E.H., Howard D.W., Kerrie L.M. , Kimberly M., James D. C., Barry J. M., Russell B., Frederick S. W., Karin F.H. Right ventricular diastolic function and exercise capacity in COPD. Respir Med. 2015 Oct;109(10):1287-92. doi: 10.1016/j.rmed.2015.09.003.
16. Fenster BE, Holm KE, Weinberger HD, Moreau KL, Meschede K, Crapo JD, Make BJ, Bowler R, Wamboldt FS, Hoth KF. Right ventricular diastolic function and exercise capacity in COPD.Respir Med. 2015 Oct; 109(10):1287-92. doi: 10.1016/j.rmed.2015.09.003.
17. Güder G, StörkS.Herz. COPD and heart failure: differential diagnosis and comorbidity.Herz. 2019 Sep; 44(6):502-508. doi: 10.1007/s00059-019-4814-7.
Review
For citations:
Titova O.N., Kuzubova N.A., Aleksandrov A.L., Perley V.E., Gichkin A.Y. Cardiopulmonary hemodynamics and respiratory function in patients with chronic obstructive pulmonary disease according to doppler echocardiography data. Regional blood circulation and microcirculation. 2020;19(4):39-43. (In Russ.) https://doi.org/10.24884/1682-6655-2020-19-4-39-43
Views:
1182
Email this article 
