Echocardiographic Changes of the Left Ventricle and Left Atrium in COPD

Introduction: Cardiac disorders are common in patients with chronic obstructive pulmonary disease (COPD). They worsen shortness of breath and physical capacity and reduce the quality of life. Ultrasound assessment of cardiac function could contribute to assessing the severity of the disease. This study aimed to assess the prognostic significance of echocardiographic parameters on the rate of exacerbations and mortality.

Materials and methods: This was a prospective study of patients with COPD without exacerbation in the previous 1 month. Patients over 40 years of age, current or former smokers with more than 10 pack-years of smoking, and postbronchodilator FEV1/FVC < 0.7 were included. All patients underwent two-dimensional transthoracic Doppler echocardiography at rest by an experienced cardiologist. Echocardiographic parameters were evaluated for prognostic significance on a composite endpoint of moderate and severe exacerbations and death for 1 year. Data from postbronchodilator spirometry, symptoms, quality of life, and demographic and clinical information were also collected.

Results: A total of 96 patients were analyzed with a mean FEV1 of 55.8%. A total of 64 patients (67%) reached the composite endpoint. A significantly higher proportion of patients with deceleration time deviations (86.2 vs. 58.2%, p = 0.0055) and increased septal thickness (55.6 vs. 24.6%, p = 0.0099) reached the primary endpoint at one-year follow-up. Echocardiographic disorders showed a correlation with the quality of life, but not with lung function.

Conclusion: Non-invasive assessment of cardiac function by echocardiography could be included in the complex assessment of disease severity in COPD patients.