1. Assessment of right ventricular geometry and mechanics in chronic obstructive pulmonary disease patients living at high altitude.
- Author
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Güvenç TS, Kul S, Doğan C, Yıldırım BZ, Karabağ Y, Cetin R, Kaya Y, Karadağ P, Değirmencioğlu A, and Balcı B
- Subjects
- Aged, Arterial Pressure, Body Surface Area, Case-Control Studies, Exercise Test, Female, Humans, Hypertrophy, Right Ventricular etiology, Hypertrophy, Right Ventricular physiopathology, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Pulmonary Artery diagnostic imaging, Pulmonary Artery physiopathology, Pulmonary Disease, Chronic Obstructive diagnosis, Pulmonary Disease, Chronic Obstructive physiopathology, Severity of Illness Index, Spirometry, Stroke Volume, Ventricular Dysfunction, Right etiology, Ventricular Dysfunction, Right physiopathology, Altitude, Echocardiography, Doppler, Color, Echocardiography, Doppler, Pulsed, Echocardiography, Three-Dimensional, Hypertrophy, Right Ventricular diagnostic imaging, Lung physiopathology, Pulmonary Disease, Chronic Obstructive complications, Ventricular Dysfunction, Right diagnostic imaging, Ventricular Function, Right
- Abstract
Degree of increase in pulmonary artery pressure (PAP) and adaptive responses in right ventricular morphology and mechanics play an important role in the prognosis of chronic obstructive pulmonary disease (COPD) patients. Three dimensional echocardiography and deformation imaging are recent advancements in echocardiography that allow more through assessment of right ventricle. We aimed to investigate right ventricular geometry and mechanics in a stable COPD population living at moderately high altitude. A total of 26 stable COPD patients with variable disease severity were included to this study. Pulmonary function tests, six minutes walking test (6MWT) and two- and three-dimensional echocardiography were performed for evaluation and data collection. Both systolic (43.06 ± 11.79 mmHg) and mean (33.38 ± 9.75 mmHg) PAPs were significantly higher in COPD patients compared to controls (p < 0.05, p < 0.001; respectively). Right ventricular volumes were similar between groups, although right ventricular free wall thickness was significantly increased in COPD group. The number of subjects with a sub-normal (<40 %) right ventricular ejection fraction was significantly higher in COPD group (45.8 vs. 17.4 %, p < 0.05), and the mean right ventricular strain was significantly lower (-21.05 ± 3.80 vs. -24.14 ± 5.37; p < 0.05). Only mean PAP and body surface area were found as independent predictors for 6MWT distance. Increased PAP and reduced right ventricular contractility were found in COPD patients living at moderately high altitude, although right ventricular volumes were normal. Similar findings can be expected in other COPD patients with high PAP, since these findings probably represents the effect of increased PAP on right ventricular mechanics.
- Published
- 2014
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