EARLY ECHOCARDIOGRAPHIC MARKERS OF STRUCTURAL AND FUNCTIONAL RIGHT VENTRICULAR REMODELLING IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Abstract
Aim. To study right ventricular (RV) structure and function, as well as cardiac and pulmonary hemodynamic parameters, in patients with chronic obstructive pulmonary disease (COPD) of moderate severity. Material and methods. The study included 37 COPD patients and 20 healthy controls. All participants underwent echocardiography (EchoCG) and the assessment of lung function (LF). Results. COPD patients demonstrated an early increase in anterior RV wall thickness and RV chamber volume, already at the stage of moderate elevation in pulmonary artery systolic pressure. Pre-capillary hemodynamic variant of pulmonary hypertension was characterised by a significant increase in pulmonary vascular resistance (р<0,001) and normokinetic hemodynamic type in patients with a longer COPD duration. Conclusion. Disturbed relaxation of RV longitudinal fibres is the initial pathological change, followed by global RV dysfunction and disturbed transverse RV contractility. These markers, which precede RV ejection fraction reduction, could be regarded as early criteria of latent systolic dysfunction in patients with a longer duration of moderately severe COPD.
About the Authors
B. Ya. Bart
N.I. Pirogov Russian Research Medical University, Moscow, Russia
Russian Federation
Russian Federation
E. N. Dergunova
Diagnostic and Clinical Centre No. 1, South-Western Autonomous Okrug, Moscow
Russian Federation
Russian Federation
E. A. Vartanyan
N.I. Pirogov Russian Research Medical University, Moscow, Russia
Russian Federation
Russian Federation
O. M. Kulbachinskaya
Diagnostic and Clinical Centre No. 1, South-Western Autonomous Okrug, Moscow
Russian Federation
Russian Federation
References
1. Global Initiative for Chronic Obstructive Lung Disease (GOLD).Global strategy for diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO workshop report. Last updated 2009.www.goldcopd.org.
2. Chuchalin A.G. Chronic obstructive illness of lungs. M: Atmosphere, 2008. 567p. Russian (Чучалин А.Г. Хроническая обструктивная болезнь лёгких.М.: Атмосфера, 2008. 567 с).
3. Avdeev S.N. Chronic obstructive illness of lungs: The pocket management for practical doctors. 2nd prod. M: Atmosphere, 2010, 160p. Russian (Авдеев С.Н. Хроническая обструктивная болезнь лёгких: Карманное руководство для практических врачей. 2 е изд.М.: Атмосфера, 2010, 160 с).
4. Avdeev S.N. COPD and cardiovascular diseases. Pulmonology, 2008; 1:5–10. Russian (Авдеев С. Н. ХОБЛ и сердечно-сосудистые заболевания. Пульмонология, 2008; 1:5–10).
5. Feigenbaum H, Armstrong WF, Ryan T. Feigenbaum’s echocardiography. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2005.
6. Konstantinos Triantafyllou, Athanasios Kranidis, Elias Karabinos, Harris Grassos and Dimitrios. Clinical Implications of the Echocardiographic Evaluation of Right Ventricular Function on the Long Axis Using Newer Techniques. Hellenic J Cardiol 2010; 51: 42–48.
7. Higenbottam T. Pulmonary hypertension and chronic obstructive pulmonary disease: a case for treatment. Proc Am Thorac Soc. 2005; 2:12–9.
8. Naeije R. Pulmonary hypertension and right heart failure in chronic obstructive pulmonary disease. Proc Am Thorac Soc. 2005; 2:20–2.
9. Avdeev S.N. Pulmonary hypertensia at chronic respiratory diseases. Pulmonology and allergology 2010; 2: page 2–10. Russian (Авдеев С.Н. Легочная гипертензия при хронических респираторных заболеваниях. Пульмонология и аллергология 2010; 2: с. 2–10).
10. Galie N, Hoeper MM, Humbert M, Torbicki A. et al. Guidelines for the diagnosis and treatment of pulmonary hypertension: the Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT). Eur Heart J 2009; 30:2493–2537.
11. ACCF/AHA 2009 Expert Consensus Document on Pulmonary Hypertension A Report of the American College of Cardiology Foundation Task Force o Expert Consensus Documents and the American Heart Association Developed in Collaboration With the American College of Chest Physicians; American Thoracic Society, Inc.; and the Pulmonary Hypertension Association Vallerie V. McLaughlin, Stephen L. Archer, David B. Badesch, Robyn J. Barst, J. Am. Coll. Cardiol. 2009; 53; 1573–1619; originally published online Mar 30, 2009;
12. Simonneau G., Galie N., Rubin L. J. et al. Clinical classification of pulmonary hypertension. J Am Coll Cardiol 2004; 12:5S 12S.
13. The Task Force on diagnosis and treatment of pulmonary arterial hypertension of the European Society of Cardiology. Guidelines on diagnosis and treatment of pulmonary arterial hypertension. Eur Heart J 2004; 25:24:2243–2278.
14. V. I. Baksheev, N. M. Kolomoyets, G. F. Tursunova. Clinical value of modern techniques of echocardiographic research of the right departments of heart. Clinical medicine 2006; 10:16–23. Russian (В. И. Бакшеев, Н. М. Коломоец, Г. Ф. Турсунова. Клиническое значение современных методик эхокардиографического исследования правых отделов сердца. Клиническая медицина 2006; 10:16–23).
15. Ruxandra Jurcut, Sorin Giusca, Andre´ La Gerche The echocardiographic assessment of the right ventricle: what to do in 2010? European Journal of Echocardiography (2010) 11, 81–96.
Review
For citations:
Bart B.Ya., Dergunova E.N., Vartanyan E.A., Kulbachinskaya O.M. EARLY ECHOCARDIOGRAPHIC MARKERS OF STRUCTURAL AND FUNCTIONAL RIGHT VENTRICULAR REMODELLING IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE. Russian Journal of Cardiology. 2012;(3):33-37. (In Russ.)
Views:
620
Email this article 