Pulmonary artery size as a predictor of pulmonary hypertension and outcomes in patients with chronic obstructive pulmonary disease

Introduction. A comorbid patient with the chronic obstructive pulmonary disease (COPD) in combination with cardiovascular diseases (CHD) has a poor prognosis due to the early progression of the pulmonary hypertension (PH). The study surveyed an opportunity of the PH detection using an active PH verification strategy in outpatients with COPD and stable angina pectoris.Goal. To evaluate the frequency of РH in patients with mild and moderate COPD in combination with CHD and the possibility of using the echocardiographic criterion «right atrial area» to prove РH.Materials and methods. The study included 52 outpatient patients with an average age of 62.8 ± 8.14 years. A comprehensive assessment of the Borg dyspnea scale, echocardiography, pulse oximetry at rest and after the 6-minute walk test (6MWT) were carried out. Two groups of patients were compared depending on the development of РH after T6MX.Results and discussion. It was shown that in patients with COPD (GOLD I-II) and angina pectoris, PH was initially detected in 3.3% of cases, and after the 6MWT in 63.3% of patients. In this group, after T6MX, an increase in pulmonary artery pressure was determined from 18.5 ± 10.6 mmHg to 41.2 ± 12.5 mmHg (p < 0.05). After physical activity with increased pressure in the pulmonary artery, there was a significant increase in the area of the right atrium. Only 1/3 of patients with PH had hypoxemia after the 6MWT.Conclusions. The T6M test makes it possible to detect РH in more than half of patients with COPD (GOLD I-II) and CHD in an outpatient setting. An enlargement in the area of the right atrium according to echocardiography, along with the other indicators of morphological and functional changes in the right heart, can be an additional diagnostic criterion for PH in comorbid patients with COPD and cardiovascular diseases.

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GW28-e0972 MR Imaging-derived pulmonary artery blood flow and Cardiac Function for Monitoring Patients with Chronic obstructive pulmonary disease with and without Pulmonary Hypertension

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2017.07.699 ◽

2017 ◽

Vol 70 (16) ◽

pp. C189

Author(s):

Chen Zhang ◽

Xiaohai Ma ◽

Lei Zhao ◽

Zhanming Fan

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Blood Flow ◽

Pulmonary Hypertension ◽

Mr Imaging ◽

Pulmonary Artery ◽

Cardiac Function ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Artery Blood Flow ◽

Obstructive Pulmonary Disease

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Noninvasive Prediction of Pulmonary Hypertension in Chronic Obstructive Pulmonary Disease by Echocardiography With & It's Co-Relation With the Disease Severity (Hospital Based Study)

Global Journal of Health Science ◽

10.5539/gjhs.v10n7p50 ◽

2018 ◽

Vol 10 (7) ◽

pp. 50

Author(s):

Muhammed Waheeb Al Obaidy ◽

Adnan M. Aljubouri ◽

Rana Ehsan

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Hypertension ◽

Pulmonary Artery ◽

Pulmonary Disease ◽

Systolic Pressure ◽

Connective Tissue Diseases ◽

Chronic Obstructive ◽

Systolic Pulmonary Artery Pressure ◽

Obstructive Pulmonary Disease ◽

2D Echocardiography

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is one of most common cause of death. Pulmonary hypertension, one of the major and under diagnosed complications of COPD which have a great impact on outcome of COAD and associated with frequent exacerbations and bad prognosis. Echocardiography provides a rapid, noninvasive, portable, and accurate method to evaluate changes related to pulmonary hypertension in COAD.OBJECTIVE OF STUDY: Study pulmonary artery systolic pressure and Tricuspid annular plane systolic excursion in patients with COAD by 2D ECHO Doppler and correlate them with COPD severity.METHOD: Cross sectional study was conducted on 50 COPD patients in Baghdad teaching hospital (age>40 year) from first of January to the end of June, 2017. First, the diagnosis of COPD was confirmed and evaluated for staging by history, clinical examination, and spirometery.All patients have undergone ECG and 2D echocardiography and systolic pulmonary artery pressure and Tricuspid Annular Plane Systolic Excursion (TAPSE) were calculated. Patients with other cardiac or respiratory problems (asthma, pulmonary TB, lung malignancy, connective tissue diseases, interstitial lung disease, and cardiac ischemia, left side heart failure) were excluded from this study.RESULTS: Study of PASP by TR jet with the use of 2D ECHO on 50 patients with COPD showed that 20 patients had normal echo study , mild increase in PASP was found in 15 patients, moderate 11, and severe increase in 4 patients.Study of TAPSE by 2D ECHO showed that 35 patients had normal TAPSE values, while others 15 had abnormal values classified as mild, moderate, and severe: 3, 9, and 3, respectively.A significant associations between echo findings of increasing PASP and abnormal TAPSE, with decrease in FEV1, and oxygen saturation measured by pulse oximeter, duration since COPD was diagnosed and MRC dyspnea scale.CONCLUSION: High incidence of pulmonary hypertension with increasing severity of COAD. Echocardiography is useful and effective tool for detection of PHT secondary to COPD.

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Features of intracardiac hemodynamics disoders in patients with chronic obstructive pulmonary disease complicated by the chronic pulmonary heart disease development and methods for their medical correction

Kazan medical journal ◽

10.17750/kmj2016-400 ◽

2016 ◽

Vol 97 (3) ◽

pp. 400-404

Author(s):

N E Aidargalieva ◽

A Zh Teleusheva

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Hypertension ◽

Heart Disease ◽

Pulmonary Artery ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Pulmonary Heart Disease ◽

The Right ◽

Chronic Pulmonary Heart Disease

Chronic pulmonary heart disease is a common pathology and has become one of the leading causes of disability and death in recent years [15]. According to the literature, two-thirds of patients with chronic obstructive pulmonary disease die during the period from 15 months to 5 years after the circulatory decompensation onset, which occupies the third place after hypertension and coronary heart disease among causes of death in the age group older than 50 years [14]. Pulmonary hypertension is considered to be the main pathogenetic mechanism of chronic pulmonary heart disease [11]. The mortality rate in patients with chronic pulmonary heart disease is directly related to the level of pulmonary artery systolic blood pressure. Thus, according to literature data, at the pulmonary artery systolic pressure from 30 to 50 mm Hg 4-5-year survival rate is 30%, and at the level of more than 50 mm Hg 5-year survival rate is zero [1]. Thus, pulmonary hypertension is a poor prognostic factor. Furthermore, it is known that the changes identified in the right ventricle amid the pulmonary hypertension are survival predictors in patients with chronic obstructive pulmonary disease [18]. Literature review showed that the hemodynamics feature in patients with chronic pulmonary heart disease is increased pressure in the pulmonary artery, which leads to both ventricles remodeling and in particular to the right heart enlargement, rise of both right and left ventricles diastolic dysfunction, reduced stroke volume and cardiac output. Furthermore, the review describes that such drug classes as angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers and selective β-blockers are successfully used for the revealed disorders correction in patients with chronic pulmonary heart disease.

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Assessment of Pulmonary Artery Pulsatility by Multidetector Computed Tomography in Patients Affected by Chronic Obstructive Pulmonary Disease and Pulmonary Hypertension: Preliminary Data

ISRN Pulmonology ◽

10.1155/2013/808615 ◽

2013 ◽

Vol 2013 ◽

pp. 1-9

Author(s):

Anna Grazia D'Agostino ◽

Giuseppe Valerio ◽

Pierluigi Bracciale ◽

Fabio Valerio

Keyword(s):

Computed Tomography ◽

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Hypertension ◽

Pulmonary Artery ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Cross Sectional ◽

Obstructive Pulmonary Disease ◽

The Right ◽

Suitable Technique

The aim was to assess if computed tomography is able to measure pulmonary artery pulsatility in patients affected by chronic obstructive pulmonary disease and to ascertain whether pulsatility is different in patients with and without pulmonary hypertension and whether it is related to haemodynamics. We selected two groups of patients, the first one with pulmonary hypertension and the second one without. In patient with hypertension, pulmonary artery pressure and resistance were increased with the increased diameters (transverse 36 ± 5 mm and axial 38 ± 4 mm versus 22 ± 3 and 25 ± 5, resp.), the increased cross-sectional area (10 ± 08 versus 4 ± 1 cm2), and the reduced pulsatility (21 ± 7 versus 10% ± 5%). Arterial stretching was decreased in patients with hypertension (10 ± 5 versus 21% ± 7%) and significantly related to pulmonary vascular resistances and pressure. Cardiac output measured by tomography was significantly related to that obtained by Fick method and was not different in the two groups. The diameters allow to identify patients with PH, assuming a cut-off of 28 mm and assuming a pulsatility of right branch of 26% as well. These preliminary observations indicate tomography as a suitable technique, being able to measure the pulsatility and the dimensions of the arteries and the right ventricular functional parameters.

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