Clinical role of cardiac examination in COPD patients
Aim. To assess cardiac structure and function, using echocardiography and Holter ECG monitoring, in patients with chronic obstructive pulmonary disease (COPD), or a combination of COPD and arterial hypertension (AH) or coronary heart disease (CHD). Material and methods. In total, 72 COPD patients (21 with COPD only, 28 with COPD and AH, and 23 with COPD and CHD) underwent echocardiography (HD 11 XE, Philips, США) and Holter ECG monitoring (Schiller, Switzerland). Results. In COPD patients without cardiac comorbidity, Stage I COPD was characterised by mild relative dilatation of right ventriculum (RV) and right atrium (RA), left ventricular (LV) diastolic dysfunction, and reduced Sm of mitral and tricuspid annulus fibrosus. Stage II COPD was additionally characterised by RV diastolic dysfunction, while in Stage III-IV COPD, RV hypertrophy was observed. Clinical manifestations of chronic heart failure (CHF) were registered in one-third of the patients with isolated COPD or COPD and AH, compared to 87% of the participants with COPD and CHD. Conclusion. RV hypertrophy was observed at Stage I COPD in patients with COPD and CHD, at Stage II in individuals with COPD and AH, and at Stage III in participants with isolated COPD. LV abnormalities, such as concentric remodelling or diastolic dysfunction, were registered in some patients at Stage I of isolated COPD. The most severe cardiac pathology, such as LV and RV hypertrophy, reduced global contractility, frequent episodes of ventricular tachycardia, and myocardial ischemic episodes, was observed in patients with COPD and CHD.