Assessment of the ventricular function of patients with advanced chronic obstructive pulmonary disease by using magnetic resonance imaging.
OBJECTIVE
To assess the mechanisms that may be involved in the evolution of right and left ventricular dysfunction in patients with chronic obstructive pulmonary disease (COPD).


METHODS
Magnetic resonance imaging was used in 11 control patients (group C) and 27 patients with COPD, who were divided into 2 groups, COPDc and COPDs, according to the presence or absence of right ventricular dysfunction, respectively. Doppler echocardiography was used for assessing the degree of pulmonary hypertension.


RESULTS
The right ventricular diameter was similar in the 3 groups, COPDs, COPDc and C (29+/-8 mm; 31+/-7 mm; and 30+/-6 mm; respectively, P=NS). Right ventricular hypertrophy was observed only in the COPD groups (8+/-2 mm and 9+/-3 mm vs 5+/-1 mm; P<0.01). The percentage of systolic right ventricular lateral wall thickening (%RVLWT) in the 3 groups were as follows: 86+/-82% vs 41+/-35% vs 86+/-89%; P=NS). Different left ventricular ejection fractions were observed in the groups as follows: 69+/-9% vs 55+/-16% vs 76+/-6%; P < 0.01. A positive and significant linear correlation was observed between the left ventricular (LV) diastolic diameter and the LV systolic volume (r = 0.72; P < 0.01). No correlation was observed between the pulmonary volumes, arterial blood gas analysis, and ventricular function.


CONCLUSIONS
No correlation was observed between the severity of pulmonary function and the degree of ventricular function impairment. Whether a preserved %RVLWT means the possibility of reversibility of right ventricular function remains to be elucidated. However, the presence of the phenomenon of ventricular interdependence was confirmed.
Rocha
Nazareth de Novaes
Nde N
Instituto do Coração, Hospital das Clínicas, FMUSP, São Paulo, SP, Brazil. nazarethrocha@superig.com.br
Stelmach
Rafael
R
Cukier
Alberto
A
Parga
José Rodrigues
JR
Avila
Luiz Francisco
LF
Caldas
Márcia
M
Buck
Paula
P
Mady
Charles
C
D000368:Aged; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*; D018497:Ventricular Dysfunction, Right / Q000503:physiopathology*