Evaluation of pulmonary hypertension in COPD patients with diabetes.
OBJECTIVE
to assess pulmonary hypertension (PH) in patients with chronic obstructive pulmonary disease (COPD) plus diabetes mellitus (DM) using transcutaneous Doppler right jugular venous echo (tDErjv).


METHODS
We examined 5 groups of patients and control group (30 healthy subjects). The 1st group consisted of 55 COPD in-patients in exacerbation with type II DM (DM2). The 2nd group' was formed of 40 in-patients with sole COPD in exacerbation. 30 patients with sole DM2 were included in the 3rd group. The 4th group consisted of 15 COPD in-patients with type I DM (DM1). The 5th group was formed of 18 patients with DM1. The following parameters, using tDErjv, were determined: direction of flow (antegrade or retrograde), velocities of systolic (Sf) and diastolic flows (Df), which are in the strong correlation with the mean pulmonary artery pressure (mPAP). If the flow was biphasic, the ratio of velocities (Df/Sf) and mPAP were calculated.


RESULTS
Antegrade biphasic flow was revealed in all patients. Sf>Df and Df/Sf <l were detected in the 3rd and control groups. While, in the 1st and 2rd groups Sf<Df (1.14 +/- 0.12 and 0.90 +/- 0.07 in the Ist and 2rd groups respectively; p < 0.05 vs control). In the 2nd group patients with Df=Sf the value of the mPAP approximately 25 mmHg was detected, whereas in the 1st group with Df/Sf >1, this value was >35 mmHg.


CONCLUSIONS
PH was more severe in COPD plus DM2 as compared with COPD only. tDErjv allowed determining mPAP in all COPD patients, even with the severe emphysema.
Makarevich
A E
AE
Department of Internal Diseases N1, The Belarusian State Medical University, Minsk, Belarus. makae@bsmu.by
Valevich
V E
VE
Pochtavtsev
A U
AU
D000328:Adult; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000175:diagnosis*; D015150:Echocardiography, Doppler / Q000379:methods; D004646:Emphysema / Q000150:complications / Q000175:diagnosis; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000175:diagnosis*; D000860:Hypoxia; D007601:Jugular Veins / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000473:pathology; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000175:diagnosis*