title: When left ventricular failure complicates chronic obstructive pulmonary disease: hypoxia plays the major role.
abstract: BACKGROUND
  As the chronic obstructive pulmonary disease (COPD) progress, is usually accompanied by involvement of the both left ventricle (LV) and right ventricle (RV), and their systolic and diastolic function. Signs and symptoms of LV failure can be difficult to distinguish from those of COPD.
  
  
  OBJECTIVE
  The study was carried out to determine the prevalence of LV systolic dysfunction in the COPD patients and to assess the possible risk factor behind such development.
  
  
  METHODS
  It is a prospective study of 60 cases of COPD patients with or without cor-pulmonale attending Manipal Teaching Hospital.
  
  
  RESULTS
  The prevalence of LV systolic dysfunction was found to be 26.7%, and the findings directly correlate with the severity of COPD i.e., the more the severity of the lung disease more the probability for the incidence of LV systolic dysfunction. These data are in support of the hypothesis that hypoxia and the excess accumulation of toxic metabolic products like lactic acid, significant right-to-left shunting through the bronchial circulation explains the diminished LV ejection fraction in severe COPD patients.
  
  
  CONCLUSIONS
  Routine echocardiography investigation of the severe COPD patients is required for assessing the status of LV function and to rule out the possible association of LV systolic dysfunction.
authors.affiliation: Department of Medicine, Manipal Teaching Hospital, Pokhara, Nepal. badribmu@gmail.com
authors.forename: B
authors.initials: B
authors.lastname: Paudel
authors.forename: S
authors.initials: S
authors.lastname: Dhungel
authors.forename: K
authors.initials: K
authors.lastname: Paudel
authors.forename: K
authors.initials: K
authors.lastname: Pandru
authors.forename: R
authors.initials: R
authors.lastname: Paudel
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015150:Echocardiography, Doppler; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D000860:Hypoxia / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010092:Oximetry; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology*; D012129:Respiratory Function Tests; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000503:physiopathology*