Treatment of acute chronic obstructive pulmonary disease exacerbation improves right ventricle function.
OBJECTIVE
It was shown that cardiac function is impaired in chronic obstructive pulmonary disease (COPD) patients who have severe pulmonary hypertension (PHT). However, no previous reports have evaluated cardiac function in COPD patients before and after medical therapy for acute COPD exacerbation. In this study, we evaluated the cardiac function of COPD patients during acute COPD exacerbation.


RESULTS
Thirty-two patients (27 men and 5 women; mean age 59 +/- 8.7 years) with acute COPD exacerbation without PHT were included in the study. Thirty-two age- and sex-matched control subjects (22 men and 10 women; mean age 57 +/- 10 years) were also examined. Right ventricular (RV) and left ventricular (LV) functions were assessed using both conventional and tissue Doppler imaging methods before and after therapy, which were performed according to accepted guidelines. Medical therapy included inhaled beta(2)-agonists, inhaled anticholinergic agents(,) oxygen, systemic corticosteroids, and antibiotics. The systolic tissue Doppler velocity (TSm) in the RV was increased after therapy (13.7 +/- 2.4 vs. 14.4 +/- 2.4 cm/s, P = 0.027). The function of the RV and LV during diastole was also improved, and pulmonary artery pressures decreased after therapy (34 +/- 5.2 vs. 28.2 +/- 4.7 mmHg, P < 0.0001). However, there was no change in LV function during systole.


CONCLUSIONS
We have demonstrated that treatment of patients with acute COPD exacerbation according to guidelines improves not only pulmonary function, but also RV and LV function and PHT.
Akcay
Murat
M
Second Department of Cardiology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey. drmuratakcay@yahoo.com
Yeter
Ekrem
E
Durmaz
Tahir
T
Keles
Telat
T
Akar Bayram
Nihal
N
Uyar
Meral
M
Davutoglu
Vedat
V
Yüksel
Isa
I
Kurt
Mustafa
M
Bozkurt
Engin
E
D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D058666:Adrenergic beta-2 Receptor Agonists / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D004452:Echocardiography; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000628:therapy; D012129:Respiratory Function Tests; D013223:Statistics as Topic; D013599:Systole; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right
D000305:Adrenal Cortex Hormones; D058666:Adrenergic beta-2 Receptor Agonists; D000959:Antihypertensive Agents