title: Left ventricular diastolic dysfunction in COPD may manifest myocardial ischemia.
abstract: BACKGROUND
  Left ventricular diastolic dysfunction (LVDD) is observed frequently in advanced COPD and it appears unrelated to the co-presence of its common risk factors as hypertension, diabetes, ischemic heart disease, etc. The patho-physiology of this association is yet unclear. We postulated that ischemia not apparent in the routine clinical evaluation could be the cause of such LVDD.
  
  
  METHODS
  Advanced COPD (GOLD III & IV) patients being excluded of concomitant presence of hypertension, diabetes, ischemic heart disease, and hypothyroidism by conventional evaluations were looked for the presence of LVDD by tissue Doppler echocardiography. The subjects having LVDD were further evaluated with 99(m)Tc MIBI stress myocardial perfusion imaging to detect the presence of ischemia.
  
  
  RESULTS
  7 out of 14 patients of advanced COPD sufferers without any known risk factors for LVDD had reversible perfusion defect in the stress perfusion imaging predominantly involving the inferior wall myocardium (71.43%). Most of the defects, though significant, were not picked up by stress ECG.
  
  
  CONCLUSIONS
  Reversible ischemic defects are quite common (50%) in advanced COPD patients with LVDD without the presence of common risk factors. This association needs further evaluation.
authors.affiliation: Institute of Pulmocare & Research, Kolkata, India. parthachest@yahoo.com
authors.forename: Parthasarathi
authors.initials: P
authors.lastname: Bhattacharyya
authors.forename: Dipabali
authors.initials: D
authors.lastname: Acharjee
authors.forename: Soumendra Nath
authors.initials: SN
authors.lastname: Ray
authors.forename: Ranjan Kumar
authors.initials: RK
authors.lastname: Sharma
authors.forename: Pradeep
authors.initials: P
authors.lastname: Tiwari
authors.forename: Rantu
authors.initials: R
authors.lastname: Paul
authors.forename: Nilratan
authors.initials: N
authors.lastname: De
authors.forename: Saikat
authors.initials: S
authors.lastname: Nag
authors.forename: Sujan
authors.initials: S
authors.lastname: Bardhan
authors.forename: Rana
authors.initials: R
authors.lastname: Dey
authors.forename: Malabika
authors.initials: M
authors.lastname: Ghosh
authors.forename: Ratna
authors.initials: R
authors.lastname: Dey
authors.forename: Surinder K
authors.initials: SK
authors.lastname: Sharma
mesh_terms: D000368:Aged; D003971:Diastole; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications* / Q000000981:diagnostic imaging; D055414:Myocardial Perfusion Imaging; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000000981:diagnostic imaging
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi