title: Echocardiographic abnormalities in patients with COPD at their first hospital admission.
abstract: Cardiovascular disease accounts for significant morbidity and mortality in chronic obstructive pulmonary disease (COPD). Its prevalence and mechanisms of association have not been elucidated. The study aimed to assess the prevalence of echocardiographic abnormalities and potential risk factors in patients with COPD at their first exacerbation requiring hospital admission. Transthoracic echocardiography was prospectively performed in 342 patients (forced expiratory volume in 1 s 52 ± 16% predicted) 3 months after discharge. Significant cardiac alterations were present in 64% of patients; 27% left- and 48% right-heart disorders. The most common were right ventricle enlargement (30%) and pulmonary hypertension (19%). Left ventricle enlargement was present in 6%, left ventricle systolic dysfunction in 13%, left ventricle diastolic impairment in 12% and left atrial dilatation in 29%. Echocardiographic abnormalities were unrelated to COPD severity and were more frequent in patients with self-reported cardiac disease. They were also observed in 63% of patients with no known cardiac disease or cardiovascular risk factors other than smoking. We conclude that cardiac abnormalities are highly prevalent in COPD patients at the time of their first severe exacerbation, even in the absence of established cardiac disease or cardiovascular risk factors. Considering the prognostic and therapeutic implications of cardiac comorbidity, echocardiography should be considered in the assessment of patients with clinically significant COPD.
authors.affiliation: Depts of Cardiology, Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Freixa
authors.forename: Karina
authors.initials: K
authors.lastname: Portillo
authors.forename: Carles
authors.initials: C
authors.lastname: Paré
authors.forename: Judith
authors.initials: J
authors.lastname: Garcia-Aymerich
authors.forename: Federico P
authors.initials: FP
authors.lastname: Gomez
authors.forename: Marta
authors.initials: M
authors.lastname: Benet
authors.forename: Josep
authors.initials: J
authors.lastname: Roca
authors.forename: Eva
authors.initials: E
authors.lastname: Farrero
authors.forename: Jaume
authors.initials: J
authors.lastname: Ferrer
authors.forename: Carlos
authors.initials: C
authors.lastname: Fernandez-Palomeque
authors.forename: Josep M
authors.initials: JM
authors.lastname: Antó
authors.forename: Joan Albert
authors.initials: JA
authors.lastname: Barberà
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D015995:Prevalence; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000000981:diagnostic imaging*; D012129:Respiratory Function Tests; D012307:Risk Factors; D013030:Spain; D014463:Ultrasonography; D018754:Ventricular Dysfunction / Q000473:pathology