title: Right heart functional changes in the acute, hypercapnic exacerbations of COPD.
abstract: OBJECTIVE
  To investigate the correlation between respiratory failure and the pulmonary circulation. We focused on anatomical and functional changes of the right heart. Design. Clinical investigation.
  
  
  METHODS
  We evaluated 75 patients hospitalized in our respiratory ward for COPD exacerbation. All patients underwent transthoracic echocardiography and measurements of right heart chambers. Moreover all patients underwent blood tests, measurement of blood pressure, evaluation of body mass index (BMI), ECGs, pulmonary function tests, and the Saint George's Respiratory Questionnaire (SGRQ).
  
  
  RESULTS
  Among 75 patients consecutively hospitalized, 56 patients with a COPD exacerbation were included in our study. We have emphasized the higher value of PAPs and the increased size of right atrial area in severe COPD patients. Significant correlation was observed between low values of PaO2 and larger area of the right atrium. The measurement of TAPSE showed a right ventricular dysfunction in all patients but especially in severe COPD patients. We have obtained a significant correlation between TAPSE and arterial blood gas.
  
  
  CONCLUSIONS
  In patients with chronic respiratory failure, blood gas parameters should be considered as negative prognostic factors of right heart failure. Respiratory failure shows a relationship with pulmonary hypertension and with the anatomy and function of the right heart sections.
authors: Respiratory Diseases Unit, ALS Respiratory and Critical Care Unit, School of Specialization in Respiratory Diseases, Sapienza University, Viale del Policlinico No. 155, 00161 Rome, Italy.
authors: Claudio
authors: C
authors: Terzano
authors: Respiratory Diseases Unit, ALS Respiratory and Critical Care Unit, School of Specialization in Respiratory Diseases, Sapienza University, Viale del Policlinico No. 155, 00161 Rome, Italy.
authors: Sofia
authors: S
authors: Romani
authors: Department of Heart and Great Vessels Attilio Reale, Sapienza University, Viale del Policlinico No. 155, 00161 Rome, Italy.
authors: Carlo
authors: C
authors: Gaudio
authors: Department of Heart and Great Vessels Attilio Reale, Sapienza University, Viale del Policlinico No. 155, 00161 Rome, Italy.
authors: Francesco
authors: F
authors: Pelliccia
authors: Respiratory Diseases Unit, ALS Respiratory and Critical Care Unit, School of Specialization in Respiratory Diseases, Sapienza University, Viale del Policlinico No. 155, 00161 Rome, Italy.
authors: Mattia
authors: M
authors: Serao
authors: Sapienza University, Viale del Policlinico No. 155, 00161 Rome, Italy.
authors: Antonio
authors: A
authors: Vitarelli
mesh_terms: D000208:Acute Disease; D000368:Aged; D001794:Blood Pressure; D002245:Carbon Dioxide / Q000378:metabolism; D003710:Demography; D018450:Disease Progression; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006334:Heart Function Tests; D006801:Humans; D006935:Hypercapnia / Q000150:complications* / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D010100:Oxygen / Q000378:metabolism; D010313:Partial Pressure; D011651:Pulmonary Artery / Q000473:pathology / Q000503:physiopathology; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000473:pathology / Q000503:physiopathology*; D013599:Systole
chemical_list: D002245:Carbon Dioxide; D010100:Oxygen