title: Right ventricular diastolic function and exercise capacity in COPD.
abstract: BACKGROUND
  Decreased exercise capacity in chronic obstructive pulmonary disease (COPD) is incompletely explained by pulmonary pathologic and physiologic abnormalities. We evaluated the extent to which right ventricular diastolic function (RVDF) is associated with exercise capacity in COPD.
  
  
  METHODS
  Fifty-one patients with COPD were evaluated by echocardiography, spirometry, and the 6 min walk test (6MWT). RVDF was assessed using 4 echocardiographic parameters: 1) the ratio of tricuspid valve (TV) early (E) and late (A) inflow velocities (TV E/A) 2) TV early tissue Doppler velocity (TV e') 3) TV deceleration time (DT) and 4) the ratio of TV E and e' velocities (TV E/e'). Multiple linear regression was used to examine the extent to which these parameters were associated with 6MWT distance. All models adjusted for age, sex, post-bronchodilator FEV1/FVC, resting heart rate, and use of supplemental O2 during 6MWT. A regression model was calculated for each of the 4 markers of RVDF.
  
  
  RESULTS
  Forty-seven percent of the sample had GOLD stage III or IV COPD. All 51 subjects had preserved left ventricular ejection fraction (LVEF, mean = 71.7%, SD = 7.8%). A higher TV E/A ratio was associated with increased 6MWT distance (p = 0.001). TV e', TV DT and TV E/e' did not have a statistically significant association with 6MWT distance in regression models.
  
  
  CONCLUSIONS
  In a cohort with moderate to severe COPD and normal LVEF, TV E/A was associated with 6MWT distance after adjusting for relevant demographic and medical covariates. RV diastolic dysfunction may independently contribute to exercise intolerance in COPD.
authors.affiliation: National Jewish Health, Division of Cardiology, Denver, CO, United States. Electronic address: fensterb@njhealth.org.
authors.forename: Brett E
authors.initials: BE
authors.lastname: Fenster
authors.affiliation: National Jewish Health, Division of Pulmonary, Critical Care and Sleep Medicine, Denver, CO, United States.
authors.forename: Kristen E
authors.initials: KE
authors.lastname: Holm
authors.affiliation: National Jewish Health, Division of Cardiology, Denver, CO, United States.
authors.forename: Howard D
authors.initials: HD
authors.lastname: Weinberger
authors.affiliation: University of Colorado School of Medicine at the Anschutz Medical Campus, Department of Medicine, Aurora, CO, United States.
authors.forename: Kerrie L
authors.initials: KL
authors.lastname: Moreau
authors.affiliation: National Jewish Health, Division of Pulmonary, Critical Care and Sleep Medicine, Denver, CO, United States.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Meschede
authors.affiliation: National Jewish Health, Division of Pulmonary, Critical Care and Sleep Medicine, Denver, CO, United States.
authors.forename: James D
authors.initials: JD
authors.lastname: Crapo
authors.affiliation: National Jewish Health, Division of Pulmonary, Critical Care and Sleep Medicine, Denver, CO, United States.
authors.forename: Barry J
authors.initials: BJ
authors.lastname: Make
authors.affiliation: National Jewish Health, Division of Pulmonary, Critical Care and Sleep Medicine, Denver, CO, United States.
authors.forename: Russell
authors.initials: R
authors.lastname: Bowler
authors.affiliation: University of Colorado School of Medicine at the Anschutz Medical Campus, Department of Psychiatry, Aurora, CO, United States.
authors.forename: Frederick S
authors.initials: FS
authors.lastname: Wamboldt
authors.affiliation: University of Iowa Carver College of Medicine, Department of Psychiatry, Iowa City, IA, United States.
authors.forename: Karin F
authors.initials: KF
authors.lastname: Hoth
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity / Q000502:physiology; D003971:Diastole / Q000502:physiology; D015150:Echocardiography, Doppler / Q000379:methods; D005080:Exercise Test / Q000379:methods; D017079:Exercise Tolerance; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D029424:Pulmonary Disease, Chronic Obstructive / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013318:Stroke Volume / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology; D016278:Ventricular Function, Right / Q000502:physiology; D016138:Walking / Q000502:physiology
keywords: COPD; Diastolic function; Exercise; Right ventricle