title: Echocardiographic predictors of outcome in patients with chronic obstructive pulmonary disease.
abstract: BACKGROUND
  We aimed to assess the relationship between echocardiographic characteristics and mortality in patients with chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  We prospectively studied 154 patients (mean age 71 ± 10 years, 71% male) with COPD. All patients underwent transthoracic Doppler echocardiography within 48 hours of hospital admission. Primary endpoint was all-cause mortality during a median period of 22 months.
  
  
  RESULTS
  Mildly elevated tricuspid regurgitation pressure and mitral E/e' ratio were the most commonly encountered echocardiographic abnormalities, observed in 60% and 56% of patients, respectively. In Kaplan-Meier analysis of survival, left atrial enlargement, E/e' ratio > 8, right atrial enlargement, right ventricular dilation, decreased tricuspid annular plane systolic excursion, decreased tricuspid annular systolic velocity, and elevated tricuspid regurgitation velocity were associated with all-cause mortality (p < 0.05 for all). In the Cox proportional hazards analysis, the mitral E/e' ratio (hazard ratio 1.048; 95% confidence interval 1.001-1.096) remained an independent echocardiographic predictor of survival after adjustment for age, COPD severity, and other baseline echocardiographic parameters.
  
  
  CONCLUSIONS
  Among patients with COPD, an abnormal mitral E/e' ratio was an independent echocardiographic predictor of all-cause mortality. Echocardiographic evaluation of structural and functional cardiac abnormalities provides important prognostic information and should be used routinely in the assessment of patients with COPD. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:211-221, 2017.
authors.affiliation: Faculty of Medicine, University of Belgrade, Clinical Hospital Center Zemun, Department of Cardiology, Belgrade, Serbia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Stankovic
authors.affiliation: University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia.
authors.forename: Robert
authors.initials: R
authors.lastname: Marcun
authors.affiliation: Faculty of Medicine, University of Belgrade, Clinical Hospital Center Zemun, Department of Cardiology, Belgrade, Serbia.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Janicijevic
authors.affiliation: Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
authors.forename: Jerneja
authors.initials: J
authors.lastname: Farkas
authors.affiliation: University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia.
authors.forename: Sasa
authors.initials: S
authors.lastname: Kadivec
authors.affiliation: Faculty of Medicine, University of Belgrade, Clinical Hospital Center Zemun, Department of Cardiology, Belgrade, Serbia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Ilic
authors.affiliation: Faculty of Medicine, University of Belgrade, Clinical Hospital Center Zemun, Department of Cardiology, Belgrade, Serbia.
authors.forename: Aleksandar N
authors.initials: AN
authors.lastname: Neskovic
authors.affiliation: Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.|Department of Cardiology, General Hospital Celje, Celje, Slovenia.
authors.forename: Mitja
authors.initials: M
authors.lastname: Lainscak
mesh_terms: D000368:Aged; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000473:pathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D009929:Organ Size; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D017524:Slovenia; D013318:Stroke Volume / Q000502:physiology; D014262:Tricuspid Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D018754:Ventricular Dysfunction / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*
keywords: chronic obstructive pulmonary disease; echocardiography; outcome; survival