Left ventricular diastolic dysfunction in patients with chronic obstructive pulmonary disease: Impact of methods of assessment.
BACKGROUND
The prevalence of left ventricular (LV) diastolic dysfunction in patients with chronic obstructive pulmonary disease (COPD), using different echocardiographic parameters, varies widely in the literature. The highest prevalence of LV diastolic dysfunction was detected using the mitral inflow indexes that are commonly altered in these patients due to the associated tachycardia, reduced preload, and ventricular septal shift. In this study, we aimed at evaluating the impact of the used echocardiographic method of assessment on the prevalence of LV diastolic dysfunction in patients with COPD and normal LV systolic function.


METHODS
We studied 35 patients with COPD and 18 age-matched controls. A comprehensive approach to diagnose and grade the LV diastolic dysfunction was performed in accordance with the recommendations of the American Society of Echocardiography published in 2009. The results were compared with those of mitral inflow indexes.


RESULTS
LV diastolic dysfunction was reported in 20 patients using the mitral inflow indexes while in only 12 patients using the comprehensive approach (P=.021). Compared to the controls, LV diastolic dysfunction was significantly more common in patients using the mitral inflow indexes (P=.001), while no statistically significant difference was detected between both groups using the comprehensive approach (P=.1).


CONCLUSIONS
The prevalence of LV diastolic dysfunction in patients with COPD varies according to the used echocardiographic approach. Further studies are recommended to determine which approach is the most accurate in estimating the true prevalence of LV diastolic dysfunction among this group of patients.
Department of Cardiovascular Medicine, Cairo University Hospitals, Cairo, Egypt.
Heba
http://orcid.org/0000-0002-9929-5448
H
Farouk
Department of Cardiovascular Medicine, Cairo University Hospitals, Cairo, Egypt.
Maged
M
Albasmi
Department of Cardiology, Essen University Hospital, Essen, Germany.
Karim
K
El Chilali
Department of Cardiovascular Medicine, Cairo University Hospitals, Cairo, Egypt.
Kareem
K
Mahmoud
Department of Cardiovascular Medicine, Cairo University Hospitals, Cairo, Egypt.
Abdo
A
Nasr
Department of Cardiovascular Medicine, Cairo University Hospitals, Cairo, Egypt.
Hussein
H
Heshmat
Department of Pulmonary Medicine, Cairo University Hospitals, Cairo, Egypt.
Samah
S
Abdel-Moneim
Department of Cardiovascular Medicine, Cairo University Hospitals, Cairo, Egypt.
Essam
E
Baligh
D003971:Diastole; D004452:Echocardiography / Q000379:methods*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000503:physiopathology; D012720:Severity of Illness Index; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000000981:diagnostic imaging* / Q000503:physiopathology
chronic obstructive pulmonary disease; left ventricular diastolic function; mitral inflow indexes; tissue Doppler imaging