The Effect of Respiratory Functions and Pulmonary Artery Pressure on Right and Left Ventricular Diastolic Function

• Published in: Journal of the American College of Cardiology Vol. 62; no. 18; pp. C156 - C157
• Main Authors: Alpsoy, Şeref, Akyüz, Aydın, Akkoyun, Dursun Cayan, Oran, Mustafa, Mutlu, Levent Cem, Topçu, Birol, Değirmenci, Hasan, Yalçın, Banu Çiçek
• Format: Journal Article
• Language: English
• Published: New York Elsevier Inc 29.10.2013; Elsevier Limited
• Subjects: Annuli; Anthropometry; Atria; Cardiology; Cardiovascular; Cholesterol; Chronic obstructive pulmonary disease; Correlation analysis; Demographics; Echocardiography; Electrocardiography; Heart; Heart rate; Hematocrit; Internal Medicine; Parameters; Pulmonary arteries; Pulmonary artery; Pulmonary functions; Respiratory function; Triglycerides; Ultrasonic imaging; Veins & arteries; Ventricle
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2013.08.461

Introductıon The aim of the study was to evaluate of biventricular diastolic function and to investigate the effect of pulmonary function and pulmonary artery pressure on diastolic functions in people with chronic obstructive pulmonary disease (COPD).Materials-Method Sixty patients with COPD and 40 healthy individuals were assessed by echocardiography and pulmonary function tests (PFTs). Correlation and regression analysis were performed to investigate the relationship between FEV1, FEV1/FVC, mean pulmonary artery pressure (MPAB) and diastolic function parameters.Results Right ventricular diameter and free wall thickness and mitral E / mitral septal annulus E' were higher whereas tricuspid E and E / A, tricuspid lateral annulus E 'and E' / A ', mitral septal annulus E' and E '/ A' values were lower in the COPD group (all p values of <0.05). Patients group, n=60 Control group, n=60 p value* Age, years 49 ± 7.4 48.5 ± 7.2 0.134 Gender, female (n, %) 16 (% 26.7) 11 (% 27.5) 0.831 BMI, kg/m2 26 ± 5 25.8 ± 2.6 0.647 Sistolic BP 126 ± 12 128 ± 17 0.848 Diastolic BP 80 (60 – 90) 78 (60 – 90) 0.281 Smoking, (n, %) 16 (% 26.7) 11 (% 27.5) 0.745 Hipertension, (n, %) 10 (% 16.7) 6 (% 15) 0.635 Dyslipidemia, (n, %) 22 (% 36.7) 14 (% 35) 0.728 Duration of disease, years 9 ± 3.3 (4 - 15) 0 <0.001 Hematocrit, % 52 (36 - 65) 38 (35 - 46) <0.001 Heart rate, beat/min 86 (63 - 115) 75 (55 - 95) <0.001 FEV1, % 67 (24 - 92) 93 (89 - 120) <0.001 FVC, % 87 (45 - 138) 93 (85 - 110) 0.003 FEV1/FEVC 59.2 (35 - 69) 89.5 (81 - 95) <0.001 Fasting glucose, mg/dl 92 (53 - 113) 93 (77 - 114) 0.821 Total cholesterol, mg/dl 200 (115 - 318) 195 (121 - 260) 0.1 Triglyceride, mg/dl 130 (43 - 368) 143 (52 - 288) 0.838 LDL-cholesterol, mg/dl 133 (34 - 231) 130 (63 - 191) 0.314 HDL-cholesterol, mg/dl 44 (18 - 64) 42 (30 - 56) 0.642 Uric acide, mg/dl 5 (3 - 9) 5.2 (4 - 8) 0.980 CRP, mg/dl 3.5 (1 - 10) 3 (2 - 12) 0.134 Demographic and anthropometric characteristics, pulmonary function tests and biochemical parameters of the patients and the control group Patients group, n= 60 Control group, n= 60 p değeri * LVDD, mm 47 (40 - 56) 46 (41 - 53) 0.525 LVSD, mm 30 ± 3.67 29 ± 3.21 0.053 IVS, mm 11 (8 - 13) 11 (8 – 13) 0.211 PW, mm 11 (9 - 13) 11 (9 - 13) 0.189 LVEF, % 66.± 4.2 66.4 ± 3.9 0.165 Left atrium, mm 31.5 (25 - 41) 31 (26 - 40) 0.882 Aortic root, mm 32 ± 3.2 30.5 ± 4 0.520 Mitral E, cm/s 70.5 (60 - 110) 79 (46 - 108) 0.145 Mitral A, cm/s 65 (35 - 98) 70 (45 - 89) 0.406 Mitral E/A 1.12 (0.6 - 2.3) 1.13 (0.6 - 2.12) 0.936 DT, ms 171 (115 - 204) 182.5 (95 - 226) 0.486 IVRT, ms 89 (68 - 114) 85.5 (70 – 108) 0.148 RV MPI 0.45 ± 0.08 0.44 ± 0.037 0.124 RVDD, mm 26 (20 - 28) 21 (18 -25) <0.001 RVFWT, mm 4 (2.8 – 4.6) 3 (2.3 – 3.5) <0.001 Tricuspid E, cm/s 52.5 (42 - 66) 71 (40 - 95) <0.001 Tricuspid A, cm/s 64.5 (55 - 90) 63 (40 - 80) 0.418 Tricuspid E/A 0.83 (0.5 - 1.7) 1.15 (0.6 - 1.9) <0.001 RV MPI 0.43 ± 0.07 0.43 ± 0.04 0.364 MPAP, mmHg 27.3 ( 20.3 – 41.6) 0 <0.001 Table 2 Two-dimensional, M-mode and conventional Doppler findings of the patients and the control group Variables Patients group n=60 Control group n=60 p value* Septal E’, cm/s 9.35 (4 - 15) 11 (7- 18) 0.001 Septal A’, cm/s 11 (6 - 18) 11 (8 - 17) 0.843 Septal S’, cm/s 9 (6 - 13) 9 (7 - 12) 0.752 Septal E’/ A’ 0.81 ± 0.26 1.1 ± 0.39 0.004 Mitral E/septal E’ 8.2 (5.7 – 14) 6.8 (5 -12) <0.001 Lateral E’, cm/s 11.2 (6 - 18) 11 (8 - 20) 0.761 Lateral A’, cm/s 8.9 (4 - 16) 9 (5 - 14) 0.682 Lateral S’, cm/sn 9 (6 - 14) 8.9 (8 - 15) 0.061 Lateral E’/ A’ 1.26 (0.6 – 2.2) 1.29 (0.7 -2.33) 0.894 Mitral E/ lateral E’ 6.9 (4 -14) 7.2 (4 -9.9) 0.612 Anterior E’, cm/s 11 (4 - 18) 11 (7 - 16) 0.368 Anterior A’, cm/s 10 (6 – 16) 10.5 (6 – 16) 0.601 Anterior S’, cm/s 9 ± 1.7 9 ± 1.6 0.734 Anterior E’/ A’ 1.02 (0.67 – 2.14) 1.04 (0.56 - 1.83) 0.789 İnferior E’, cm/s 9 (5 – 14) 9.2 (6 – 17) 0.060 İnferior A’, cm/s 9 (4 – 14) 9 (4 – 14) 0.348 İnferior S’, cm/s 9 (6 – 18) 8 (6 – 17) 0.326 İnferior E’/ A’ 1.0 (0.5 - 2) 1.09 (0.6 – 1.85) 0.091 Tricuspid E’, cm/s 7.5 ± 2.2 11.4 ± 3.3 <0.001 Tricuspid A’, cm/sn 9.3 (4.6 – 11.5) 9.3 (8.4 – 14.5) 0.203 Tricuspid S’, cm/sn 12.8 ± 2.5 12.9 ± 2 0.438 Tricuspid E’/ tricuspid A’ 0.80 (0.4 -1.74) 1.2 (0.75 – 2.24) <0.001 Table 3 Tissue Doppler findings of patient and control group FEV1 FEV1/FVC MPAP r - p r - p r - p Tricuspid E 0.027 - 0.838 0.096 - 0.468 -0.127 - 0.333 Tricuspid E / A 0.215 - 0.099 0.256 - 0.049 -0.282 - 0.029 TA lateral E’ 0.436 - <0.001 0.666 - <0.001 -0.634 - <0.001 TA lateral E’/A’ 0.441 - <0.001 0.615 - <0.001 -0.563 - <0.001 MA septal E’ 0.136 - 0.300 0.410 - 0.001 -0.374 - 0.003 MA septal E’/ MA septal A’ 0.155 - 0.238 0.349 - 0.006 -0.292 - 0.024 Mitral E/ MA septal E’ -0.137- 0.295 -0.347 - 0.007 0.283 - 0.029 Table 4 Correlation between tissue Doppler parameters with pulmonary function tests and mean pulmonary artery pressure.