Assessment of diastolic dysfunction parameters and cardiac chamber size in smokers with COPD: A case control study

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a critical health care burden across the globe. Pulmonary Hypertension (PH) is a widespread feature of advanced COPD and is estimated to affect 20% of individuals with advanced COPD. Aim: To compare the variables of cardiac function, chamber size and diastolic parameters across various stages of COPD. Materials and Methods: A prospective case control study was conducted among 50 subjects and 50 controls (convenient sampling) with COPD over a period of two years in kasturba Medical college, Manipal (July 2012-July 2014). Chronic smokers who met the criteria for COPD according to GOLD criteria were included in the study. All patients underwent Pulmonary Function Test (PFT) using spirometer. Results: Twenty seven out of 50 studied patients (54%) had Pulmonary Artery Hypertension (PAH). Nineteen patients had mild PAH (38%). Dimension of cardiac chamber across various stages of COPD were found to have a significant decrease in Left Atrial (LA) area. Our study found an increase in Isovolumic Relaxation Time (IVRT), Pulmonary Artery Pressure (PAP) and TEI index (myocardial performance index) across stages of COPD however it was not statistically significant. Conclusion: Majority of the patients with COPD had PH, with increasing frequency of PAH across the GOLD stages. A decrease in cardiac chamber size was demonstrated with increasing severity of COPD.