Abstract
Cardiovascular disease accounts for significant morbidity and mortality in chronic obstructive pulmonary disease (COPD). Its prevalence and mechanisms of association have not been elucidated. The study aimed to assess the prevalence of echocardiographic abnormalities and potential risk factors in patients with COPD at their first exacerbation requiring hospital admission.
Transthoracic echocardiography was prospectively performed in 342 patients (forced expiratory volume in 1 s 52±16% predicted) 3 months after discharge.
Significant cardiac alterations were present in 64% of patients; 27% left- and 48% right-heart disorders. The most common were right ventricle enlargement (30%) and pulmonary hypertension (19%). Left ventricle enlargement was present in 6%, left ventricle systolic dysfunction in 13%, left ventricle diastolic impairment in 12% and left atrial dilatation in 29%. Echocardiographic abnormalities were unrelated to COPD severity and were more frequent in patients with self-reported cardiac disease. They were also observed in 63% of patients with no known cardiac disease or cardiovascular risk factors other than smoking.
We conclude that cardiac abnormalities are highly prevalent in COPD patients at the time of their first severe exacerbation, even in the absence of established cardiac disease or cardiovascular risk factors. Considering the prognostic and therapeutic implications of cardiac comorbidity, echocardiography should be considered in the assessment of patients with clinically significant COPD.
Footnotes
Support Statement
Supported by grants from the Fondo de Investigación Sanitaria (PI020541, PI052486, PI052302); Agència d’Avaluació de Tecnologia i Recerca Mèdiques (AATRM 035/20/02); Spanish Society of Pulmonology and Thoracic Surgery (SEPAR 2008/732); Catalan Foundation of Pulmonology (FUCAP 2008); Red RESPIRA (RTIC C03/11); Red RCESP (RTIC C03/09); Fundació La Marató de TV3 (041110); DURSI (2005SGR00392); and an unrestricted educational grant from Novartis Farmacéutica, Spain. CIBERESP and CIBERES are funded by the Instituto de Salud Carlos III, Ministry of Scientific Research and Innovation, Spain. Judith Garcia-Aymerich was the recipient of a researcher contract from the Instituto de Salud Carlos III (CP05/00118).
Statement of Interest
None declared.
- Received December 18, 2011.
- Accepted August 19, 2012.
- ©ERS 2013