RT Journal Article
SR Electronic
T1 Lung function is associated with left ventricular wall stress in coincident COPD and heart failure
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA4620
DO 10.1183/13993003.congress-2015.PA4620
VO 46
IS suppl 59
A1 Alter, Peter
A1 Vand de Sand, Kirsten
A1 Nell, Christoph
A1 Greulich, Timm
A1 Vogelmeier, Claus
A1 Koczulla, Andreas Rembert
YR 2015
UL http://erj.ersjournals.com/content/46/suppl_59/PA4620.abstract
AB Background. COPD and heart failure exhibit a considerable coincidence. Beside a well-known increased right heart load, dedicated pulmonary interactions with the left ventricle (LV) are less understood and the question remains, whether specific interactions exist beyond common shared risk factors of both diseases.Methods: LV wall stress was measured by cardiac magnetic resonance imaging in 28 patients with COPD and left heart failure (LVEF 42±19%) due to non-ischemic and ischemic cardiomyopathy.Results: Reduced lung function was associated with LV dilatation. LV enddiastolic volume (LVEDV, by trend) and endsystolic volume (LVESV) increased from GOLD stage I to III (p<0.05), respectively. LV enddiastolic and endsystolic wall stress increased from GOLD I to III (p<0.05).Conclusions: Reduced lung function (FEV1) was correlated with increased LV wall stress. It is suggested that respiration at a level of hyperinflation requires increased negative pleural pressure when compared with normal lung function, which is transmitted to the heart and increases the transmural pressure gradient and thereby distending forces on the LV. Additionally proinflammatory processes in COPD potentially invoked in early processes of cardiac dilatation should be taken into account. Increased ventricular wall stress is known to exhibit various unfavourable consequences in heart failure, which could also contribute substantially to a worse prognosis in COPD.