The Relation Of Lung Function With Cardiac Chamber Sizes And Heart Dysfunction In Patients With Chronic Obstructive Pulmonary Disease

Objective:To study the relationship of lung function with heart size and heart dysfunction and associated consequences for6-min walk distance (6MWD) in patients with COPD of different severities.Methods:In61inpatients and outpatients with COPD in Department of Respiratory Medicine of Shaoxing People’s Hospital of Zhejiang Province from March2011to January2012(Global Initiative for Obstructive Lung Disease [GOLD] Ⅰ-Ⅳ), we measured lung function(FEV1/FVC、FEV1/%pred、RV/%pred、IC/TLC、 DLCO/%pred).We also measured the size of all cardiac chambers, left ventricular systolic and diastolic function, global right ventricular function(Tei-index) and diastolic pulmonary artery pressure by echocardiography and6MWD. Results:The size of all cardiac chambers decreased with increasing GOLD stage. Overall, moderate relationships existed between variables of lung function and cardiac chamber sizes. Static hyperinflation (IC/TLC and RV) showed stronger associations with cardiac chamber sizes than airway obstruction or diffusion capacity. IC/TLC showed the strongest associations with Left ventricular end-diastolic diameter in the four indexes of cardiac chamber sizes and correlated best with cardiac chamber sizes.and IC/TLC was an independent predictor of cardiac chamber sizes after adjustment for body surface area. Patients with an IC/TLC<or=0.25had a significantly impaired left ventricular diastolic filling pattern and a significantly impaired Tei-index compared with patients with an IC/TLC>0.25. An impaired left ventricular diastolic filling pattern was independently associated with a reduced6MWD.Conclusion:An increasing rate of COPD severity is associated with a decreasing heart size, a significantly impaired left ventricular diastolic filling pattern and a significantly impaired right ventricular Tei-index.Hyperinflation could play a significant role regarding heart size and heart dysfunction in patients with COPD.