Evaluation Of Left Ventricular Function In Patients With Chronic Obstructive Pulmonary Disease By Two-dimensional Speckle Tracking

Objective: To evaluate the left ventricular function in patients with chronic obstructive pulmonary disease with two-dimensional speckle tracking and to provide important information for clinical diagnosis,prognosis and prognosis.Methods: A total of 70 patients with COPD diagnosed in our hospital from December2015 to December 2017 were selected according to the diagnostic criteria in line with the2016 Global Initiative for Chronic Obstructive Lung Disease guidelines.According to ASE guidelines,the parameters of echocardiography were collected and the peak tricuspid regurgitation peak velocity was more than 2.8m/s,that is,patients with pulmonary hypertension were excluded.COPD patients were examined pulmonary function and bronchial dilatation test,and according to the severity of airflow limitation COPD patients were divided into 4 grades:GOLD1: FEV1? 80% predicted value;GOLD2: 50% ?FEV1 <80% predicted value;GOLD3: 30% ?FEV1<50% predicted value;GOLD4: FEV1 <30% predicted value.Patients with FEV1?50% predicted were classified as mild to moderate(GOLD1: 4 cases;GOLD2: 27 cases),and those with predicted FEV1 <50% were classified as severe and very severe(GOLD3: 24 cases;GOLD4: 9 cases).A total of 61 patients without pulmonary disease and with matched sex,age and blood pressure were selected as control group.Conventional echocardiography and 2D-STE were performed for following parameters:1.Left ventricular systolic function: LVEF,Left ventricle global longitudinal peak stain(LV-GLS),Septal global longitudinal peak strain(LS-Sept).2.Left ventricular diastolic function: Left atrium end-systolic diameter(LAD),Mitral flow early and later diastolic velocity(Mitral E and Mitral A),Mitral early diastolic E peak deceleration time(Mitral EDT),Early diastolic velocity of mitral annulus measured by TDI(Mitral e?).Calculated Mitral E/A and Mitral E/e?.Results:1.Compared between two groups:the LV-GLS in COPD group was significantly higher than that in control group(P <0.05),the results suggest that left ventricular systolic function is decreased in COPD patients.2.Compared with COPD patients:LV-GLS and LS-Sept were significantly higher in heavy-very severe group(FEV1 <50% of predicted value)and mild-moderate group(FEV1?50% of predicted value)in patients with COPD,the difference was statistically significant(P < 0.05),suggesting that in patients with severe-extreme severe COPD,left ventricular systolic function was more severe.3.The relationship between pulmonary function and left ventricular systolic function:LV-GLS in COPD patients was negatively correlated with FEV1(r =-0.34,P = 0.005).Conclusion:1.COPD patients have early left ventricular dysfunction.2.The extent of left ventricular dysfunction in patients with COPD is related to the severity of the disease.3.FEV1 and left ventricular systolic function was positively correlated.4.Two-dimensional speckle tracking technology can be early detection of COPD patients with reduced left ventricular systolic function,early detection of clinical disease,provide important information to guide the treatment.