E-ISSN 2231-3206 | ISSN 2320-4672
 

Original Research 


Myocardial dysmorphism and functional failure: A cardiac sting in patients with advancing chronic obstructive pulmonary disease

Jugal Kishore Bajpai, Sudhir Modala, Sunil Kumar, Deepak Kumar Das.

Abstract
Background: Extrapulmonary cardiac manifestations in chronic obstructive pulmonary disease (COPD) exhibit a great deal of deterioration in ventricular geometry and function, contributing to high mortality and morbidity. Echocardiography data regarding ventricular remodeling and functional deterioration in COPD patients are rare and insufficient.

Aims and Objectives: The aim of the study was to assess and compare the early deterioration of ventricular geometry and function by echocardiography in COPD (Group-2) and non COPD patients (Group-1).

Materials and Methods: In this study, 150 individual patient data (IPD) patients diagnosed of COPD admitted in a pulmonary unit of Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, between 30 and 80 years of both the sexes, were analyzed randomly (Group-2). Retrospective comparative study was undertaken with the same number of IPD patients admitted for other ailments (Group-1). Pulmonary function test, electrocardiography, and two-dimensional-echocardiography were done to assess and compare the ventricular geometry and function.

Results: The study revealed a significant increase in the echo parameters such as left ventricular (LV) internal dimension in diastole (<0.0001**) LV internal dimension in systole (<0.0345**), posterior wall thickness (<0.0067**), relative wall thickness (RWT) (<0.0001**), LV ejection fraction (EF) % (<0.0001**) E-velocity (<0.0001**), and E-and A-wave velocity ratio (<0.0001**). On the other hand, right ventricular (RV) parameters such as RV internal dimension in diastole (<0.0073**), RV mass (<0.0001**), RVEF, deceleration time (<0.0008**), pulmonary artery pressure (<0.0001**), and pulmonary flow (<0.0001**) were significantly high in COPD patients. Higher RWT (<0.0001**) in COPD was significantly associated with reduced forced expiratory volume at 1s (FEV1), forced vital capacity (FVC), and the ratio (FEV1/FVC).

Conclusion: COPD patients exhibited biventricular hypertrophy and diastolic and systolic dysfunction resulting in four geometrical patterns, namely concentric hypertrophy, eccentric hypertrophy, concentric remodeling, and normal geometry. It also causes increase LV mass, LV mass index, and decrease in EF% and LV volume as a deteriorating compensatory effect.

Key words: Chronic Obstructive Pulmonary Disease; Two-Dimensional-echocardiography; Left Ventricular Hypertrophy; Diastolic Dysfunction


 
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How to Cite this Article
Pubmed Style

Bajpai JK, Modala S, Kumar S, Das DK. Myocardial dysmorphism and functional failure: A cardiac sting in patients with advancing chronic obstructive pulmonary disease. Natl J Physiol Pharm Pharmacol. 2019; 9(8): 731-737. doi:10.5455/njppp.2019.9.0103217052019


Web Style

Bajpai JK, Modala S, Kumar S, Das DK. Myocardial dysmorphism and functional failure: A cardiac sting in patients with advancing chronic obstructive pulmonary disease. http://www.njppp.com/?mno=28923 [Access: August 23, 2019]. doi:10.5455/njppp.2019.9.0103217052019


AMA (American Medical Association) Style

Bajpai JK, Modala S, Kumar S, Das DK. Myocardial dysmorphism and functional failure: A cardiac sting in patients with advancing chronic obstructive pulmonary disease. Natl J Physiol Pharm Pharmacol. 2019; 9(8): 731-737. doi:10.5455/njppp.2019.9.0103217052019



Vancouver/ICMJE Style

Bajpai JK, Modala S, Kumar S, Das DK. Myocardial dysmorphism and functional failure: A cardiac sting in patients with advancing chronic obstructive pulmonary disease. Natl J Physiol Pharm Pharmacol. (2019), [cited August 23, 2019]; 9(8): 731-737. doi:10.5455/njppp.2019.9.0103217052019



Harvard Style

Bajpai, J. K., Modala, . S., Kumar, . S. & Das, . D. K. (2019) Myocardial dysmorphism and functional failure: A cardiac sting in patients with advancing chronic obstructive pulmonary disease. Natl J Physiol Pharm Pharmacol, 9 (8), 731-737. doi:10.5455/njppp.2019.9.0103217052019



Turabian Style

Bajpai, Jugal Kishore, Sudhir Modala, Sunil Kumar, and Deepak Kumar Das. 2019. Myocardial dysmorphism and functional failure: A cardiac sting in patients with advancing chronic obstructive pulmonary disease. National Journal of Physiology, Pharmacy and Pharmacology, 9 (8), 731-737. doi:10.5455/njppp.2019.9.0103217052019



Chicago Style

Bajpai, Jugal Kishore, Sudhir Modala, Sunil Kumar, and Deepak Kumar Das. "Myocardial dysmorphism and functional failure: A cardiac sting in patients with advancing chronic obstructive pulmonary disease." National Journal of Physiology, Pharmacy and Pharmacology 9 (2019), 731-737. doi:10.5455/njppp.2019.9.0103217052019



MLA (The Modern Language Association) Style

Bajpai, Jugal Kishore, Sudhir Modala, Sunil Kumar, and Deepak Kumar Das. "Myocardial dysmorphism and functional failure: A cardiac sting in patients with advancing chronic obstructive pulmonary disease." National Journal of Physiology, Pharmacy and Pharmacology 9.8 (2019), 731-737. Print. doi:10.5455/njppp.2019.9.0103217052019



APA (American Psychological Association) Style

Bajpai, J. K., Modala, . S., Kumar, . S. & Das, . D. K. (2019) Myocardial dysmorphism and functional failure: A cardiac sting in patients with advancing chronic obstructive pulmonary disease. National Journal of Physiology, Pharmacy and Pharmacology, 9 (8), 731-737. doi:10.5455/njppp.2019.9.0103217052019





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