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Assessment of right ventricular geometry and mechanics in chronic obstructive pulmonary disease patients living at high altitude

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Abstract

Degree of increase in pulmonary artery pressure (PAP) and adaptive responses in right ventricular morphology and mechanics play an important role in the prognosis of chronic obstructive pulmonary disease (COPD) patients. Three dimensional echocardiography and deformation imaging are recent advancements in echocardiography that allow more through assessment of right ventricle. We aimed to investigate right ventricular geometry and mechanics in a stable COPD population living at moderately high altitude. A total of 26 stable COPD patients with variable disease severity were included to this study. Pulmonary function tests, six minutes walking test (6MWT) and two- and three-dimensional echocardiography were performed for evaluation and data collection. Both systolic (43.06 ± 11.79 mmHg) and mean (33.38 ± 9.75 mmHg) PAPs were significantly higher in COPD patients compared to controls (p < 0.05, p < 0.001; respectively). Right ventricular volumes were similar between groups, although right ventricular free wall thickness was significantly increased in COPD group. The number of subjects with a sub-normal (<40 %) right ventricular ejection fraction was significantly higher in COPD group (45.8 vs. 17.4 %, p < 0.05), and the mean right ventricular strain was significantly lower (−21.05 ± 3.80 vs. −24.14 ± 5.37; p < 0.05). Only mean PAP and body surface area were found as independent predictors for 6MWT distance. Increased PAP and reduced right ventricular contractility were found in COPD patients living at moderately high altitude, although right ventricular volumes were normal. Similar findings can be expected in other COPD patients with high PAP, since these findings probably represents the effect of increased PAP on right ventricular mechanics.

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Authors and Affiliations

  1. Department of Cardiology, School of Medicine, Kafkas University, Kars, Turkey

    Tolga Sinan Güvenç, Yavuz Karabağ, Yüksel Kaya & Bahattin Balcı

  2. Department of Cardiology, School of Medicine, Bezmialem Vakıf University, Fatih, Istanbul, Turkey

    Şeref Kul

  3. Department of Pulmonary Disorders, School of Medicine, Kafkas University, Kars, Turkey

    Coşkun Doğan, Binnaz Zeynep Yıldırım & Pelin Karadağ

  4. Department of Cardiology, Kars State Hospital, Kars, Turkey

    Rengin Çetin

  5. Department of Cardiology, Acıbadem University Maslak Hospital, İstanbul, Turkey

    Aleks Değirmencioğlu

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  1. Tolga Sinan Güvenç
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  2. Şeref Kul
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  3. Coşkun Doğan
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Correspondence to Şeref Kul.

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Güvenç, T.S., Kul, Ş., Doğan, C. et al. Assessment of right ventricular geometry and mechanics in chronic obstructive pulmonary disease patients living at high altitude. Int J Cardiovasc Imaging 30, 1305–1313 (2014). https://doi.org/10.1007/s10554-014-0475-z

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  • DOI: https://doi.org/10.1007/s10554-014-0475-z

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