Publication: When left ventricular failure complicates chronic obstructive pulmonary disease: Hypoxia plays the major role
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Date
2008
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Publisher
Kathmandu University
Abstract
Abstract
Introduction: As the chronic obstructive pulmonary disease (COPD) progress, is usually accompanied by
involvement of the both left ventricle (LV) and right ventricle (RV), and their systolic and diastolic function. Signs
and symptoms of LV failure can be difficult to distinguish from those of COPD.
Objective: The study was carried out to determine the prevalence of LV systolic dysfunction in the COPD patients
and to assess the possible risk factor behind such development.
Material and Methods: It is a prospective study of 60 cases of COPD patients with or without cor-pulmonale
attending Manipal Teaching Hospital.
Results: The prevalence of LV systolic dysfunction was found to be 26.7%, and the findings directly correlate with
the severity of COPD i.e., the more the severity of the lung disease more the probability for the incidence of LV
systolic dysfunction. These data are in support of the hypothesis that hypoxia and the excess accumulation of toxic
metabolic products like lactic acid, significant right-to-left shunting through the bronchial circulation explains the
diminished LV ejection fraction in severe COPD patients.
Conclusion: Routine echocardiography investigation of the severe COPD patients is required for assessing the
status of LV function and to rule out the possible association of LV systolic dysfunction.
Key words: Chronic obstructive pulmonary disease, Cor-pulmonale, Hypoxia, LV systolic dysfunction
Description
Paudel B1, Dhungel S2, Paudel K1, Pandru K1, Paudel R1
1Department of Medicine, Manipal Teaching Hospital, Pokhara, Nepal, 2Professor and Head; Department of Medicine, Nepal Medical College, Attarkhel, Kathmandu