INTEGRATED USE OF ECHOCARDIOGRAPHY AND SPIROMETRY IN EVALUATING PATIENTS WITH BRONCHIAL ASTHMA IN A TERTIARY CARE HOSPITAL AT NORTH KERALA: A CROSS-SECTIONAL STUDY
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Keywords
Asthma, cardiovascular disease, spirometry, echocardiography
Abstract
Bronchial asthma and coronary vascular disease often co-exist, as they share many common risk factors in their etiopathogenesis. The persistent hypoxia in bronchial asthma compromises cardiovascular haemodynamic to a greater extent. Our objective was to assess the cardiac changes by echocardiography in patients with bronchial asthma and to correlate with its severity and pulmonary function test parameters. A total of 130 patients were selected and classified based on their severity, as per GINA (Global Initiative for Asthma) guidelines. All patients underwent spirometry and echocardiography evaluation. On echocardiographic evaluation, 59.3 % patients had abnormal findings. Majority of cases (60%) had pulmonary hypertension (PH) and the incidence of PH was more in the uncontrolled asthma group (44.4%). The frequency of cor pulmonale and tricuspid regurgitation (TR) were 3.08% and 5.38% respectively. There was a significant association (p <0.05) with a positive correlation between the severity of asthma and frequency of PH, LVDD (Left Ventricular Diastolic Dysfunction) and cor pulmonale.
There was a significant (p<0.05) positive correlation between the echo parameter ejection expressed as percentage (EF%) and spirometry parameters. But there was a negative correlation between spirometry parameters and echo parameters PH and LVDD. To conclude, the prevalence of cardiac dysfunction showed a liner relationship with the severity of asthma and pulmonary function parameters, especially, PH and LVDD with a statistical significance (p<0.05). Echocardiography detects cardiovascular abnormality in asthma patients at the subclinical stage and helps in the improvement of health care.
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Vidhiyasagaran J
Associate Professor, Department of Pharmacology, Malabar Medical College Hospital & Research Centre (MMC HRC), Kozhikode, Kerala.
Pallavi Kulkarni
Associate Professor, Department of Pharmacology, KLE’s Jagadguru Gangadhar Mahaswamigalu Moorusaviramath Medical College, Hubballi, Karnataka.
James P.T
Professor & HOD, Department of Pulmonology, Malabar Medical College Hospital & Research Centre (MMC HRC), Kozhikode, Kerala.
Manimekalai K
Professor & HOD, Department of Pharmacology, Mahatma Gandhi Medical College Hospital & Research centre (MGM CHRI).