ECHOCARDIOGRAPHIC FINDINGS AND ITS CORRELATION WITH THE SEVERITY OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN A TERTIARY CARE HOSPITAL AT NORTH KERALA: A CROSS-SECTIONAL STUDY

Abstract

Chronic obstructive pulmonary disease (COPD) and cardiovascular diseases (CVD) are more frequently associated and their coexistence worsen the prognosis of the condition. The irreversible airflow obstruction in COPD, leads to persistent hypoxia and cardiovascular damage. Our objective was to assess the cardiac changes secondary to COPD by echocardiography and to correlate the echo findings with pulmonary function parameters across the severity of COPD. A total of 120 patients were selected and the severity was graded by Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines using spirometry. All patients were subjected to echocardiographic evaluation. On echocardiographic evaluation, 60.83% patients had abnormal findings. Majority of cases had pulmonary hypertension (PH). Severe grade of PH was present in severe (33.33%) and very severe (66.67%) stages of COPD. There was a significant association (p <0.05) between the severity of COPD and frequency of PH, cor pulmonale and tricuspid regurgitation (TR). The frequency of left ventricular systolic dysfunction (LVSD) and left ventricular diastolic dysfunction (LVDD) were 12.5% and 55.83% respectively. There was a significant(p<0.05) negative correlation between echo parameters (cor pulmonale, TR degree) and spirometry parameters. To conclude, the prevalence of cardiac dysfunction showed a liner relationship with the severity of COPD, especially cor pulmonale and TR, with a statistical significance (p<0.05). Echocardiography detects cardiovascular abnormality in COPD patients at the subclinical stage and helps in the improvement of health care.