Background/Aims : In patients with chronic obstructive pulmonary disease (COPD), left ventricular (LV) systolic dysfunction and structural changes are rare, while right ventricular (RV) dysfunction and structural alteration and/or LV diastolic dysfunction are common. We evaluated the cardiac structure and function in patients with COPD using echocardiography. Methods : Echocardiography examinations were performed in 69 patients with clinically stable COPD and without a history of heart disease; 22 control subjects with normal lung function were enrolled for comparison. Echocardiography parameters of the COPD patients were compared with those of the controls, and assessed according to the COPD stage classified using the Global initiative for chronic Obstructive Lung Disease (GOLD) criteria. Results : Patients with COPD had significantly lower body weight (p=0.001) and higher pack-years of smoking than did the controls (p=0.002). The echocardiogram showed that LV end diastolic diameter (p<0.001), LV end systolic diameter (p=0.020), left atrial (LA) diameter (p=0.026), and LV mass in the COPD patients were significantly decreased compared to the controls (p=0.003). However, there were no differences between the COPD patients and controls in the parameters reflecting LV diastolic function and mean RV systolic pressure (RVSP). According to the COPD stage, body weight (p<0.001), body mass index (BMI) (p<0.001), and LV mass were significantly different (p=0.011). In patients with COPD, LV mass (r=0.432) (p<0.001) and BMI were significantly correlated with FEV1% predicted (r=0.600) (p<0.001). Conclusions : Patients with COPD had lower LV mass and LA and LV diameters than did the controls, even though both groups had normal LV function. In particular, the LV mass appeared to correlate with the lung function in the patients with COPD. (Korean J Med 74:162-169, 2008)

Background/Aims : In patients with chronic obstructive pulmonary disease (COPD), left ventricular (LV) systolic dysfunction and structural changes are rare, while right ventricular (RV) dysfunction and structural alteration and/or LV diastolic dysfunction are common. We evaluated the cardiac structure and function in patients with COPD using echocardiography. Methods : Echocardiography examinations were performed in 69 patients with clinically stable COPD and without a history of heart disease; 22 control subjects with normal lung function were enrolled for comparison. Echocardiography parameters of the COPD patients were compared with those of the controls, and assessed according to the COPD stage classified using the Global initiative for chronic Obstructive Lung Disease (GOLD) criteria. Results : Patients with COPD had significantly lower body weight (p=0.001) and higher pack-years of smoking than did the controls (p=0.002). The echocardiogram showed that LV end diastolic diameter (p<0.001), LV end systolic diameter (p=0.020), left atrial (LA) diameter (p=0.026), and LV mass in the COPD patients were significantly decreased compared to the controls (p=0.003). However, there were no differences between the COPD patients and controls in the parameters reflecting LV diastolic function and mean RV systolic pressure (RVSP). According to the COPD stage, body weight (p<0.001), body mass index (BMI) (p<0.001), and LV mass were significantly different (p=0.011). In patients with COPD, LV mass (r=0.432) (p<0.001) and BMI were significantly correlated with FEV1% predicted (r=0.600) (p<0.001). Conclusions : Patients with COPD had lower LV mass and LA and LV diameters than did the controls, even though both groups had normal LV function. In particular, the LV mass appeared to correlate with the lung function in the patients with COPD. (Korean J Med 74:162-169, 2008)

목적 : COPD 환자에서 우심실비대와 기능장애는 흔한 반면, 좌심실의 수축기능은 비교적 잘 보존되는 것으로 알려져 있다. 최근에 COPD 환자에서 좌심실이완기능장애가 흔하다는 보고가 있다. 저자들은 심장초음파를 이용하여 COPD 환자에서의 심장의 구조와 기능의 변화를 평가해 보고자 하였다. 방법 : 심장질환을 진단받은 적이 없는 안정상태의 COPD 환자 69명과 정상폐활량을 가진 대조군 22명에서 심장초음파검사 결과를 비교하였고, Global initiative for chronic Obstructive Lung Disease (GOLD) 기준에 따른 COPD의 중증도에 따라 심장의 구조와 기능에 변화가 있는지 평가하였다. 결과 : COPD 환자가 대조군보다 몸무게가 유의하게 작았고(p=0.001), 흡연량이 많았다(p=0.002). 심장초음파검사 결과 COPD 환자의 좌심실이완기말지름(p<0.001), 좌심실수축기말지름(p=0.020), 좌심방지름(p=0.026)과 좌심실질량이 대조군보다 유의하게 작았다(p=0.003). 그러나 좌심실의 이완기능을 나타내는 여러 지표와 평균 우심실수축기압은 COPD 환자와 대조군 사이에 차이가 없었다. COPD의 중증도에 따라 몸무게(p<0.001), 체질량지수(p<0.001)와 좌심실질량이 유의한 차이를 보였고(p=0.011), 좌심실질량과(r=0.432) (p<0.001) 체질량지수는 FEV1% 예측치와 유의한 양의 상관관계를 보였다(r=0.600)(p<0.001). 결론 : COPD 환자와 대조군 사이에 심박출계수는 차이가 없음에도 불구하고, COPD 환자에서 좌심실질량, 좌심방지름, 좌심실이완기말지름, 좌심실수축기말지름은 대조군보다 유의하게 작았다. 특히, 좌심실질량은 폐기능이 감소할수록 감소하였다.

Pulmonary disease; Chronic obstructive; Echocardiography; Ventricle; Left; Hypertension; Pulmonary