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Title: High prevalence of left ventricle diastolic dysfunction in severe COPD associated with a low exercise capacity: A cross-sectional study
Author: López Sánchez, Marta
Muñoz Esquerre, Mariana
Huertas, Daniel
González-Costello, José
Ribas, Jesús
Manresa, Federico
Dorca i Sargatal, Jordi
Santos Pérez, Salud
Keywords: Malalties pulmonars obstructives cròniques
Malalties dels pulmons
Ventricles cardíacs
Malalties cardiovasculars
Chronic obstructive pulmonary diseases
Pulmonary diseases
Ventricle of heart
Cardiovascular diseases
Issue Date: 27-Jun-2013
Publisher: Public Library of Science (PLoS)
Abstract: Background: a subclinical left ventricle diastolic dysfunction (LVDD) has been described in patients with chronic obstructive pulmonary disease (COPD). Objectives: to evaluate the prevalence of LVDD in stable severe COPD patients, to analyze its relationship with exercise capacity and to look for its possible causes (lung hyperinflation, ventricular interdependence or inflammatory mechanisms). Methods: we evaluated 106 consecutive outpatients with severe COPD (FEV1 between 30-50%). Thirty-three (31%) were excluded because of previous heart disease. A pulmonary function test, a 6-minute walking test (6MWT), a Doppler echocardiography test, including diastolic dysfunction parameters, and an analysis of arterial blood gases, NT-proBNP and serum inflammatory markers (CRP, leucocytes), were performed in all patients. Results: the prevalence of LVDD in severe stable COPD patients was 90% (80% type I, n=57, and 10% type II, n=7). A significant association between a lower E/A ratio (higher LVDD type I) and a lower exercise tolerance (6-minute walked distance (6MWD)) was found (r=0.29, p<0.05). The fully adjusted multivariable linear regression model demonstrated that a lower E/A ratio, a DLCO in the quartile 4th and a higher tobacco consumption were associated with a lower 6MWD (76, 57 and 0.7 metres, respectively, p<0.05). A significant correlation between E/A ratio and PaO2 was observed (r=0.26, p<0.05), but not with static lung hyperinflation, inflammation or right ventricle overload parameters. Conclusion: in stable severe COPD patients, the prevalence of LVDD is high and this condition might contribute in their lower exercise tolerance. Hypoxemia could have a concomitant role in their pathogenesis.
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It is part of: PLoS One, 2013, vol. 8, num. 6, p. e68034
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ISSN: 1932-6203
Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
Articles publicats en revistes (Ciències Clíniques)

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