已发表论文

慢性阻塞性肺病对老年住院病患左心室舒张功能的影响

 

Authors Huang YS, Feng YC, Zhang J, Bai L, Huang W, Li M, Sun Y

Published Date December 2014 Volume 2015:10 Pages 81—87

DOI http://dx.doi.org/10.2147/CIA.S71878

Received 28 July 2014, Accepted 26 September 2014, Published 19 December 2014

Objective: To evaluate the impact of chronic obstructive pulmonary disease (COPD) on left ventricular (LV) diastolic function in hospitalized elderly patients.
Methods: This was a case–control observational study of 148 consecutive hospitalized elderly patients (≥65 years old): 73 subjects without COPD as controls and 75 patients with COPD. Mild-to-moderate COPD was defined as stages 1 and 2, while severe and very severe COPD was defined as stages 3 and 4, according to the Global Initiative for Chronic Obstructive Lung Disease guidelines. Clinical characteristics and echocardiographic parameters were analyzed and compared.
Results: Compared with the control group, patients with COPD had a higher frequency of LV diastolic dysfunction and heart failure with preserved ejection fraction. Smoking frequency, frequency of cerebrovascular diseases and diabetes, and serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were higher in the COPD group (all <0.05). COPD patients showed more abnormalities in diastolic function (E/e' : 11.51±2.50 vs 10.42±3.25,=0.047), but no differences in systolic function and right ventricular function (all >0.05). Patients with severe/very severe COPD showed no differences in LV diastolic function compared to patients with mild/moderate COPD (>0.05), but serum NT-proBNP levels were higher in severe/very severe COPD (<0.05).
Conclusion: Results suggest that early-stage COPD may have an impact on the LV diastolic function. Severe COPD mainly affected right ventricular function. In hospitalized elderly patients with COPD, LV diastolic dysfunction should be taken into account together with right ventricular function.
Keywords: chronic obstructive pulmonary disease, heart failure, left ventricular diastolic dysfunction, elderly, echocardiography