ĐẶC ĐIỂM SIÊU ÂM TIM Ở BỆNH NHÂN BỆNH PHỔI TẮC NGHẼN MẠN TÍNH ĐỢT CẤP TẠI BỆNH VIỆN ĐẠI HỌC Y HẢI PHÒNG

Abstract

Background: Cardiac involvement, particularly pulmonary hypertension (PH) and right-ventricular remodelling, is a common complication that affects prognosis in chronic obstructive pulmonary disease (COPD). Echocardiography is a useful non-invasive tool for screening these abnormalities. Objectives: To describe echocardiographic characteristics in patients with acute exacerbation of COPD and to explore relationships among echocardiographic parameters. Materials and methods: A cross-sectional descriptive study of 31 patients with acute exacerbation of COPD who underwent transthoracic echocardiography at Hai Phong University Medical Hospital. Measured parameters included left-ventricular end-diastolic (Dd) and end-systolic (Ds) diameters, left-ventricular ejection fraction (LVEF), left-atrial (LA) diameter, right-ventricular diameter, and estimated systolic pulmonary artery pressure (sPAP). Results: Mean age was 73.1 ± 9.7 years (44-90); 71.0% were male. Median LVEF was 65.0% [52.5-67.5], with preserved LVEF (≥50%) in 83.9%. Median sPAP was 28.0 mmHg [22.5-40.5]; echocardiographic PH (sPAP ≥36 mmHg) was found in 32.3% (95% CI: 18.6-49.9). sPAP strongly correlated with right-ventricular diameter (ρ = 0.72; p < 0.001) and inversely with LVEF (ρ = -0.53; p = 0.002). The PH group had lower LVEF and larger Dd and right-ventricular diameter than the non-PH group (p < 0.01). Conclusions: About one-third of patients with acute exacerbation of COPD had echocardiographic PH, accompanied by right-ventricular dilatation and reduced left-ventricular systolic function. Echocardiography may be considered as a non-invasive screening tool in patients with acute exacerbation of COPD who are at risk of, or suspected to have, cardiac complications.