Right Ventricular Dysfunction and Remodeling in Chronic Obstructive Pulmonary Disease Without Pulmonary Hypertension

Objectives The aim of the present study was to elucidate right ventricular (RV) function and structure in patients with chronic obstructive pulmonary disease (COPD) without pulmonary hypertension (PH). Background There is little knowledge of RV function and remodeling in COPD without PH. Methods Thi...

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Veröffentlicht in:Journal of the American College of Cardiology 2013-09, Vol.62 (12), p.1103-1111
Hauptverfasser: Hilde, Janne Mykland, MD, Skjørten, Ingunn, MD, Grøtta, Ole Jørgen, MD, Hansteen, Viggo, MD, Melsom, Morten Nissen, MD, PhD, Hisdal, Jonny, PhD, Humerfelt, Sjur, MD, PhD, Steine, Kjetil, MD, PhD
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container_issue 12
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container_title Journal of the American College of Cardiology
container_volume 62
creator Hilde, Janne Mykland, MD
Skjørten, Ingunn, MD
Grøtta, Ole Jørgen, MD
Hansteen, Viggo, MD
Melsom, Morten Nissen, MD, PhD
Hisdal, Jonny, PhD
Humerfelt, Sjur, MD, PhD
Steine, Kjetil, MD, PhD
description Objectives The aim of the present study was to elucidate right ventricular (RV) function and structure in patients with chronic obstructive pulmonary disease (COPD) without pulmonary hypertension (PH). Background There is little knowledge of RV function and remodeling in COPD without PH. Methods Thirty-four controls and 98 patients with COPD were included. The study patients were divided into 2 groups by right heart catheterization: no PH (mean pulmonary artery pressure [mPAP] 
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Background There is little knowledge of RV function and remodeling in COPD without PH. Methods Thirty-four controls and 98 patients with COPD were included. The study patients were divided into 2 groups by right heart catheterization: no PH (mean pulmonary artery pressure [mPAP] <25 mm Hg) and PH (mPAP ≥25 mm Hg). The echocardiographic tissue Doppler imaging variables of RV isovolumic acceleration, peak systolic strain, and RV myocardial performance index were measured at the basal free wall, and RV wall thickness and RV internal dimension were measured in the RV outflow tract. Results The increases in RV wall thickness and RV dimension were more evident when comparing controls with the no PH group (3.5 ± 0.5 mm to 5.5 ± 1.0 mm [p < 0.01] and 1.5 cm ± 0.2 to 2.0 ± 0.5 cm [p < 0.01]) than comparing the no PH group with the PH group (5.5 ± 1.0 mm to 6.6 ± 1.1 mm [p < 0.01] and 2.0 cm ± 0.5 to 2.1 ± 0.3 cm [p = NS]), respectively. Similarly, RV isovolumic acceleration, performance index, and strain deteriorated significantly when comparing controls with the no PH group and comparing the no PH group with the PH group (p < 0.01). Significant correlations were observed between mPAP and RV isovolumic acceleration, performance index, strain, and RV wall thickness (p < 0.01). RV impairment and increased RV wall thickness and RV dimensions were present even at slight elevations of mPAP (18 ± 3 mm Hg) in the no PH group. Conclusions The present study showed that impaired RV systolic function, hypertrophy, and dilation were present even at a slight increase of mPAP, which indicates an early impact on RV function and structure in patients with COPD. RV isovolumic acceleration, performance index, and strain could detect subclinical disease and separate controls from those with no PH.]]></description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/j.jacc.2013.04.091</identifier><identifier>PMID: 23831444</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Biological and medical sciences ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Case-Control Studies ; Chronic obstructive pulmonary disease ; Chronic obstructive pulmonary disease, asthma ; COPD ; echocardiography ; Echocardiography, Doppler - statistics &amp; numerical data ; Female ; Heart ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Heart Ventricles - diagnostic imaging ; Heart Ventricles - pathology ; Hemodynamics ; Humans ; Internal Medicine ; Male ; Medical sciences ; Medical treatment ; Middle Aged ; Observer Variation ; Pneumology ; pulmonary circulation ; Pulmonary Disease, Chronic Obstructive - complications ; Pulmonary Disease, Chronic Obstructive - diagnostic imaging ; Pulmonary Disease, Chronic Obstructive - pathology ; Pulmonary Disease, Chronic Obstructive - physiopathology ; Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases ; Regression Analysis ; right ventricular function ; Systole ; Veins &amp; arteries ; Ventricular Dysfunction, Right - diagnostic imaging ; Ventricular Dysfunction, Right - etiology ; Ventricular Remodeling</subject><ispartof>Journal of the American College of Cardiology, 2013-09, Vol.62 (12), p.1103-1111</ispartof><rights>American College of Cardiology Foundation</rights><rights>2013 American College of Cardiology Foundation</rights><rights>2014 INIST-CNRS</rights><rights>Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Sep 17, 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c469t-979ccef1596ae31beb833f018e607ea2da43ffeb183a2b09e828ab5d67d2c7fa3</citedby><cites>FETCH-LOGICAL-c469t-979ccef1596ae31beb833f018e607ea2da43ffeb183a2b09e828ab5d67d2c7fa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jacc.2013.04.091$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>315,782,786,3552,27931,27932,46002</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=27738666$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23831444$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hilde, Janne Mykland, MD</creatorcontrib><creatorcontrib>Skjørten, Ingunn, MD</creatorcontrib><creatorcontrib>Grøtta, Ole Jørgen, MD</creatorcontrib><creatorcontrib>Hansteen, Viggo, MD</creatorcontrib><creatorcontrib>Melsom, Morten Nissen, MD, PhD</creatorcontrib><creatorcontrib>Hisdal, Jonny, PhD</creatorcontrib><creatorcontrib>Humerfelt, Sjur, MD, PhD</creatorcontrib><creatorcontrib>Steine, Kjetil, MD, PhD</creatorcontrib><title>Right Ventricular Dysfunction and Remodeling in Chronic Obstructive Pulmonary Disease Without Pulmonary Hypertension</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description><![CDATA[Objectives The aim of the present study was to elucidate right ventricular (RV) function and structure in patients with chronic obstructive pulmonary disease (COPD) without pulmonary hypertension (PH). Background There is little knowledge of RV function and remodeling in COPD without PH. Methods Thirty-four controls and 98 patients with COPD were included. The study patients were divided into 2 groups by right heart catheterization: no PH (mean pulmonary artery pressure [mPAP] <25 mm Hg) and PH (mPAP ≥25 mm Hg). The echocardiographic tissue Doppler imaging variables of RV isovolumic acceleration, peak systolic strain, and RV myocardial performance index were measured at the basal free wall, and RV wall thickness and RV internal dimension were measured in the RV outflow tract. Results The increases in RV wall thickness and RV dimension were more evident when comparing controls with the no PH group (3.5 ± 0.5 mm to 5.5 ± 1.0 mm [p < 0.01] and 1.5 cm ± 0.2 to 2.0 ± 0.5 cm [p < 0.01]) than comparing the no PH group with the PH group (5.5 ± 1.0 mm to 6.6 ± 1.1 mm [p < 0.01] and 2.0 cm ± 0.5 to 2.1 ± 0.3 cm [p = NS]), respectively. Similarly, RV isovolumic acceleration, performance index, and strain deteriorated significantly when comparing controls with the no PH group and comparing the no PH group with the PH group (p < 0.01). Significant correlations were observed between mPAP and RV isovolumic acceleration, performance index, strain, and RV wall thickness (p < 0.01). RV impairment and increased RV wall thickness and RV dimensions were present even at slight elevations of mPAP (18 ± 3 mm Hg) in the no PH group. Conclusions The present study showed that impaired RV systolic function, hypertrophy, and dilation were present even at a slight increase of mPAP, which indicates an early impact on RV function and structure in patients with COPD. RV isovolumic acceleration, performance index, and strain could detect subclinical disease and separate controls from those with no PH.]]></description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Case-Control Studies</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Chronic obstructive pulmonary disease, asthma</subject><subject>COPD</subject><subject>echocardiography</subject><subject>Echocardiography, Doppler - statistics &amp; numerical data</subject><subject>Female</subject><subject>Heart</subject><subject>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</subject><subject>Heart Ventricles - diagnostic imaging</subject><subject>Heart Ventricles - pathology</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medical treatment</subject><subject>Middle Aged</subject><subject>Observer Variation</subject><subject>Pneumology</subject><subject>pulmonary circulation</subject><subject>Pulmonary Disease, Chronic Obstructive - complications</subject><subject>Pulmonary Disease, Chronic Obstructive - diagnostic imaging</subject><subject>Pulmonary Disease, Chronic Obstructive - pathology</subject><subject>Pulmonary Disease, Chronic Obstructive - physiopathology</subject><subject>Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases</subject><subject>Regression Analysis</subject><subject>right ventricular function</subject><subject>Systole</subject><subject>Veins &amp; arteries</subject><subject>Ventricular Dysfunction, Right - diagnostic imaging</subject><subject>Ventricular Dysfunction, Right - etiology</subject><subject>Ventricular Remodeling</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kl2L1DAUhoso7rj6B7yQgAjetOarSQOyILPqCgsr69dlSNPTnYxtOibpwvx7U2Z0ZS-8ykWe9z0f7ymK5wRXBBPxZlttjbUVxYRVmFdYkQfFitR1U7JayYfFCktWlwQreVI8iXGLMRYNUY-LE8oaRjjnqyJdu5tNQt_Bp-DsPJiAzvexn71NbvLI-A5dwzh1MDh_g5xH602YvLPoqo0pzJm6BfR5HsbJm7BH5y6CiYB-uLSZ5vTPz8V-ByGBj9n2afGoN0OEZ8f3tPj24f3X9UV5efXx0_rdZWm5UKlUUlkLPamVMMBIC23DWI9JAwJLMLQznPU9tKRhhrZYQUMb09adkB21sjfstHh98N2F6dcMMenRRQvDYDxMc9SEMyqIFIJn9OU9dDvNwefuNBG8pqqpmcgUPVA2TDEG6PUuuDGPpwnWSyZ6q5dM9JKJxlznTLLoxdF6bkfo_kr-hJCBV0fARGuGPhhvXbzjpGSNEEv1twcO8s5uHQQdrQNvoXMBbNLd5P7fx9k9uc2hulzxJ-wh3s2rI9VYf1muZzkewjDN9yTZb8ivwRo</recordid><startdate>20130917</startdate><enddate>20130917</enddate><creator>Hilde, Janne Mykland, MD</creator><creator>Skjørten, Ingunn, MD</creator><creator>Grøtta, Ole Jørgen, MD</creator><creator>Hansteen, Viggo, MD</creator><creator>Melsom, Morten Nissen, MD, PhD</creator><creator>Hisdal, Jonny, PhD</creator><creator>Humerfelt, Sjur, MD, PhD</creator><creator>Steine, Kjetil, MD, PhD</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20130917</creationdate><title>Right Ventricular Dysfunction and Remodeling in Chronic Obstructive Pulmonary Disease Without Pulmonary Hypertension</title><author>Hilde, Janne Mykland, MD ; Skjørten, Ingunn, MD ; Grøtta, Ole Jørgen, MD ; Hansteen, Viggo, MD ; Melsom, Morten Nissen, MD, PhD ; Hisdal, Jonny, PhD ; Humerfelt, Sjur, MD, PhD ; Steine, Kjetil, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c469t-979ccef1596ae31beb833f018e607ea2da43ffeb183a2b09e828ab5d67d2c7fa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cardiology</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Case-Control Studies</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Chronic obstructive pulmonary disease, asthma</topic><topic>COPD</topic><topic>echocardiography</topic><topic>Echocardiography, Doppler - statistics &amp; numerical data</topic><topic>Female</topic><topic>Heart</topic><topic>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</topic><topic>Heart Ventricles - diagnostic imaging</topic><topic>Heart Ventricles - pathology</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medical treatment</topic><topic>Middle Aged</topic><topic>Observer Variation</topic><topic>Pneumology</topic><topic>pulmonary circulation</topic><topic>Pulmonary Disease, Chronic Obstructive - complications</topic><topic>Pulmonary Disease, Chronic Obstructive - diagnostic imaging</topic><topic>Pulmonary Disease, Chronic Obstructive - pathology</topic><topic>Pulmonary Disease, Chronic Obstructive - physiopathology</topic><topic>Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases</topic><topic>Regression Analysis</topic><topic>right ventricular function</topic><topic>Systole</topic><topic>Veins &amp; arteries</topic><topic>Ventricular Dysfunction, Right - diagnostic imaging</topic><topic>Ventricular Dysfunction, Right - etiology</topic><topic>Ventricular Remodeling</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hilde, Janne Mykland, MD</creatorcontrib><creatorcontrib>Skjørten, Ingunn, MD</creatorcontrib><creatorcontrib>Grøtta, Ole Jørgen, MD</creatorcontrib><creatorcontrib>Hansteen, Viggo, MD</creatorcontrib><creatorcontrib>Melsom, Morten Nissen, MD, PhD</creatorcontrib><creatorcontrib>Hisdal, Jonny, PhD</creatorcontrib><creatorcontrib>Humerfelt, Sjur, MD, PhD</creatorcontrib><creatorcontrib>Steine, Kjetil, MD, PhD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hilde, Janne Mykland, MD</au><au>Skjørten, Ingunn, MD</au><au>Grøtta, Ole Jørgen, MD</au><au>Hansteen, Viggo, MD</au><au>Melsom, Morten Nissen, MD, PhD</au><au>Hisdal, Jonny, PhD</au><au>Humerfelt, Sjur, MD, PhD</au><au>Steine, Kjetil, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Right Ventricular Dysfunction and Remodeling in Chronic Obstructive Pulmonary Disease Without Pulmonary Hypertension</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>2013-09-17</date><risdate>2013</risdate><volume>62</volume><issue>12</issue><spage>1103</spage><epage>1111</epage><pages>1103-1111</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract><![CDATA[Objectives The aim of the present study was to elucidate right ventricular (RV) function and structure in patients with chronic obstructive pulmonary disease (COPD) without pulmonary hypertension (PH). Background There is little knowledge of RV function and remodeling in COPD without PH. Methods Thirty-four controls and 98 patients with COPD were included. The study patients were divided into 2 groups by right heart catheterization: no PH (mean pulmonary artery pressure [mPAP] <25 mm Hg) and PH (mPAP ≥25 mm Hg). The echocardiographic tissue Doppler imaging variables of RV isovolumic acceleration, peak systolic strain, and RV myocardial performance index were measured at the basal free wall, and RV wall thickness and RV internal dimension were measured in the RV outflow tract. Results The increases in RV wall thickness and RV dimension were more evident when comparing controls with the no PH group (3.5 ± 0.5 mm to 5.5 ± 1.0 mm [p < 0.01] and 1.5 cm ± 0.2 to 2.0 ± 0.5 cm [p < 0.01]) than comparing the no PH group with the PH group (5.5 ± 1.0 mm to 6.6 ± 1.1 mm [p < 0.01] and 2.0 cm ± 0.5 to 2.1 ± 0.3 cm [p = NS]), respectively. Similarly, RV isovolumic acceleration, performance index, and strain deteriorated significantly when comparing controls with the no PH group and comparing the no PH group with the PH group (p < 0.01). Significant correlations were observed between mPAP and RV isovolumic acceleration, performance index, strain, and RV wall thickness (p < 0.01). RV impairment and increased RV wall thickness and RV dimensions were present even at slight elevations of mPAP (18 ± 3 mm Hg) in the no PH group. Conclusions The present study showed that impaired RV systolic function, hypertrophy, and dilation were present even at a slight increase of mPAP, which indicates an early impact on RV function and structure in patients with COPD. RV isovolumic acceleration, performance index, and strain could detect subclinical disease and separate controls from those with no PH.]]></abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>23831444</pmid><doi>10.1016/j.jacc.2013.04.091</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record>
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subjects Aged
Biological and medical sciences
Cardiology
Cardiology. Vascular system
Cardiovascular
Case-Control Studies
Chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease, asthma
COPD
echocardiography
Echocardiography, Doppler - statistics & numerical data
Female
Heart
Heart failure, cardiogenic pulmonary edema, cardiac enlargement
Heart Ventricles - diagnostic imaging
Heart Ventricles - pathology
Hemodynamics
Humans
Internal Medicine
Male
Medical sciences
Medical treatment
Middle Aged
Observer Variation
Pneumology
pulmonary circulation
Pulmonary Disease, Chronic Obstructive - complications
Pulmonary Disease, Chronic Obstructive - diagnostic imaging
Pulmonary Disease, Chronic Obstructive - pathology
Pulmonary Disease, Chronic Obstructive - physiopathology
Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases
Regression Analysis
right ventricular function
Systole
Veins & arteries
Ventricular Dysfunction, Right - diagnostic imaging
Ventricular Dysfunction, Right - etiology
Ventricular Remodeling
title Right Ventricular Dysfunction and Remodeling in Chronic Obstructive Pulmonary Disease Without Pulmonary Hypertension
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