Abstract Background: Chronic obstructive pulmonary disease (COPD) is a common preventable
and treatable disease characterized by persistent airflow limitation that is usually progressive and
associated with an enhanced chronic inflammatory response in the airways and the lung to noxious
particles or gases. It has some significant extra pulmonary effects that may contribute to its severity
in individual patient. Among COPD patients, cardiovascular diseases (CVD) are responsible for
approximately 50% of all hospitalizations and 20% of all deaths. Left ventricular diastolic dysfunction
(LVDD) is a frequent condition in COPD patients. Inflammation is considered to be one of the
systemic manifestations of COPD and provides an alternative hypothesis to explain the relationship
between airflow limitation and cardiovascular risk. The present study aimed to assess the prevalence
of LV diastolic dysfunction in COPD patients and its relation to the disease severity and presence of
inflammatory markers.
Patient and methods: Forty nine (49) COPD patients were included in this study. All patients
were subjected to full medical history, physical examination, chest roentgenogram, spirometry, laboratory
blood testing for inflammatory mediators (C-reactive protein, matrix metalloproteinase-9
and tissue inhibitor metalloproteinase-1) and Echo Doppler study (conventional and tissue
Doppler analysis).
Results: The results showed that 36 COPD patients had LVDD (73.3%). There was a good
correlation between LVDD parameters and COPD severity across GOLD stages and inflammatory
markers. MMP-9 was statistically high in COPD patient with increasing severity with ap-value < 0.0001. Also LVDD parameters were correlated with MMP-9 (p-value < 0.00001).
Other inflammatory markers were also correlated to the degree of airway obstruction (FEV1)
and presence of LVDD.
Conclusion: There is a high prevalence of LVDD in COPD patients which is associated with
increased disease severity and associated with high levels of inflammatory markers (serum MMP-
9 and TIMP-1). It is important to exclude decompensated heart failure during COPD exacerbation. |
