Left ventricular concentric remodeling in COPD patients: A cross-sectional observational study

Abstract

Objective

To investigate the association between left ventricular structure and disease severity in COPD patients.

Methods

Twenty-eight COPD patients were stratified according to the disease severity, using the BODE index, into L_ower (n = 17) and H_igher (n = 11) groups, composed of patients with lower severity (BODE <5) and higher severity (BODE ≥5), respectively. Left ventricle (LV) was assessed by 2D-echocardiography. BODE index was calculated using body mass index (BMI); forced expiratory volume in the first second (FEV₁, %); modified Medical Research Council (mMRC) and distance walked during 6-minute walk test (6MWD).

Results

Patients in the H_igher group showed lower oxygen arterial saturation (p = 0.02), FEV₁ (p < 0.01) and 6MWD (p = 0.02) and higher value of relative posterior wall thickness (RWT) compared to L_ower group (p = 0.02). There were significant associations between LV end-systolic diameter (LVESD) and BODE index (r = −0.38, p = 0.04), LV end-diastolic diameter (LVEDD) and FEV₁ (r = 0.44, p = 0.02), LVEDD and BMI (r = 0.45, p = 0.02), LVESD and BMI (r = 0.54, p = 0.003) and interventricular septal thickness and 6MWD (r = −0.39, p = 0.04).

Conclusions

More severe COPD patients, BODE score ≥5, may have higher RWT, featuring a possible higher concentric remodeling of LV in this group. Besides that, a greater disease severity may be related to LV chamber size reduction.