Echocardiography should be considered in the assessment of patients with clinically significant COPD, according to Spanish researchers who found that cardiac abnormalities are commonplace in COPD patients who experienced their first severe exacerbation.
“The proportion of patients presenting cardiac disorders remained high even after excluding those with cardiovascular risk factors [other than smoking], and it was unrelated to COPD severity,” the authors noted.
When studying 342 COPD patients who were hospitalized for the first time due to an exacerbation, 64% of the patients had significant echocardiographic abnormalities. Of the 181 patients in whom the right side of the heart could be adequately assessed, 48% showed significant abnormalities, and of the 278 patients in whom the left ventricle could be fully assessed, 27% had significant abnormalities.
Right ventricular enlargement and pulmonary hypertension were the most common abnormalities, affecting 30% and 19% of patients, respectively; 29% of patients had left atrial dilatation, 13% had left ventricle systolic dysfunction, 12% had left ventricle diastolic impairment, and 6% had left ventricle enlargement.
“This large, prospective, multicenter, comprehensive echocardiographic study shows that cardiac disorders are highly prevalent in patients with moderate-to-severe COPD, even among those without cardiovascular risk factors other than cigarette smoking,” the authors concluded. “Accordingly, the implementation of echocardiography in the evaluation of COPD patients should be considered, since it might help detect unrecognized cardiac disorders and establish adequate treatment that may potentially improve patient prognosis.”