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Original Article

JCDR. 2016; 7(1): 1-15

Correlation of Tissue Doppler imaging parameters with Chronic Obstructive Pulmonary Disease

Virendra C. Patil, Harsha V. Patil, Vaibhav Agrwal, Sandhya Kulkarni, Shrikant A. Lomte, Bhupal Pujari.


Background: Chronic Obstructive Pulmonary Disease (COPD) has considerable
effects on cardiac functions primarily affecting the pulmonary
vasculature, right ventricle and then left ventricle. Echocardiography provides
a rapid and non-invasive method to evaluate cardiac changes. Aims
and Objectives: To assess the parameters of diastolic function and Tissue
Doppler imaging (TDI) and to correlate with severity of COPD by
GOLD stages and to find out relation of TDI parameters with spirometic
variables.Material and Methods: A total 60 stable COPD patients,
fulfilling inclusion criteria were selected and were classified according
to pulmonary function test (PFT) and evaluated by 2-Dimensional
transthoracic echocardiography (TTE) and tissue Doppler imaging (TDI).
Results: Total 32 (68.08%) subjects had grade-I diastolic dysfunction,
11 (23.40%) had grade-II and 4 (8.51%) had grade–III diastolic dysfunction
with predominance of grade-I diastolic dysfunction [p’< 0.002]. Total 22
(36.66%) subjects had pulmonary hypertension. Stage –II and IV had
significant prevalence of pulmonary hypertension compared to stage-I and
II with ‘p’=0.000234. E/Ea, E/A, right ventricular myocardial performance
index (RVMPI) were negatively correlated with FEV1, FEV1/FCV ratio, PEFR
and RV wall thickness and RV diameter were negatively correlated with
FEV1, FEV1/ FVC ratio and PEFR. There was strong negative correlation
of pulmonary artery pressure (sPAP) with FEV1/FVC ratio and PEFR. E/A
ratio was negatively correlated with FEV1, FEV1/FCV ratio, PEFR and
pulmonary artery systolic pressure (sPAP). Diastolic dysfunction was
present in 78.33% subjects and pulmonary hypertension was present
in 36.66%. In multivariate analysis spirometric variables were negatively
correlated with tissue Doppler parameter (E/Ea ratio), PAP, E/A ratio
and RVMPI [‘p’< 0.0013] and positively correlated with IVRT, VP and DT

Key words: Diastolic dysfunction, Tissue Doppler Imaging, COPD spiromety, Pulmonary hypertension, 2-Dimensional transthoracic echocardiography.

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