Assessment of proportion of pulmonary hypertension in Chronic Obstructive Pulmonary Disease by using 2D echocardiography

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable and treatable disease. The present study was conducted to assess the proportion of pulmonary hypertension in Chronic Obstructive Pulmonary Disease by using 2D echocardiography.
Materials & Methods: The study was carried out on 80 patients of COPD in the Department of Pulmonary Medicine, Department of medicine and Department of cardiology, Guru Gobind Singh Medical College & Hospital, Faridkot, Punjab. Spirometry and Modified MRC dyspnea scale was recorded. 2D ECHOCARDIOGRAPHY was done and pulmonary artery systolic pressure was analysed. The comparative analysis of severity of pulmonary artery hypertension correlating with GOLD stages of COPD. Pulmonary hypertension (PH) was defined in this study as Pulmonary artery systolic pressure (PASP) ≥ 30 mmHg. The grading of PH was done according to PASP.
Results: Emphysematous changes were seen in all the patients (100%). Cardiomegaly was seen in 28.7%, tubular heart seen in 37.5%, hilar prominence in 22.5%, pruning of blood vessels at periphery in 22.5% and bullae seen in 10% of the patients. Maximum number of
patients was present in stage 2 with 48.8% of patients followed by stage3 and stage4 with 32.5 and 18.8% of patients respectively. None of the patients had stage1 COPD. Maximum no. of cases i.e. 43.8 % had mild PSAP grade followed by 20% in moderate and only 3.8% in
the severe grade. 32.5% of patients were normal .p-pulmonale was more pronounced in severe stages with 10 cases seen in S3 and 13 cases present in S4 gold stage. The correlation between them was statistically significant.
Conclusion: PH is an under diagnosed entity that frequently complicates the course of disease in COPD patients and adversely affects exercise capacity. 2D Echocardiography is an accurate, non-invasive and routine screening tool for PH.