Left Ventricular Diastolic Dysfunction in Chronic Obstructive Pulmonary Disease: A Case-Control Study
Background: Left ventricular diastolic dysfunction (LVDD) may be present in patients with chronic obstructive
pulmonary disease (COPD). This case-control study assessed the prevalence of LVDD in patients with COPD and
its association with severity and duration of COPD.
Methods: Seventy-seven patients with COPD attending a tertiary care hospital in Uttarakhand, India and 77 ageand
sex-matched healthy controls were included in the study. COPD was diagnosed as per the global initiative for
chronic obstructive lung disease (GOLD) criteria. LVDD was assessed by pulsed-wave Doppler & tissue Doppler
echocardiography as per the current American Society of Echocardiography criteria.
Results: Spirometry parameters were suggestive of severe nature of COPD in 98.7% of cases. COPD patients
had a higher prevalence of LVDD than controls (32.46% versus 1.29%; p<0.0001). Grade II LVDD was seen in
24.67% and Grade III LVDD in 7.79% patients with COPD. LVDD showed a significant association with age
(p=0.0007), duration of disease (p=0.004), forced expiratory volume in 1 second (FEV1) (p<0.0001), FEV1 (%
predicted) (p<0.0001) and FEV1/FVC (%) (p=0.012) but not with gender (p=0.928) and forced vital capacity (FVC)
(p=0.078). E/E' ratio (p=0.0001), deceleration time (DT) (p<0.0001), left atrial (LA) volume (p<0.0001) and peak
tricuspid regurgitation (TR) velocity (p=0.0001) were significantly higher while E' velocity, A' velocity, E'/A' ratio and
left ventricular ejection fraction (LVEF) were significantly lower among cases than controls (p<0.05 each).
Conclusions: LVDD was present in a significant number of patients with COPD and had a significant association
with the severity and duration of COPD.
Key words: Chronic obstructive pulmonary disease; Chronic bronchitis; Emphysema; Left ventricular diastolic