Abstract
Introduction
The type and extent of RV function alterations during COPD exacerbation are poorly described. Whether these alterations could be reflected by changes in NT-proBNP levels, is also unknown.
This study aimed to describe the changes in RV morphology and function during COPD exacerbation, and delineate their relationship with circulating levels of NT-pro BNP.
Patients and Methods
Sixty-nine consecutive patients (mean age 66 ± 10, 53 men) presenting with COPD exacerbation requiring ventilatory support, underwent echocardiographic assessment of RV function (RV diameter, RV/LV ratio, TAD, Teig, PAPs) on admission and at discharge in survivors (n = 57). NT-pro BNP levels were measured simultaneously.
Results
Exacerbation was ascribed to infectious origin in 54 patients. Non invasive ventilation was used in 58 patients. 57 patients survived the index episode and had an echocardiographic examination at discharge. Variation of RV echocardiographic variables between admission and discharge are depicted in figure 1.
NT-proBNP levels significantly decreased from 2111±400 to 595±111 pg/ml. Significant correlations were found between NT-proBNP on one side, and the ratio RV/LV (R2 = 0.22 ; p = 0.02), PAPs (R2 = 0.37 ;p = 0.001), and RV diameter (R= 0.24; p=0.01).
Conclusion: COPD exacerbation has a significant impact on both, the morphology and function of the right ventricle. NT-proBNP accurately reflects these changes.
- © 2013 ERS