原创力文档right heart structural changes are independently associated with exercise capacity in non-severe copd对心脏结构变化与运动能力不重的慢性阻塞性肺病独立相关.pdfVIP
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right heart structural changes are independently associated with exercise capacity in non-severe copd对心脏结构变化与运动能力不重的慢性阻塞性肺病独立相关
Right Heart Structural Changes Are Independently
Associated with Exercise Capacity in Non-Severe COPD
1 1,3 2 1 3
Michael J. Cuttica *, Sanjiv J. Shah , Sharon R. Rosenberg , Randy Orr , Lauren Beussink , Jane E.
1 2 2
Dematte , Lewis J. Smith , Ravi Kalhan
1 Pulmonary Hypertension Program, Division of Pulmonary and Critical Care Medicine, Northwestern University, Chicago, Illinois, United States of America, 2 Asthma and
COPD Program, Division of Pulmonary and Critical Care Medicine, Northwestern University, Chicago, Illinois, United States of America, 3 Division of Cardiology,
Department of Medicine, Northwestern University, Chicago, Illinois, United States of America
Abstract
Background: Pulmonary hypertension (PH) occurs frequently and results in functional limitation in advanced COPD. Data
regarding the functional consequence of PH in less severe COPD are limited. Whether echocardiographic evidence of right
sided heart pathology is associated with functional outcomes in patients with non-severe COPD is unknown.
Methods: We evaluated pulmonary function, six minute walk distance, and echocardiography in 74 consecutive patients
with non-severe COPD. We performed multivariable linear regression to evaluate the association between right heart
echocardiographic parameters and six minute walk distance adjusting for lung function, age, sex, race, and BMI.
Main Results: The mean six minute walk distance was 324 6106 meters. All subjects had preserved left ventricular (LV)
systolic function (LV ejection fraction 62.3%66.1%). 54.1% had evidence of some degree of diastolic dysfunction. 17.6% of
subjects had evidence of right ventricular enlargement and 36.5% h
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