COPD advances in left ventricular diastolic dysfunction

Figures & data

Figure 1 Inclusion criteria for the study population.

Abbreviation: LV, left ventricular.

Table 1 Clinical characteristics of the study population

Variables	COPD (n=115), mean ± SD	Control (n=115), mean ± SD	P-value
Age (years)	74.4±10.3	74.4±10.3	1.000
Male sex (%)	72.3	72.3	1.000
BMI (kg/m^2)	21.5±4.3	22.5±3.8	0.060
Hypertension (%)	55.4	45.5	0.143
Diabetes mellitus (%)	20.5	25.0	0.428
AF (%)	14.3	8.0	0.139
BNP (pg/mL)	118.6±76.5	73.9±109.1	0.062
Hemoglobin (g/dL)	12.3±3.1	12.9±2.0	0.155
Creatinine (mg/dL)	1.05±0.93	0.88±0.34	0.074
CKD (%)	38.4	41.1	0.684
EF (%)	67.1±9.2	68.3±8.3	0.292
TRPG (mmHg)	32.4±13.0	34.7±18.9	0.303
Smoke (Brinkman index)	1.147.7±869.5	625.3±839.5	<0.001

Notes: Data presented as mean ± SD unless otherwise indicated. P-value obtained using unpaired t-test.

Abbreviations: BMI, body mass index; AF, atrial fibrillation; BNP, brain-type natriuretic peptide; CKD, chronic heart disease; EF, ejection fraction; SD, standard deviation; TRPG, transtricuspid pressure gradient.

Table 2 Echocardiography and pulmonary function test parameters of the study population

Variables	COPD (n=115)	Control (n=115)	P-value
Echocardiography
IVST (mm)	9.4±2.2	8.4±1.6	0.183
PWT (mm)	9.0±1.7	8.2±1.4	0.354
LVEDD (mL)	87.8±31.2	92.7±27.6	0.228
LVESD (mL)	28.4±16.9	27.7±12.3	0.751
SV (mL)	59.4±19.1	63.1±21.4	0.181
LAD (mL)	35.4±10.3	34.3±8.3	0.398
E/A	0.79±0.41	0.74±0.57	0.396
E	58.7±18.5	53.3±16.3	0.027
e′ (septal)	5.9±1.7	6.1±5.3	0.779
e′ (lateral)	7.7±2.3	7.8±3.0	0.747
Mean E/e′	10.5±5.0	9.1±2.7	0.009
High E/e′ (%)	11.3	4.3	0.046
Pulmonary function test
FEV1(L)	1.33±0.70	1.76±0.73	–
FVC (L)	2.46±0.93	2.25±0.99	–
FEV1/FVC ratio (%)	57.8±12.1	79.9±13.1	–
RV (L)	2.09±0.68	1.44±0.64	–
RV/TLC ratio (%)	45.3±10.4	37.5±11.0	–

Notes: Data presented as mean ± SD unless otherwise indicated. P-value obtained using unpaired t-test.

Abbreviations: IVST, interventricular septal thickness; PWT, posterior wall thickness; LVEDD, left ventricular end-diastolic diameter; LVESD, left ventricular end-systolic diameter; SV, stroke volume; LAD, left atrial dimension; FEV₁, forced expiratory volume in 1 second; FVC, forced vital capacity; RV, residual volume; TLC, total lung capacity.

Table 3 The relationship between PFT parameters and mean E/e′

Variables	Mean E/e′
	R	P-value
PFT
FEV1(L)	−0.263	<0.001
FVC (L)	−0.043	0.526
FEV1/FVC ratio (%)	−0.018	0.791
RV (L)	0.112	0.125
RV/TLC ratio (%)	0.152	0.036
Smoke (Brinkman index)	−0.089	0.190

Note: P-value obtained using Pearson’s correlation.

Abbreviations: PFT, pulmonary function test; FEV₁, forced expiratory volume in 1 second; FVC, forced vital capacity; RV, residual volume; TLC, total lung capacity.

Figure 2 Proportion of high E/e′ in each group.

Notes: Proportion of high E/e′ was significantly higher in the severe COPD group (Global Initiative for Chronic Obstructive Lung Disease III or IV) than in the control group (17.5% vs 4.3%, P=0.041). However, no difference was found in the proportion of high E/e′ between the severe COPD group and the mild-to-moderate COPD group (Global Initiative for Chronic Obstructive Lung Disease I or II; 17.5% vs 8.0%, P=0.320). P-value obtained using unpaired t-test.

Figure 3 Correlation between mean E/e′ and FEV₁ or RV/TLC ratio in all patients (n=230).

Notes: Mean E/e′ was significantly associated with FEV₁ (r=−0.263, P<0.001) and RV/TLC ratio (r=0.152, P=0.036). P-value obtained using Pearson’s correlation.
Abbreviations: FEV₁, forced expiratory volume in 1 second; RV, residual volume; TLC, total lung capacity.

Table 4 The odds ratio of prediction for high E/e′

Variables	Univariate (95% CI)	P-value	Multivariate (95% CI)	P-value
Age (>75 years)	2.26 (0.78–6.58)	0.134	2.47 (0.62–6.48)	0.247
Male sex	0.58 (0.27–2.09)	0.580	–	–
Obesity	1.10 (0.35–3.55)	0.863	–	–
Hypertension	1.60 (0.60–4.30)	0.349	–	–
Diabetes mellitus	0.94 (0.30–3.00)	0.920	–	–
Atrial fibrillation	3.50 (1.13–10.84)	0.030	2.63 (0.75–9.17)	0.130
COPD (GOLD I or II)	2.87 (0.99–8.35)	0.053	–	–
COPD (GOLD III or IV)	5.81 (2.13–15.89)	0.001	6.00 (2.08–17.35)	0.001
Anemia	3.39 (1.22–9.40)	0.019	3.34 (1.11–10.08)	0.032
CKD	2.03 (0.77–5.36)	0.154	–	–

Note: P-value obtained using univariate and multivariable logistic regression analyses.

Abbreviations: CI, confidence interval; GOLD, Global Initiative for Chronic Obstructive Lung Disease; CKD, chronic kidney disease.