Left ventricular structure and remodeling in patients with COPD

Figures & data

Table 1 Anthropometric and clinical data

Parameter	COPD (n=49)	Controls (n=36)	P-value
Age (years)	66.3±9.1	62.7±6.5	<0.05
Male/female (%)	76/24	69/31	ns
Height (cm)	1.7±0.1	1.7±0.1	ns
Weight (kg)	72±13	75±10	ns
BMI (kg/m^2)	25.3±4.0	25.8±3.0	ns
BSA (m^2)	1.8±0.2	1.9±0.2	ns
SBP (mmHg)	132±12	131±11	ns
DBP (mmHg)	82±8	83±5	ns
HR (beats-per-minute)	77±13	67±8	<0.001
Smokers (active and non) (%)	90	31	<0.001
Arterial hypertension history I stage (%)	43	19	<0.05
Diabetes mellitus (%)	6	0	ns
No hospitalization (%)	32/49 (66)	0
1 hospitalization (%)	8 (16.7)	–
>1 hospitalization (%)	8 (16.7)	–

Note: Data are mean ± standard deviation or percentage.

Abbreviations: BMI, body mass index; BSA, body surface area; DBP, diastolic blood pressure; HR, heart rate; ns, nonsignificant; SBP, systolic blood pressure.

Table 2 Lung functional characteristics

Spirometry and pletismography	COPD (n=49)	Controls (n=36)	P-value
FEV1 (L)	1.6±0.8	3.1±0.6	<0.0001
FEV1 (%)	57±25	106±13	<0.0001
FVC (L)	3.0±1.0	4.0±0.8	<0.0001
FEV1/FVC	49±12	75±5	<0.0001
Residual volume (L)	3.4±1.3	2.9±1.0	ns
Residual volume (%)	149±55	126±46	ns
TLC (L)	6.9±1.5	7.2±1.4	ns
TLC (%)	115±23	115±20	ns
RV/TLC	48±13	41±16	0.05

Note: Data mean ± standard deviation or percentage.

Abbreviations: FEV₁, forced expiratory volume in 1 second; FVC, forced vital capacity; ns, nonsignificant; RV, right ventricular; TLC, total lung capacity.

Table 3 Cardiac structural characteristics assessed by echocardiography

LV morphologic parameters	COPD (n=49)	Controls (n=36)	P-value
End-diastolic diameter (mm)	45±6	48±4	<0.01
End-systolic diameter (mm)	28±6	29±5	ns
End-diastolic volume (mL)	90±27	101±18	<0.05
End-systolic volume (mL)	29±12	32±11	ns
Septal thickness (mm)	9.8±1.6	9.0±1.4	<0.05
Posterior wall thickness (mm)	9.4±1.4	8.9±1.9	ns
RWT	0.44±0.09	0.37±0.05	<0.001
LVM (g)	183±54	191±50	ns
LVM/BSA (g/m^2)	99±24	100±22	ns
LV hypertrophy (%)	36	44	ns

Note: Data mean ± standard deviation or percentage.

Abbreviations: BSA, body surface area; LV, left ventricular; LVM, left ventricular mass; RWT, relative wall thickness.

Table 4 Left ventricular functional characteristics assessed by echocardiography

Parameter	COPD (n=49)	Controls (n=36)	P-value
FS (%)	40±12	42±6	ns
EF (%)	69±6	68±7	ns
SV (mL)	61±17	69±11	<0.05
Mitral E pv (cm/s)	53.6±13.6	58.3±13.2	ns
Mitral E tvi (cm)	8.8±2.6	10.2±2.0	<0.05
Mitral A pv (cm/s)	69.8±12.3	67.1±11.8	ns
Mitral A tvi (cm)	8.4±1.9	8.4±2.5	ns
Mitral E/A pv (cm/s)	0.8±0.2	0.9±0.1	ns
Mitral E/A tvi (cm)	1.1±0.3	1.3±0.4	<0.01
DTE S pv (cm/s)	10.7±2.2	10.6±2.1	ns
DTE S tvi (cm)	2.1±0.8	2.1±0.4	ns
DTE E′ pv (cm/s)	10.0±2.6	9.8±2.4	ns
DTE E′ tvi (cm)	1.1±0.3	1.1±0.4	ns
DTE A′ pv (cm/s)	13.9±3.1	13.9±2.6	ns
DTE A′ tvi (cm)	1.2±0.3	1.2±0.3	ns
DTE E′/A′ pv	0.9±0.9	0.8±0.3	ns
DTE E′/A′ tvi	0.9±0.3	0.9±0.4	ns

Notes: Data mean ± standard deviation. Values from DTE analysis are the mean of septal and lateral walls.

Abbreviations: A′, end-diastolic myocardial wave; DTE, Doppler tissue echocardiography; E′, proto-diastolic myocardial wave; EF, ejection fraction; FS, fraction of shortening; pv, peak velocity; S, systolic myocardial wave; SV, stroke volume; tvi, time velocity integral.

Table 5 Right ventricular characteristics assessed by echocardiography

Right ventricle	COPD (n=49)	Controls (n=36)	P-value
End-diastolic diameter (mm)	35.2±5.2	33.4±4.1	ns
End-systolic diameter (mm)	25.2±4.7	24.1±3.9	ns
Trasversal diameter (mm)	36.8±6.5	36.3±5.1	ns
Longitudinal diameter (mm)	65.7±8.7	65.2±7.2	ns
DTE S pv (cm/s)	15.4±4.2	16.1±4.2	ns
DTE S tvi (cm)	2.9±0.9	3.2±0.7	<0.05
Tricuspid E pv (cm/s)	40.9±8.9	40.9±8.7	ns
Tricuspid E tvi (cm)	6.6±2.2	7.7±2.1	<0.05
Tricuspid A pv (cm/s)	42.5±9.5	40.1±7.1	ns
Tricuspid A tvi (cm)	5.0±1.5	5.1±1.4	ns
DTE E′ pv (cm/s)	13.1±4.0	14.6±3.7	ns
DTE E′ tvi (cm)	2.1±0.8	2.5±0.7	0.01
DTE A′ pv (cm/s)	18.3±4.3	18.5±4.2	ns
DTE A′ tvi (cm)	1.9±0.5	1.9±0.5	ns
Tricuspid E/A pv	1.0±0.2	1.0±0.3	ns
Tricuspid E/A tvi	1.4±0.5	1.6±0.5	ns
DTE E′/A′ pv	0.7±0.2	0.8±0.2	ns
DTE E′/A′ tvi	1.1±0.4	1.3±0.3	<0.05
Pulmonary pressure (mmHg)	30.9±8.2	25.8±3.4	<0.01
AT on pulmonary flow (ms)	119±29	144±22	<0.001

Note: Data are mean ± standard deviation.

Abbreviations: A′, end-diastolic myocardial wave; AT, acceleration time; DTE, Doppler tissue echocardiography; E′, proto-diastolic myocardial wave; pv, peak velocity; tvi, time velocity integral; S, systolic myocardial wave.

Table 6 Correlations between lung function, CT score, and cardiac chamber size values

Variable	EDD		EDV		RWT		SWT
	r	P-value	r	P-value	r	P-value	r	P-value
FEV1	0.10	ns	0.16	ns	−0.35	<0.05	−0.32	<0.05
FEV1/FVC	0.17	ns	0.18	ns	−0.34	<0.05	−0.22	ns
GOLD class	−0.15	ns	−0.21	ns	0.36	<0.01	0.33	<0.05
CT score	−0.36	<0.01	−0.28	<0.05	0.41	<0.01	0.28	<0.05

Abbreviations: CT, computed tomography; EDD, left ventricular end-diastolic diameter; EDV, left ventricular end-diastolic volume; FEV₁, forced expiratory volume in 1 second; FVC, forced vital capacity; GOLD, Global Initiative for Chronic Obstructive Lung Disease; ns, nonsignificant; RWT, relative wall thickness; SWT, septal wall thickness.

Table 7 Multiple regression analysis of the predicting relationship of COPD status with the echocardiographic-based variables, ie, RWT, EDV, EDD, and SWT

Variable	RWT (R^2=0.30)		EDD (R^2=0.35)		EDV (R^2=0.41)		SWT (R^2=0.34)
	β (SE)	Sig	β (SE)	Sig	β (SE)	Sig	β (SE)	Sig
COPD	0.039 (0.017)	0.027	−1.83 (1.17)	0.12	−6.08 (4.77)	0.21	0.53 (0.32)	0.11
Age	0.001 (0.001)	0.74	−0.034 (0.077)	0.66	−0.31 (0.31)	0.33	0.018 (0.021)	0.40
Sex	−0.057 (0.021)	0.009	−2.63 (1.44)	0.072	−17.05 (5.89)	0.005	−1.65 (0.40)	<0.001
SBP	−0.001 (0.001)	0.062	0.086 (0.050)	0.090	0.46 (0.20)	0.021	−0.035 (0.014)	0.012
BMI	−0.005 (0.002)	0.059	0.39 (0.17)	0.024	1.14 (0.66)	0.091	0.038 (0.046)	0.72
HR	0.002 (0.001)	0.011	−0.16 (0.05)	0.003	−0.76 (0.20)	<0.001	0.010 (0.014)	0.82

Notes: Age, HR, BMI, and SBP were considered as the covariates. Only RWT was significantly associated with COPD status. Data with statistical significance are shown in bold.

Abbreviations: BMI, body mass index; EDD, end-diastolic diameter; EDV, end-diastolic volume; HR, heart rate; RWT, relative wall thickness; SE, standard error; SBP, systolic blood pressure; SWT, septal wall thickness.