M. Takakura et al., Echocardiographic detection of occult cor pulmonale during exercise in patients with chronic obstructive pulmonary disease, ECHOCARDIOG, 16(2), 1999, pp. 127-134
Citations number
25
Categorie Soggetti
Cardiovascular & Respiratory Systems
Journal title
ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES
We tested the ability of cycle ergometer exercise echocardiography to detec
t cases of occult cor pulmonale among 25 patients with chronic obstructive
pulmonary disease (COPD). The M-mode echocardiographic ventricular septal m
otion, Left ventricular shape determined by short-axis two-dimensional (2-D
) echocardiography, and right and Left ventricular pressure curves were rec
orded at rest and during exercise and were compared between patients. The v
entricular septal motion was normal at rest in all of the patients. In nine
patients (dip group), there was marked downward ventricular septal motion
in early diastole during exercise, indicating distortion of the left ventri
cular shape. There were no distinct changes in the remaining 16 patients (n
on-dip group). At rest, the cardiac index teas significantly Lower, and rig
ht ventricular systolic and mean pulmonary artery pressures were significan
tly higher in the dip group than in the non-dip group. However, no signific
ant difference was noted in the right ventricular end-diastolic pressure be
tween the two groups at rest. The right ventricular systolic and end-diasto
lic pressures were greater during exercise in the dip group than in the non
-dip group. In all of the patients in the dip group, the right ventricular
pressure exceeded the left ventricular pressure only in early diastole, coi
nciding with the early diastolic dip of the ventricular septum, during exer
cise. In conclusion, occult cor pulmonale can. be diagnosed accurately by t
he appearance of an early diastolic dip of the ventricular septum and disto
rted left ventricular shape during exercise in, patients with COPD.