[Diagnosis of pulmonary heart in patients with chronic obstructive pulmonary disease]. 2009

A V Strutynskiĭ, and R G Bakaev, and A I Sivtseva, and A M Pal'shina, and A N Khorunov, and S V Shakhurdina, and D V Vinogradova

Informative value of clinical, electrocardiographic, and echocardiographic diagnostic criteria of compensated chronic pulmonary heart (CPH) in patients with chronic obstructive pulmonary disease (COPD) was considered. The study included 229 patients with COPD of which 105 (group 1) showed no signs of CPH, 71 (group 2) had compensated and 53 (group 3) uncompensated CPH. They were examined by the standard echoCG method using an Acuson-128 HR apparatus (USA) and 12-lead ECG during a 2 year-long follow-up period. Direct cardiac clinical and electrocardiographic signs of right ventricular eccentric hypertrophy were found to have high informative value (100%) but very low sensitivity (7-53%). Indirect diagnostic criteria of compensated CHP are such non-specific signs as age of COPD patients above 50 yr, duration of the disease over 8 yr and broncho-obstructive syndrome (episodes of low-productive cough, dyspnea under small physical load and at rest, X-ray signs of lung emphysema, substantial reduction of FEV and FEV/FVC ratio) in 73-94% of the patients were associated with compensated CPH. The most valuable (75.8-90.5%) cardiographic diagnostic criteria for compensated CPH were MPAP > 22 mmHg (at rest), LVEDD > 24 mm, LVEDS > 17 mm, RVWT = > 5 mm, RAEDD > 32 mm. Criterion LVEDD > 24 mm has the optimal ratio of sensitivity (94.4%), specificity (85.7%), and positive predictive value (86.6%). Comprehensive clinical assessment of COPD character and duration, patients' age, manifestation of broncho-obstructive syndrome and direct clinical signs suggesting involvement of the right half of the heart permits to predict CPH in patients with COPD with a probability of 75%. The definitive diagnosis is verified by echoCG or other instrumental methods.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011660 Pulmonary Heart Disease Hypertrophy and dilation of the RIGHT VENTRICLE of the heart that is caused by PULMONARY HYPERTENSION. This condition is often associated with pulmonary parenchymal or vascular diseases, such as CHRONIC OBSTRUCTIVE PULMONARY DISEASE and PULMONARY EMBOLISM. Cor Pulmonale,Disease, Pulmonary Heart,Diseases, Pulmonary Heart,Heart Disease, Pulmonary,Heart Diseases, Pulmonary,Pulmonary Heart Diseases
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D004452 Echocardiography Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic. Echocardiography, Contrast,Echocardiography, Cross-Sectional,Echocardiography, M-Mode,Echocardiography, Transthoracic,Echocardiography, Two-Dimensional,Transthoracic Echocardiography,2-D Echocardiography,2D Echocardiography,Contrast Echocardiography,Cross-Sectional Echocardiography,Echocardiography, 2-D,Echocardiography, 2D,M-Mode Echocardiography,Two-Dimensional Echocardiography,2 D Echocardiography,Cross Sectional Echocardiography,Echocardiography, 2 D,Echocardiography, Cross Sectional,Echocardiography, M Mode,Echocardiography, Two Dimensional,M Mode Echocardiography,Two Dimensional Echocardiography
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D016276 Ventricular Function The hemodynamic and electrophysiological action of the HEART VENTRICLES. Function, Ventricular,Functions, Ventricular,Ventricular Functions

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