CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN NON-ISCHEMIC, DILATED HEART FAILURE: LINK BETWEEN AIR FLOW LIMITATION AND LEFT VENTRICULAR WALL STRESS
Rmadan Shawki* and Tarek Dabash**
Departments of Chest Disease* and Cardiology** Faculty of Medicine, Al-Azhar University
Background: the link between heart and lung and interaction between both systems is will-known. However, the link between air flow limitation and left ventricle wall stress is under investigated. Aim of the work: to investigate the association between respiratory function tests and left ventricle wall stress in patients presented with concomitant heart failure and chronic obstructive heart disease (COPD). Patients and methods: Thirty patients were included. Patient demographics, weight and height were documented and BMI was calculated. All patients underwent spirometry and echocardiographic examination. Finally, left ventricle wall stress was calculated by the equation; and brain natriuretic peptide was estimated by immune-assay. Patients were allocated to three groups according to GOLD criteria. These groups were mild (GOLD I), moderate (GOLD II) and severe (GOLD III). Results: no significant difference was found between different groups regarding demographics, anthropometric measurements and drugs used by those patients at enrollment of the study. However, patients with severe COPD disease had significant air flow limitation; increased PaCO2, decreased PaO2; decreased ejection fraction, increased heart volumes, and decreased deceleration time. In addition, both systolic and diastolic left ventricle wall stress and brain natriuretic peptide (BNP) were significantly increased in severe disease. Finally, there was negative correlation between respiratory function tests with left ventricle wall stresses and BNP, while BNP was positively correlated with left ventricle walls stresses. Conclusion: air flow limitation was significantly associated with increased left ventricle wall stress.