Study of Right Ventricular Dysfunction in Patients with Chronic Obstructive Pulmonary Disease Using Echocardiography

Abstract

Background
Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disorder associated with significant cardiovascular complications, particularly right ventricular (RV) dysfunction due to chronic hypoxia, pulmonary vascular remodeling, and increased pulmonary vascular resistance. Early detection of RV impairment is essential for risk stratification and management. Echocardiography provides a non-invasive approach for evaluating right ventricular structure and function in COPD patients.

Aim
The present study aimed to assess right ventricular dysfunction among patients with COPD using echocardiographic parameters and to evaluate its association with disease severity and serum CA125 levels.

Materials and Methods
This prospective observational study included 70 patients with COPD. All participants underwent detailed clinical assessment, spirometric evaluation, serum CA125 estimation, and transthoracic echocardiography. Right ventricular function was assessed using parameters including tricuspid annular plane systolic excursion (TAPSE), right ventricular fractional area change (RVFAC), tissue Doppler-derived systolic velocity (S′), right ventricular myocardial performance index (MPI), and pulmonary artery systolic pressure (PASP).

Results
The mean age of participants was 61.8 ± 8.6 years, with male predominance (82.9%). Right ventricular dysfunction was identified in 24 (34.3%) patients. Patients with RV dysfunction demonstrated significantly lower TAPSE (15.2 ± 2.1 mm vs 19.8 ± 2.9 mm; p<0.001), reduced RVFAC (29.8 ± 5.6% vs 39.8 ± 6.2%; p<0.001), and higher PASP (55.6 ± 10.8 mmHg vs 31.6 ± 7.5 mmHg; p<0.001) compared with patients having preserved RV function. RV dysfunction was significantly associated with advanced COPD severity. Serum CA125 levels were significantly elevated among patients with RV dysfunction (48.6 ± 18.9 vs 24.8 ± 10.6 U/mL; p<0.001).

Conclusion
Right ventricular dysfunction is a common cardiovascular manifestation in COPD and is associated with disease severity, elevated pulmonary artery pressure, and increased CA125 levels. Echocardiographic assessment provides a valuable, non-invasive method for early detection of RV involvement and may improve prognostic evaluation and clinical management of COPD patients.