Echocardiographic abnormalities and their impact on health status in patients with COPD referred for pulmonary rehabilitation

Sarah Houben-Wilke*, Martijn A. Spruit, Nicole H. M. K. Uszko-Lencer, Gosia Otkinska, Lowie E. G. W. Vanfleteren, Paul W. Jones, Emiel F. M. Wouters, Frits M. E. Franssen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background and objectiveBoth patients with cardiac diseases as well as those with COPD report an impaired health status. The frequencies of objectively assessed co-morbid cardiac diseases and their impact on health status in patients with COPD are unknown. We aimed to investigate echocardiographic abnormalities and their impact on health status in a large cohort of patients with COPD referred for pulmonary rehabilitation (PR).

MethodsIn this cross-sectional, observational analyses, demographic and clinical characteristics were assessed during an inpatient pre-PR assessment. All patients underwent Doppler echocardiographic evaluation. Health status was assessed using the COPD Assessment Test (CAT), Clinical COPD Questionnaire (CCQ) and St George's Respiratory Questionnaire (SGRQ).

ResultsA total of 514 patients (55.3% males, age: 64.1 (9.1) years, forced expiratory volume in 1s (FEV1 ): 48.6 (20.0) % predicted) were included for analyses. Two hundred and seventy-six patients (53.7%) were diagnosed with one or more echocardiographic abnormalities. Most prevalent were left ventricular (LV) hypertrophy (LVH, 31.0%), increased right ventricular systolic pressure (RVSP, 20.4%) and impaired LV ejection fraction (LVEF, 16.5%). Of the 276 patients, 176 (63.8%) with echocardiographic abnormalities did not have these recorded in their medical history. Patients with echocardiographic abnormalities reported a worse health status as assessed with the SGRQ total score (62.5 (17.1) vs 59.3 (17.6) points, P=0.044). CCQ and CAT did not differ between groups.

ConclusionMore than half of the patients referred to PR had echocardiographic abnormalities of which two-third did not have them recorded in their medical history. We detected a limited impact of echocardiographic abnormalities on health status.

Echocardiographic abnormalities occurred in almost 54% of the patients with COPD, two-third were previously unknown. Although we only detected a limited impact of echocardiographic abnormalities on health status, early identification and treatment of cardiac co-morbidities may be important for the patients' safety and prognosis.

Original languageEnglish
Pages (from-to)928-934
Number of pages7
JournalRespirology
Volume22
Issue number5
DOIs
Publication statusPublished - Jul 2017

Keywords

  • Chronic Obstructive Pulmonary Disease Assessment Test
  • Clinical Chronic Obstructive Pulmonary Disease Questionnaire
  • co-morbidity
  • echocardiography
  • St George's Respiratory Questionnaire
  • QUALITY-OF-LIFE
  • LEFT-VENTRICULAR HYPERTROPHY
  • HEART-FAILURE
  • RESPIRATORY QUESTIONNAIRE
  • CARDIOVASCULAR-DISEASE
  • FUNCTIONAL STATUS
  • COMORBIDITIES
  • OUTCOMES
  • HYPERTENSION
  • VALIDATION

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