Echocardiographic characteristics of cardiac performance in patients with exacerbation of chronic obstructive pulmonary disease in the dynamics of the disease

Introduction. Comorbid conditions in chronic obstructive pulmonary disease (COPD) can significantly worsen quality of life and prognosis, contribute to frequent exacerbations, and increase the risk of hospitalization. Aim. To study the effect of comorbid conditions on cardiac performance in patients with COPD exacerbation. Materials and methods. The study included 103 patients with COPD exacerbation, divided into two groups. The first group consisted of 36 patients without comorbid conditions, the second group – 67 patients with comorbidities. The control group included 25 persons without COPD. Repeated studies were conducted after 3–6 and 9–12 months. Lung function was assessed using spirometry before and after the bronchodilatory test, bodyplethysmography, and measuring the lung diffusion capacity using the CO single breath technique. The severity of dyspnea was assessed using the mMRC scale and quality of life using the CAT questionnaire. NT-proBNP levels were determined in blood plasma using immunochromatography. The structural and functional state of the heart was assessed using echocardiography with a 5 ms sector sensor at a frequency of 1.5–4.6 MHz with an assessment of global longitudinal strain of the ventricles using speckle tracking. Results. In both groups of patients during an exacerbation of COPD, we diagnosed changes in cardiac performance with a decrease in systolic and diastolic functions of both ventricles, which were most pronounced in the group of COPD patients with a comorbid background. According to the correlation analysis, these disorders are closely associated with the degree of bronchial obstruction and impaired diffusion lung capacity, associated with an increase in NT-proBNP levels. In the group without a comorbid background, partial correction of a number of echocardiographic indices was noted 3–6 months after the exacerbation. Conclusion. COPD exacerbations lead to significant changes in cardiac function, the severity of which significantly depends on the presence of comorbidity. The results of the analysis confirm the need for active cardiac monitoring in patients with COPD as a basis for improving clinical outcomes and reducing the burden of comorbid conditions.