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World Journal of Pharmaceutical
and Medical Research

An International Peer Reviewed Journal for Pharmaceutical and Medical Research and Technology
An Official Publication of Society for Advance Healthcare Research (Reg. No. : 01/01/01/31674/16)
ISSN 2455-3301
IMPACT FACTOR: 4.639

ICV : 78.6

Abstract

COMPARATIVE STUDY BETWEEN BIVENTRICULAR DIASTOLIC DYSFUNCTION IN PATIENTS WITH COPD AND BRONCHIAL ASTHMA DURING EXACERBATION AND STABLE CONDITIONS

Inass M. Taha (MD), Ahmed Abdel Sadek (MD) and Tarek S.Z. Soliman (MD)

ABSTRACT

Objectives: To compare right and left ventricular diastolic dysfunction in patients with chronic obstructive pulmonary disease (COPD) and bronchial asthma patients during exacerbation and in between the attacks. Methods: Thirty patients, 22 males and 8 females, 56 ± 10 years old, with COPD: Group I, were compared to thirty asthmatic patients, 20 males and 10 females, 55 ± 8 years old, Group II. Complete echo-Doppler study and spirometry were done to all patients during exacerbation and in between the attacks. Results: In group I with COPD, right ventricular wall thickness (RVWT), right ventricular end diastolic area (RVEDA) and right atrial area (RAA) were increased significantly in addition to a significant decrease in pulmonary acceleration time (ACT) and ACT/ET ratio (ET: ejection time), compared to asthmatic group II, (P<0.05). In group I with COPD, mitral E/A ratio was decreased and isovolumic relaxation time (IVRT) was increased significantly when compared to other studied asthmatic group II, (P<0.05), reflecting LV diastolic dysfunction. It was also found, In group I with COPD, right ventricular end diastolic area (RVEDA) and right atrial area (RAA) were increased significantly together with a significant decrease in pulmonary acceleration time (ACT) and ACT/ET ratio (ET: ejection time), in addition, mitral E/A ratio was decreased and isovolumic relaxation time (IVRT) was increased significantly during exacerbation when compared to in between the attacks in the same group I, (P<0.05). Also, there was a significant inverse correlation between FEV1 and diastolic dysfunction parameters in group I with COPD only. Conclusion: RV dilatation and Doppler evidence of pulmonary hypertension and LV diastolic dysfunction were reported in all patients with COPD compared to asthmatics with more profound RV affection associated with higher pulmonary artery pressure and more impairment of diastolic function parameters during exacerbation in COPD patients. Further studies are recommended in high risk COPD patients with concomitant diabetes, hypertension or with evidence of coronary heart disease.

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