Early changes of cardiac structure and function in COPD patients with mild hypoxemia

Anton Vonk-Noordegraaf, J Tim Marcus, Sebastiaan Holverda, Bea Roseboom, Pieter E Postmus

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BACKGROUND: COPD is often associated with changes of the structure and the function of the heart. Although functional abnormalities of the right ventricle (RV) have been well described in COPD patients with severe hypoxemia, little is known about these changes in patients with normoxia and mild hypoxemia.

STUDY OBJECTIVES: To assess the structural and functional cardiac changes in COPD patients with normal Pa(O2) and without signs of RV failure.

METHODS: In 25 clinically stable COPD patients (FEV1, 1.23 +/- 0.51 L/s; Pa(O2), 82 +/- 10 mm Hg [mean +/- SD]) and 26 age-matched control subjects, the RV and left ventricular (LV) structure and function were measured by MRI. Pulmonary artery pressure (PAP) was estimated from right pulmonary artery distensibility.

RESULTS: RV mass divided by RV end-diastolic volume as a measure of RV adaptation was 0.72 +/- 0.18 g/mL in the COPD group and 0.41 +/- 0.09 g/mL in the control group (p < 0.01). LV and RV ejection fractions were 62 +/- 14% and 53 +/- 12% in the COPD patients, and 68 +/- 11% and 53 +/- 7% in the control subjects, respectively. PAP estimated from right pulmonary artery distensibility was not elevated in the COPD group.

CONCLUSION: From these results, we conclude that concentric RV hypertrophy is the earliest sign of RV pressure overload in patients with COPD. This structural adaptation of the heart does not alter RV and LV systolic function.

Original languageEnglish
Pages (from-to)1898-903
Number of pages6
Issue number6
Publication statusPublished - Jun 2005


  • Aged
  • Analysis of Variance
  • Case-Control Studies
  • Female
  • Heart Function Tests
  • Humans
  • Hypertension, Pulmonary/complications
  • Hypertrophy, Right Ventricular/complications
  • Hypoxia/complications
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Prognosis
  • Pulmonary Disease, Chronic Obstructive/complications
  • Pulmonary Emphysema/complications
  • Regression Analysis
  • Respiratory Function Tests
  • Risk Assessment
  • Severity of Illness Index
  • Ventricular Function, Left/physiology
  • Ventricular Function, Right/physiology

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