Noninvasive imaging of the cardiopulmonary circulation in chronic obstructive pulmonary disease

PH leading to cor pulmonale, defined as right ventricular hypertrophy secondary to diseases that affect the structure or function of the lungs is often observed in patients with COPD. Evaluation of the development of cor pulmonale and monitoring of cardiac function in the course of the disease are, therefore, clinically important. Measurement of right ventricular and pulmonary artery pressures by means of right sided heart catheterization is often utilized to diagnose secondary pulmonary hypertension in COPD patients. However, the amputation of the pulmonary vascular bed must be higher than 50%-60% to induce resting PH² and, hence, PH occurs only in the late course of the disease. Therefore, there is a search for new techniques that are able to visualize cardiopulmonary hemodynamic changes in an early stage of the disease and make it possible to evaluate possible effects of therapy. This review covers a number of imaging techniques, which can be used for this purpose.