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Echocardiographic predictors of outcome in patients with chronic obstructive pulmonary disease
Author(s) -
Stankovic Ivan,
Marcun Robert,
Janicijevic Aleksandra,
Farkas Jerneja,
Kadivec Sasa,
Ilic Ivan,
Neskovic Aleksandar N.,
Lainscak Mitja
Publication year - 2017
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.22433
Subject(s) - medicine , cardiology , hazard ratio , copd , mitral regurgitation , proportional hazards model , confidence interval , regurgitation (circulation) , tricuspid valve
Background We aimed to assess the relationship between echocardiographic characteristics and mortality in patients with chronic obstructive pulmonary disease (COPD). Methods We prospectively studied 154 patients (mean age 71 ± 10 years, 71% male) with COPD. All patients underwent transthoracic Doppler echocardiography within 48 hours of hospital admission. Primary endpoint was all‐cause mortality during a median period of 22 months. Results Mildly elevated tricuspid regurgitation pressure and mitral E/e′ ratio were the most commonly encountered echocardiographic abnormalities, observed in 60% and 56% of patients, respectively. In Kaplan‐Meier analysis of survival, left atrial enlargement, E/e′ ratio > 8, right atrial enlargement, right ventricular dilation, decreased tricuspid annular plane systolic excursion, decreased tricuspid annular systolic velocity, and elevated tricuspid regurgitation velocity were associated with all‐cause mortality ( p < 0.05 for all). In the Cox proportional hazards analysis, the mitral E/e′ ratio (hazard ratio 1.048; 95% confidence interval 1.001–1.096) remained an independent echocardiographic predictor of survival after adjustment for age, COPD severity, and other baseline echocardiographic parameters. Conclusions Among patients with COPD, an abnormal mitral E/e′ ratio was an independent echocardiographic predictor of all‐cause mortality. Echocardiographic evaluation of structural and functional cardiac abnormalities provides important prognostic information and should be used routinely in the assessment of patients with COPD. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45 :211–221, 2017;