Chronic Obstructive Pulmonary Disease (COPD) leads to pulmonary arterial hypertension at severe stage and so often affects the right ventricle but left ventricular function can also be impaired.

Investigate the impact of pulmonary arterial hypertension (PAH) observed in COPD patients on the LV function.

A case control study including 45 patients followed for chronic obstructive pulmonary disease with PAH constituting (group 1 and 30 healthy control subjects (group 2). All patients included are free from diabetes, hypertension, ischemic heart disease, valvular heart disease, cardiomyopathy and are all in sinus rhythm. The 2 groups have a comparable average age. Both group underwent an echocardiography exam (left ventricular mass, the systolic function of the LV, the Tei index, the peak velocity of the S wave of the mitral annulus at the tissue Doppler, the strain left ventricle, mitral profil and protodiastolic Emitral/Ea velocities ratio were assessed) and compared to each other.

There is no significant difference between the 2 groups regarding the left ventricular mass, the systolic function of the LV, the Tei index, the peak velocity of the S wave of the mitral annulus at the tissue Doppler and the strain left ventricle rate. However, the analysis of the diastolic function shows a significant decrease in the velocity of the protodiastolic Ea wave of the mitral annulus in group 1 (7.1±1.4cm/s vs. 12.8±1.7cm/s; P<0.01) as well as a significant elevation of the protodiastolic Emitral/Ea velocities ratio (14.4±1.9 vs. 8.1±1.2; P<0.01) suggesting the presence of severe diastolic dysfunction.

This study shows that pulmonary arterial hypertension in COPD patients affects especially LV diastolic function. LV/RV interdependence is probably the main cause.