Left ventricular hypertrophy prevalent in lung disease patients

Jan 25 2013

By Mark Cowen, Senior medwireNews Reporter

The prevalence of left ventricular hypertrophy (LVH) is increased in normoxemic patients with chronic obstructive pulmonary disease (COPD), results from a pilot study suggest.

The research team found that around a third of COPD patients with normal blood oxygen saturation levels met echocardiographic criteria for LVH based on LV mass index (>95 g/m² in women and >115 g/m² in men).

"Given the pivotal role of LVH as a cardiovascular risk factor, and given the greater cardiovascular disease in COPD, further studies are warranted to see if regression of LVH in COPD reduces cardiovascular events and mortality, as it does in other patient cohorts," comment Jacob George (University of Dundee, UK) and colleagues.

"Indeed, a focus on aggressive cardiovascular risk reduction along with LVH regression in COPD may provide a greater benefit than improving lung function by an increment of a few milliliters with new and expensive inhaled therapies," they add.

The findings come from a study of 93 patients with COPD, who had a mean forced expiratory volume in 1 second of 70.0% predicted, and 34 controls matched for gender, body mass index, and alcohol consumption. The mean age of patients with COPD was around 10 years greater than that of controls, at 68.1 versus 57.8, and they were more likely to be current smokers (34.4 vs 5.9%).

Mean oxygen saturation, 24-hour blood pressure levels, LV ejection fraction, and B-type natriuretic peptide levels were normal in COPD patients and controls.

However, the researchers found that 30.1% of COPD patients met criteria for LVH compared with 20.6% of controls. Indeed, mean LV mass index was significantly higher in COPD patients than controls, at 96.2 versus 82.9 g/m².

Furthermore, mean LV mass index remained significantly greater in COPD patients than controls after excluding those with a history of hypertension, at 94.5 versus 79.9 g/m², or those with 24-hour systolic blood pressure levels greater than 135 mmHg, at 96.7 versus 82.5 g/m².

The researchers also found that, among COPD patients, women were more likely to have LVH than men, at 43.2% versus 21.4%. No such gender difference was observed in controls.

George and team conclude in Chest: "We have demonstrated an increased prevalence of LVH in normoxemic and normotensive patients with COPD, with a particularly high prevalence in women."

They add: "Clinical trials are, therefore, indicated to evaluate treatments to regress LVH in patients with COPD."

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