Abdulaziz H. Alzeer, Abdulellah F. Al-Mobeirek, Hadil A. K. Al-Otair, Usama A. F. Elzamzamy, Ismail A. Joherjy and Ahmed S. Shaffi Chest 2008;133;468-473; Prepublished online December 10, 2007; DOI 10.1378/chest.07-1639 The online version of this article, along with updated information and servicescan be found online on the World Wide Web at: http://chestjournal.chestpubs.org/content/133/2/468.full.html
Chest is the official journal of the American College of Chest Physicians. It has been published monthly since 1935. Copyright2008by the American College of Chest Physicians, 3300 Dundee Road, Northbrook, IL 60062. All rights reserved. No part of this article or PDF may be reproduced ordistributed without the prior written permission of the copyright holder. (http://chestjournal.chestpubs.org/site/misc/reprints.xhtml) ISSN:0012-3692
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Right and Left Ventricular Function and Pulmonary Artery Pressure in Patients WithBronchiectasis*
Abdulaziz H. Alzeer, MBBS; Abdulellah F. Al-Mobeirek, MBBS; Hadil A. K. Al-Otair, MBBS, FCCP; Usama A. F. Elzamzamy, MBBS; Ismail A. Joherjy, MBBS; and Ahmed S. Shaffi, PhD
Background: Bronchiectasis may have deleterious effects on cardiac function secondary to pulmonary hypertension (PH). This study was designed to assess cardiac function and determine the prevalence of PH inpatients with cystic and cylindrical bronchiectasis. Methods: A cross-sectional study of patients with bronchiectasis diagnosed by CT scan was conducted at King Khalid University Hospital, Riyadh, Saudi Arabia between December 2005 and January 2007. Pulmonary function tests were performed, arterial blood gas measurements were made, and cardiac function and systolic pulmonary artery pressure(SPAP) were assessed by echocardiography. Results: Of 94 patients (31% men, n 29), 62 patients (66%) had cystic bronchiectasis and 32 patients (34%) had cylindrical bronchiectasis. Right ventricular (RV) systolic dysfunction was observed in 12 patients (12.8%), left ventricular (LV) systolic dysfunction was observed in 3 patients (3.3%), and LV diastolic dysfunction was observed in 11 patients (11.7%);all had cystic bronchiectasis. RV dimensions were significantly greater in the cystic bronchiectasis group, and were positively correlated with SPAP (p < 0.0001) and negatively correlated with PaO2 (p < 0.016). Other hemodynamic variables were not different between groups. PH in 31 patients (32.9%) was significantly greater in patients with cystic bronchiectasis compared with cylindricalbronchiectasis (p 0.04). In cystic bronchiectasis, SPAP was positively correlated with PaCO2 (p 0.001), and inversely correlated with PaO2 (p 0.03), diffusion capacity of the lung for carbon monoxide percentage (p 0.02), and FEV1 (p 0.02). Conclusions: RV systolic dysfunction and PH were more common than LV systolic dysfunction in bronchiectatic patients. LV diastolic dysfunction was mainly seen in severePH. We recommend detailed assessment of cardiac function, particularly LV diastolic function, in patients with bronchiectasis. (CHEST 2008; 133:468–473)
Key words: bronchiectasis; cardiac function; pulmonary hypertension Abbreviations: CO cardiac output; Dlco diffusion capacity of the lung for carbon monoxide; EDD end-diastolic diameter; FS fractional shortening; LV left ventricular; LVEDD leftventricular end-diastolic diameter; LVEF left ventricular ejection fraction; LVESD left ventricular end-systolic diameter; PH pulmonary hypertension; RA right atrial; RV right ventricular/ventricle; SPAP systolic pulmonary artery pressure; SV stroke volume; TLC total lung capacity
leads to structural lung tissue damage. It is manifested by repetitive productive cough and is occasionally...