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Abstract
This study was planned to evaluate the contractile reserve (CR) of both right and left ventricles (RV &LV) in patients with chronic obstructive pulmonary disease (COPD) using dobutamine stress tissue Doppler imaging (TDI). A total of ٥٠ patients [٤٠ (٨٠٪) men, mean age ٥٢ ± ٨٫٦ years with clinically stable COPD and ١٥ healthy subjects were included in the study. ١٥ COPD patients had pulmonary artery pressure (PAP) ≥٣٥ mmHg (COPD/PH) and ٣٥ patients had PAP <٣٥ mmHg (COPD/no PH). TDI parameters were obtained from tricuspid and mitral annuli at rest and during dobutamine infusion. St and Sm were defined as the peak systolic velocities of tricuspid and average of four mitral annulus corners by TDI respectively Conventional echoDoppler parameters were obtained and respiratory function tests were assessed including; forced expiratory volume in one second (FEV١), forced vital capacity FVC and their ratios No significant difference at rest between COPD/PH and COPD/noPH regarding LV wall thickness LV systolic and diastolic diameters, LVEF% In COPD/PH mitral annular S (Sm) did differ between groups at rest but become significantly lower during stress. LV delay was significantly longer in COPD/PH. Tricuspid annular S (St) velocity was significantly lower in COPD/PH compared with COPD/noPH and control at rest and stress CR RV showed significant reduction in COPD/PH compared with COPD/noPH and control but no significant difference between COPD/noPH and control. Similarly CRLV was significantly lower in COPD/PH group compared with other groups. In COPD/PH CRRV was correlated positively with pulmonary ventilatory function, and negatively with RV delay, PAP