Análise da função ventricular de pacientes com doença pulmonar obstrutiva crônica avançada pela ressonância magnética

Abstract

Objective: To assess the mechanisms that may be involved in the evolution of right and left ventricular dysfunction in patients with chronic obstructive pulmonary disease (COPD). Methods: Magnetic resonance imaging was used in 11 control patients (group C) and 27 patients with COPD, who were divided into 2 groups, COPD c and COPD s, according to the presence or absence of right ventricular dysfunction, respectively. Doppler echocardiography was used for assessing the degree of pulmonary hypertension. Results: The right ventricular diameter was similar in the 3 groups, COPD s, COPD c and C (29±8 mm; 31±7 mm; and 30±6 mm; respectively, P=NS). Right ventricular hypertrophy was observed only in the COPD groups (8±2 mm and 9±3 mm vs 5±1 mm; P<0.01). The percentage of systolic right ventricular lateral wall thickening (%RVLWT) in the 3 groups were as follows: 86±82% vs 41±35% vs 86±89%; P=NS). Different left ventricular ejection fractions were observed in the groups as follows: 69±9% vs 55±16% vs 76±6%; P < 0.01. A positive and significant linear correlation was observed between the left ventricular (LV) diastolic diameter and the LV systolic volume (r = 0.72; P < 0.01). No correlation was observed between the pulmonary volumes, arterial blood gas analysis and ventricular function. Conclusion: We correlation was observed between the severity of pulmonary function and the degree of ventricular function impairment. Whether a preserved %RVLWT means the possibility of reversibility of right ventricular function remains to be elucidated. However, the presence of the phenomenon of ventricular inter-dependence was confirmed.