Emerging role of transesophageal echocardiography in severe chronic obstructive pulmonary disease

2016-06-06T03-14-12Z
Source: International Journal of Research in Medical Sciences
Ashwin Songara, Nikhilesh Pasari, Arpita Ajmera, Kapil Jangid, Divya Malpani, Mriganka Madhab Misra.
Background: Pulmonary hypertension (PH) secondary to chronic obstructive pulmonary disease (COPD) has a prevalence from 20 to 91% depending on the definition of PH (mPAP >20 versus >25 mmHg). Pulmonary vasoconstriction, pulmonary vascular remodeling, endothelial dysfunction, inflammation and destruction of the pulmonary vascular bed being the common mechanisms behind. Transthoracic echocardiograms (TTE) though the most important non-invasive tool to measure degree of PH, may give false negative results in severe COPD cases due to poor echo window. This could be overcome by doing transesophageal echocardiograms (TEE) in those cases, which is, though invasive but gives good results. The aim of the study was to evaluate the role of transesophageal echocardiography in COPD patients. Methods: Total 100 patients of COPD were evaluated for PH via TTE and TEE was performed in all those 33 patients whose TTE were non-confirmatory due to poor echo window. Results: There were 0% patient with poor echo window in COPD grade 1, 18.18% in grade 2, 42.2% and 39.39% in grade 3 and grade 4 respectively. P-value obtained was statistically significant P


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