Chronic obstructive pulmonary disease (COPD) is a common and treatable disease in the general population, accounting for high morbidity and mortality rates. In patients with severe COPD, hypoxemia is the main cause of complications such as pulmonary hypertension (PH) and right ventricle (RV) dysfunction. However, the presence of RV vascular structural and functional changes may occur in the early stages of COPD, even before significant hypoxemia or PH. Subclinical RV dysfunction often precedes the development of signs and symptoms of RV failure; thus, there is an evident need to detect it from the onset of the disease.

The importance of the RV in cardiovascular physiology has been underestimated for decades. Previously considered a mere conduit, the chamber is now known to play a major role in maintaining global cardiac function intact. Impairment of RV systolic function is an essential determinant of clinical outcomes in different scenarios and should thus be considered in the individualized management of patients.^,

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