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  2. Keyword: Pulmonary Disease, Chronic Obstructive / rehabilitation
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Original Article

Right Ventricular Functional Improvement after Pulmonary Rehabilitation Program in Patients with COPD Determined by Speckle Tracking Echocardiography

Batur Gonenc Kanar et al. Ipek Ozmen Elif Ozari Yildirim Murat Ozturk Murat Sunbul

Abstract

Background:

Although right ventricular (RV) dysfunction in pulmonary diseases has been associated with increased morbidity, tools for RV dysfunction identification are not well defined.

Objective:

The aim of this study was to evaluate the magnitude of RV dysfunction by means of speckle tracking echocardiography (STE) in patients with chronic obstructive pulmonary disease (COPD) and to investigate whether STE could be used as an index of RV improvement after a pulmonary rehabilitation (PR) program.

Methods:

Forty-six patients with COPD undergoing PR program and 32 age-sex matched healthy subjects were enrolled. RV function was evaluated at admission and after PR program by conventional two-dimensional echocardiography (2DE) and STE. In addition, exercise tolerance of subjects was evaluated using the six-minute walk test (6MWT).

Results:

COPD patients had worse RV function according to STE and 2DE as well. STE was more sensitive than conventional 2DE in determining RV improvement after PR program – RV global longitudinal strain (LS): 20.4 ± 2.4% vs. 21.9 ± 2.9% p < 0.001 and RV free wall LS: 18.1 ± 3.4% vs. 22.9 ± 3.7%, p < 0.001). RV free wall LS was directly related to distance walked at baseline 6MWT (r = 0.58, p < 0.001) and to the change in the 6MWT distance (6MWTD ∆) (r = 0.41, p = 0.04).

Conclusions:

We conclude that STE might be as effective as 2DE for evaluation of global and regional RV functions. STE may become an important tool for assessment and follow-up of COPD patients undergoing PR program to determine the relationship between RV function and exercise tolerance.

  • Echocardiography/methods
  • Pulmonary Disease, Chronic Obstructive / rehabilitation
  • Strain, Speckle Tracking
  • Ventricular Dysfunction, Right / rehabilitation
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Creative Commons Attribution (CC BY) Creative Commons license
06/08/2018 DOI: 10.5935/abc.20180123
IJCS
Original Article

Influence of Pulmonary Rehabilitation on Clinical Characteristics in Patients with Chronic Heart Failure and Chronic Obstructive Pulmonary Disease

Ganna S. Smyrnova et al. Tetiana M. Babkina Gennadii G. Taradin Mykola T. Vatutin

Abstract

Background:

The improvement of treatment strategies in patients with chronic obstructive pulmonary disease (COPD) and especially with comorbid pathology should provide rational conversion of standard schemes of therapy and rehabilitation in accordance with their clinical, pathogenic, functional and economic feasibility.

Objective:

To assess the influence of pulmonary rehabilitation on clinical characteristics in patients with chronic heart failure (CHF) and concomitant COPD.

Methods:

The study included 102 patients with CHF and concomitant COPD (males, 62%; mean age, 68.2 ± 4.5 years). All patients were divided into two groups: control group (CG) (n = 54), received only standard therapy of CHF and COPD; and intervention group (IG) (n = 48) were additionally taught the full yogic breathing as a program of pulmonary rehabilitation. Calculation of points by clinical evaluation scale (CES), assessment of CHF functional class (FC) (NYHA) and 6-minute walk test (6MWT – with the evaluation of dyspnea by the Borg scale) were performed in all patients on admission to the department and at discharge. Significant association was defined by p value < 0.05.

Results:

At baseline, there were no significant differences in clinical characteristics of the patients and studied parameters between the groups. At discharge both groups showed significant reduction of dyspnea by the Borg scale (in CG: from 7.2 ± 0.8 points to 5.2 ± 0.3; in IG: from 7.4 ± 0.6 points to 3.2 ± 0.4), the number of points by CES (in CG: from 10.8 ± 0.3 points to 7.2 ± 0.4; in IG: from 10.7 ± 0.6 points to 5.9 ± 0.6). Increase in exercise tolerance (by the distance of 6MWT) was observed in both groups (in CG: from 215 ± 24 m to 275 ± 22 m; in IG: from 219 ± 21 m to 308 ± 24 m). The changes were more significant in IG compared to CG. We observed the prominent decrease in CHF FC and length of hospital stay in IG.

Conclusions:

Application of full yogic breathing as the program of pulmonary rehabilitation in addition to standard therapy of the patients with CHF and COPD is associated with a significant decrease in CHF FC, an increase in exercise tolerance and a reduced length of hospital stay.

  • Cardiac Insufficiency / physiopathology
  • Exercise Therapy
  • Oxygen Consumption
  • Pulmonary Disease, Chronic Obstructive / rehabilitation
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Creative Commons Attribution (CC BY) Creative Commons license
30/07/2018 DOI: 10.5935/2359-4802.20180051

How to cite this article

EndNote RIS

Electronic Document Format (Vancouver)

Kanar BG, Ozmen I, Yildirim EO, Ozturk M, Sunbul M. Right Ventricular Functional Improvement after Pulmonary Rehabilitation Program in Patients with COPD Determined by Speckle Tracking Echocardiography. Arquivos Brasileiros de Cardiologia 2018;111(3):375-81.

Electronic Document Format (ABNT)

Kanar, Batur Gonenc; Ozmen, Ipek; Yildirim, Elif Ozari; Ozturk, Murat; Sunbul, Murat. Right Ventricular Functional Improvement after Pulmonary Rehabilitation Program in Patients with COPD Determined by Speckle Tracking Echocardiography. Arquivos Brasileiros de Cardiologia, v. 111, n. 3, p. 375-381, Aug. 2018.

Electronic Document Format (APA)

Kanar, B. G., Ozmen, I., Yildirim, E. O., Ozturk, M., & Sunbul, M. (2018). Right Ventricular Functional Improvement after Pulmonary Rehabilitation Program in Patients with COPD Determined by Speckle Tracking Echocardiography. Arquivos Brasileiros de Cardiologia, 111(3), 375-381.

Electronic Document Format (ISO)

Kanar, Batur Gonenc and Ozmen, Ipek and Yildirim, Elif Ozari and Ozturk, Murat and Sunbul, Murat. Right Ventricular Functional Improvement after Pulmonary Rehabilitation Program in Patients with COPD Determined by Speckle Tracking Echocardiography. Arquivos Brasileiros de Cardiologia [online]. 2018, vol. 111, n. 3, [cited 2026-10-14], pp. 375-381. Available from: <https://journals.cardiol.br/en/article/right-ventricular-functional-improvement-after-pulmonary-rehabilitation-program-in-patients-with-copd-determined-by-speckle-tracking-echocardiography/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Smyrnova GS, Babkina TM, Taradin GG, Vatutin MT. Influence of Pulmonary Rehabilitation on Clinical Characteristics in Patients with Chronic Heart Failure and Chronic Obstructive Pulmonary Disease. International Journal of Cardiovascular Sciences 2018;31(5):499-504.

Electronic Document Format (ABNT)

Smyrnova, Ganna S.; Babkina, Tetiana M.; Taradin, Gennadii G.; Vatutin, Mykola T.. Influence of Pulmonary Rehabilitation on Clinical Characteristics in Patients with Chronic Heart Failure and Chronic Obstructive Pulmonary Disease. International Journal of Cardiovascular Sciences, v. 31, n. 5, p. 499-504, Jul. 2018.

Electronic Document Format (APA)

Smyrnova, G. S., Babkina, T. M., Taradin, G. G., & Vatutin, M. T. (2018). Influence of Pulmonary Rehabilitation on Clinical Characteristics in Patients with Chronic Heart Failure and Chronic Obstructive Pulmonary Disease. International Journal of Cardiovascular Sciences, 31(5), 499-504.

Electronic Document Format (ISO)

Smyrnova, Ganna S. and Babkina, Tetiana M. and Taradin, Gennadii G. and Vatutin, Mykola T.. Influence of Pulmonary Rehabilitation on Clinical Characteristics in Patients with Chronic Heart Failure and Chronic Obstructive Pulmonary Disease. International Journal of Cardiovascular Sciences [online]. 2018, vol. 31, n. 5, [cited 2026-10-14], pp. 499-504. Available from: <https://journals.cardiol.br/en/article/influence-of-pulmonary-rehabilitation-on-clinical-characteristics-in-patients-with-chronic-heart-failure-and-chronic-obstructive-pulmonary-disease/>. ISSN 2359-4802

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