QUANTITATIVE LEFT-VENTRICULAR CINEANGIOGRAPHY IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY-DISEASE

Using quantitative measurements from cineangiograms, left ventricular function was evaluated in 19 patients with disabling COPD [chronic obstructive pulmonary disease], 10 without and 9 with previous right-sided heart failure. None had clinical evidence of diseases known to affect left ventricular function. Severity of airway obstruction was similar in patients without and with prior right-sided heart failure, but hypoxemia and pulmonary hypertension were significantly more severe in the latter. Mean resting cardiac index, left ventricular filling pressure and end-diastolic volume were normal in both groups. In 16 patients (10 without and 6 with prior right-sided heart failure), left ventricular function was clearly normal, as indicated by normal left ventricular wall motion, ejection fraction and mean velocity of circumferential fiber shortening (VCF). The remaining 3 patients had abnormal left ventricular wall motion, ejection fraction and VCF; these abnormalities could probably be attributed to coronary artery disease in 2 of the 3 patients but could not be explained in the 3rd. Abnormal left ventricular function could not be correlated with the severity of COPD, hypoxemia or pulmonary hypertension. Left ventricular wall thickness and mass were normal in all, except for minimal increases in 1 patient without and 1 with prior right-sided heart failure. There are no previous reports of quantitative left ventricular cineangiography in patients with COPD, but the results are similar to those reported recently by investigators who measured ejection indices by other methods. A majority of patients with COPD, with or without right-sided heart failure, have normal left ventricular function in the absence of other heart disease.