PURPOSE: To assess of pulmonary hypertension (PH) expressiveness by using of transcutaneous Doppler Echo of right jugular vein (TDERJV) in COPD in-patients (pts) with acute exacerbation plus DM2 vs. only COPD pts.
METHODS: The 1-st group consisted of 55 COPD pts (aged 36-60 yrs, mostly males) plus DM2. 27%, 59%, 14% of these pts had mild-moderate-severe COPD respectively. The 2-nd group was formed of 40 comparable COPD pts. The control group consisted of 30 healthy. The mean pulmonary arterial pressure (mPAP), diameter of pulmonary artery trunk (DPAT), stroke volume of right ventricle (SVRV) were detected by standard Echo (SDE). Direction of flow (antegrade or retrograde), velocities of systolic (Sf) and diastolic flows (Df), which strongly correlated with the mPAP were determined by TDERJV. The ratio of velocities (Df/Sf) was evaluated, if the flow was biphasic. Then mPAP was calculated according to the diagram of W. Matsuyama.
RESULTS: We can not detect mPAP by SDE in 10 and 6 pts of the 1-st and 2-nd groups due to sever lung emphysema. The level of mPAP was the highest in the 1-st group vs. 2-nd and the control (32,2 mmHg vs. 29,0 and 16,0 mmHg respectively; p<0,05). We did not detect the significant difference of mPAP, DPAT, SVRV in mild COPD pts with or without DM2 vs. the control. There was a significance increase of mPAP (by 2,4 and 2,2 times), DPAT (by 18% and 15%) and decrease of SVRV (by 6% both) only in pts with moderate to severe COPD of 1-st and 2-nd groups respectively. The ratio of Df/Sf was increased in 1-st and 2-nd groups vs. control (by 1,8 and 1,4 times respectively, p<0,05). The level of mPAP according to TDERJV in moderate to severe COPD pts was about the same, that was obtained by SDE.
CONCLUSION: DM2 had a negative influence on pulmonary hemodynamics. Thus, PH was more severe in COPD plus DM2 pts vs. only COPD.
CLINICAL IMPLICATIONS: TDERJV allowed to determine mPAP in all COPD pts.
DISCLOSURE: Alexander Makarevich, None.