SESSION TITLE: COPD Diagnosis & Evaluation Posters
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM
PURPOSE: Differential diagnostic consideration of serum Homocysteine (Hcy) levels in chronic obstructive pulmonary disease (COPD) , cigarette smoking, patients (Pts) aims to evaluate possible coincident dyspnea of any other latent etiology.
METHODS: 42 COPD Pts,32 males and 10 females (mean age 68±13.5 years) with no history of cardiovascular pathology and 33,matched control,normal subjects were submitted to clinical examination,ECG,Pulmonary function tests(PFTs) and arterial blood gasses(ABGs),echocardiography and serum Biomarkers evaluation,including primarily Homocysteine (Hcy) levels,statistically correlated with all indices studied.
RESULTS: 1) Moderate hypoxemia,alveolo-arterial oxygen difference [P(A-a)O2] = 46 mm Hg and respiratory impairment of mixed type. 2) ECG indices of Cor pulmonale 3) Ejection fraction (EF) = 60±13%, left atrial dimention (LAD) = 4.3 cm ,right ventricular internal dimention (RVID ) =2.9 cm ,right ventricular systolic pressure (RVSP) =46±14 mm Hg,ASH =1.5 4) Serum Hcy levels =18 μmol/L,NT-ProBNP = 3376 pg/ml, Troponin-I (Tr-I) = 0.45 ng /ml , 5 )Significant correlations were found between Hcy and NT-ProBNP ( r = 0.690 ), Tr-I ( r = 0.690), ASH ( r =0.780), Urea ( r =0.540) , creatinine (r = 0.840 ) and carnitine ( r = 0.470 ), 6 ) No statistical correlations were recognized between Hcy and PFTs or ABGs.
CONCLUSIONS: 1) COPD Pts presented mixed respiratory impairment with increased P(A-a)O2 , 2) Increased RVSP with frequently normal EF presented in 52% of Pts , 3) Significant correlations of Hcy, especially with NT-ProBNP and Tr-I, indicates co-existance of congestive ventricular pathophysiology,due to latent ischemic dysfunction, myocardial cell apoptosis and damage, followed by significant metabolic correlations of Hcy with plasma urea and creatinine levels, 4) PFTs and ABGs remain independent original factors of COPD dyspnea, 5) In every day clinical practice, regarding COPD pts, latent ischemic dysfunction with possibly consequent congestive indices should always be evaluated to select proper combined therapy for COPD dyspnea individuals.
CLINICAL IMPLICATIONS: Further studies should be carried out to determine COPD dyspnea Pts category and further sustain evaluation of ischemic and congestive indices, indicating proper,specific and combined therapy.
DISCLOSURE: The following authors have nothing to disclose: Ioannis Angomachalelis, George Kyriazis, Nestor Angomachalelis
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