Right Ventricle Ejection Fraction Contributes Severity of Dyspnea in Chronic Obstructive Pulmonary Disease (COPD)

Jung Eun Lee; Bo Ram Min; Jae Seok Park; Hun Pyo Park; Mi Jung Jun; Kyung Sook Won; Won II Choi

doi:10.4046/trd.2006.60.06.631

Journal List > Tuberc Respir Dis > v.60(6) > 1000960

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Lee, Min, Park, Park, Jun, Won, and Choi: Right Ventricle Ejection Fraction Contributes Severity of Dyspnea in Chronic Obstructive Pulmonary Disease (COPD)

Original Article

Tuberc Respir Dis 2006;60(6):631-637.

Published online: 19 June 2006

DOI: https://doi.org/10.4046/trd.2006.60.06.631

Right Ventricle Ejection Fraction Contributes Severity of Dyspnea in Chronic Obstructive Pulmonary Disease (COPD)

Jung Eun Lee, M.D.¹, Bo Ram Min, M.D.¹, Jae Seok Park, M.D.¹, Hun Pyo Park, M.D.¹, Mi Jung Jun, M.S.², Kyung Sook Won, M.D.³, Won II Choi, M.D.^1,

¹Departments of Medicine

²Preventive Medicine

³Nuclear Medicine, Keimyung University School of Medicine, Daegu, Korea

Address for correspondence : Won-II Choi, M.D. Department of Medicine, Keimyung University School of Medicine 194 Dongsan-Dong, Jung-Gu, Daegu, 700-712, Korea Telephone : +82-53-250-7405 Fax : +82-53-250-7434 E-mail : wichoi@dsmc.or.kr

Received 18 April 2006 Accepted 0 June 2006

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background:

Patients with COPD generally complain of very different degrees of dyspnea regardless of their pulmonary function. The study, we assessed the right ventricular ejection fraction in relation to dyspnea in COPD patient.

Methods:

The pulmonary function including the diffusion capacity was measured. The right ventricle ejection fraction (RVEF) was measured using a first-pass radionuclide scan by multigated acquisition (MUGA). Forty patients with chronic obstructive pulmonary disease (COPD) were stratified for dyspnea according to the Medical Research Council (MRC) scale. Moderate dyspnea and severe dyspnea is defined as MRC 2/3 (n = 16) and MRC 4/5 (n = 24) respectively.

Results:

The baseline pulmonary function tests including DLCO and the resting arterial blood gas were similar in the moderate and severe dyspnea group, with the exception of the residual volume (% predicted) (moderate 160 ±27, severe 210 ±87, p < 0.03). The right ventricle ejection fraction was significantly (p < 0.001) lower in the severe dyspnea group (25 ±8) than in the moderate group (35 ±6). The independent factor assessed by multiple logistic regression revealed only the severity of dyspnea to be significantly associated with RVEF (p < 0.02).

Conclusion:

This study showed that the right ventricle ejection fraction would contributes to severity of dyspnea in patients with a similar pulmonary function

Keywords: COPD, Ejection fraction, Dyspnea.

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Table 1.

Characteristics and Lung function of the study subjects

Characteristic	Severe dyspnea (n = 24)	Moderate dyspnea (n = 16)	P value
Age, year	64 ±10	71 ±10	0.06
Male gender No. (%)	20 (83%)	11 (63%)	0.29
Smoker (pack/year)	38 ±5	37 ±6	0.96
BMI (kg/m2)	20 ±2	21 ±4	0.26
FVC (% predicted)	64 ±16	68 ±21	0.45
FEV1 (% predicted)	43 ±17	53 ±23	0.13
FEV1/FVC (%)	47 ±9	52 ±9	0.11
TLC (% predicted)	124 ±24	111 ±15	0.07
RV (% predicted)	210 ±87	160 ±27	0.03
DLCO (% predicted)	65 ±21	70 ±25	0.40
DLCO/VA (% predicted)	82 ±30	87 ±18	0.52

Values are patient number or means with standard deviation (percentage)

BMI = body mass index

FEV1 = forced expiratory volume in one second

FVC = forced vital capacity

TLC = total lung capacity

RV = residual volume

DLCO = carbon monoxide diffusion capacity

VA = alveolar volume

Table 2.

Right ventricle ejection fraction (RVEF) and resting blood gas of the study subjects

	Severe dyspnea (n = 24)	Moderate dyspnea (n = 16)	P value
RVEF	25 ±8	36 ±6	< 0.001
PCO2, mmHg	43 ±10	41 ±7	0.13
PO2, mmHg	68 ±16	76 ±16	0.22
HCO3-, mmol/L	26 ±4	27 ±3	0.69
O2 saturation (%)	91 ±6	94 ±2	0.07

Values are means with standard deviation

Table 3.

Factors associated with dyspnea in patients with COPD

	B	S.E.	Sig.	OR	95% CI
Age	0.01	1.29	0.19	1.10	0.95 ~ 1.28
Smoking	-0.04	-1.25	0.21	0.95	0.89 ~ 1.28
FEV1 (% predicted)	0.12	1.17	0.24	1.12	0.92 ~ 1.38
FEV1/FVC (%)	-0.05	-0.58	0.24	0.94	0.77 ~ 1.15
TLC (% predicted)	0.11	1.10	0.26	1.12	0.91 ~ 1.35
RV (% predicted)	-0.04	-1.17	0.24	0.95	0.88 ~ 1.03
DLCO (% predicted)	-0.06	-0.06	0.37	0.94	0.82 ~ 1.07
O2 Saturation (%)	0.31	0.31	0.59	1.37	0.42 ~ 4.44
RVEF	0.27	2.26	0.02	1.30	1.03 ~ 1.63

Abbreviations: B., regression coefficient; S.E., standard error; Sig., significance; OR, odd ratio; CI, confidence interval

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