Abstract
Background: Cardiac dysfunction is common in COPD exacerbations and is associated with poor outcomes. We assessed cardiac function using measurements of natriuretic peptide NT-proBNP and cardiac MRI (CMR).
Methods: Patients admitted with COPD exacerbations were enrolled: 8 with high NT-proBNP (>220pmol/L) and 15 with normal NT-proBNP. CMR was done within 2 weeks and at clinical stability (≥30days later) that measured left and right ventricular ejection fraction, end-systolic and end-diastolic volume indices (LVEF, RVEF, LVESVi, RVESVi, LVEDVi, RDEDVi) and left ventricular mass index (LVMi). 3 had no stable CMR: 2 high NT-proBNP patients died and 1 did not reach clinical stability.
Results: Most had impaired LVEF and RVEF in both acute and stable CMR. There were no differences in LVEF and RVEF between high and normal NT-proBNP in acute (median LVEF 51%[IQR35-54] vs 52%[38-54] p=0.56; RVEF 42%[27-53] vs 44%[41-49] p=0.63) or stable CMR (LVEF 52%[43-53] vs 52%[44-58] p=0.59; RVEF 40%[36-44] vs 49%[45-53] p=0.115). RVESVi was higher in acute than stable CMR in normal NT-proBNP (35ml/m2[30-42] vs 33[29-39] p=0.02) but not in high NT-proBNP (46ml/m2[32-81] vs 47[43-76] p=0.69). High NT-proBNP had higher LVMi than normal NT-proBNP in acute (55g/m2[51-63] vs 42[34-51] p<0.01) and stable CMR (55g/m2[43-66] vs 40[35-53] p<0.05). High NT-proBNP also had higher LVEDVi, RVEDVi and RVESVi than normal NT-proBNP in stable CMR (p<0.05).
Conclusion: Low biventricular ejection fractions are common in COPD exacerbations. High right ventricular systolic volume during exacerbations in normal NT-proBNP may reflect compensatory mechanisms but was absent in high NT-proBNP. High NT-proBNP was associated with cardiac overload at clinical stability.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, OA1919.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019