Clinical profile in chronic obstructive pulmonary disease patients and their evaluation with spirometry and 2d echo

Introduction: Chronic obstructive pulmonary disease (COPD) is defined as a disease state characterized by airflow limitation that is not fully reversible. The Global Burden of Disease Study has projected that COPD, which ranked sixth as the cause of death in 1990, will become the third leading cause of death worldwide by 20202.The pooled global prevalence of COPD in adults 40 years or older is approximately 9 to 10% and is higher in smokers than non smokers, and is higher in men than in women. COPD includes emphysema, chronic bronchitis and small airway disease. Aims and Objectives: To study the clinical profile of Chronic Obstructive Pulmonary disease patients. Evaluation of COPD patients with spirometry and 2D Echocardiography. To correlate between spirometry and 2D Echocardiography findings. Evaluation of left ventricular function in COPD patients by 2D Echocardiography. Material s and Methods: The proposed study is comprised of 100 patients of COPD admitted in Dr. V. M. Govt. Medical College, Solapur. (Maharashtra) (India) They were studied clinically and with routine laboratory investigations, ECG, chest x ray, pulmonary function tests on spirometry and 2D and Doppler Echocardiography during their hospital stay. Inclusion criteria: Patients who present with symptoms suggestive of COPD like dyspnea, chronic cough with or without sputum production. Spirometry showing ratio of forced expiratory volume in one second (FEV1) to forced vital capacity (FVC) expressed in percentage less than 70%. Exclusion criteria: Pulmonary tuberculosis, Pneumonia, Bronchiectasis. Pneumoconiosis. Primary cardiovascular or renal disease particularly if these result in pulmonary edema. Patients with rheumatic valvular heart disease, Ischemic heart disease and hypertension. Patients with Bronchial Asthma. Results: All patients in our study were more than 40 years of age indicating a rising trend of COPD in patients above the age of 40 years. The mean age was 62 ± 9 years. In our study COPD was predominantly found in males, comprising 80% of the total patients and Male: Female= 4:1. 75% of the patients in our study were smokers indicating higher incidence of COPD in smokers than non smokers. The common symptoms were dyspnea and cough with expectoration. Most common sign was wheeze present in 70% of COPD patients in our study. Conclusions: 1) 25% of the patients had normal chest x-ray. Changes observed in chest x-ray were prominent bronchovascular markings, changes of emphysema, prominent central pulmonary artery and cardiomegaly. 2) 50% of the patients had normal ECG. Most common ECG finding in our study was P pulmonale present in 40% of the patients. 3) Spirometry is an essential tool to establish the diagnosis and grading of severity of COPD by calculating FEV1 % predicted and FEV1/ FVC.