THE CONTRIBUTION OF THE ECHOCARDIOGRAPHY IN EVALUATING THE PATIENTS WITH SECONDARY CHRONICAL COR PULMONALE COPD
Abstract:
The classic non-invasive imagistic techniques which evaluate the structure and function of the
right ventricle (RV) in patients with COPD (chronic obstructive pulmonary disease) shows important
limitations caused by its complex geometry. They have a special importance in following the evolution of
the illness and the remodelling of the RV. Among the impediments in the classic echocardiography
evaluation of the right heart we can distinguish the difficult visualization of the front RV wall, because of
its retrosternal position, a difficult acoustic window in 10-20% of cases, diminished accuracy and
reproducibility of the measurements and ejection fraction of the right RV as a consequence of its
complex geometry. The calculation of the right RV volumes and ejection fraction do not represent ideal
methods for evaluating its function. The regional movement of the myocardial wall detected through the
M-mode echography and the tissue Doppler imaging (TDI) velocities seem to be the best methods used
in the actual practice. The evaluation of the RV function at patients with COPD is important because the
presence of the RV insufficiency has a reserved prognosis.
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