BETA BLOCKER THERAPY IMPROVES RIGHT VENTRICULAR FUNCTIONS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Year 2025, Volume: 26 Issue: 1, 33 - 38, 27.01.2025

Uğur Aksu , Deya Aksu , Emrah Aksakal , Fehim Can Sevil

https://doi.org/10.18229/kocatepetip.1436678

Abstract

OBJECTIVE: Chronic obstructive pulmonary disease (COPD) is a clinical condition with a high mortality and morbidity rate. Cardiac involvement is common in COPD patients. In this disease, beta-blocker (BB) treatment could not be used in sufficient doses most of the time since it is thought that this treatment may aggravate the disease. However, BB is the main drug therapy in patients with atherosclerotic heart disease. In this study, right ventricular (RV) functions were examined using speckle-tracking echocardiography in COPD patients under BB therapy.
MATERIAL AND METHODS: Patients, who were followed up with the diagnosis of COPD, were involved in the study. Patients under BB treatment for three months or more were assigned to Group 1 and patients with similar demographic and clinical features to the control group by using propensity score matching (PSM) analysis. Baseline demographic and clinical features of patients were compared, and the effects of BB treatment were analyzed.
RESULTS: After PSM analysis, right ventricular free-wall global strain (p <0.001), right ventricular global longitudinal strain (p <0.001), right ventricular right ventricular free-wall global strain rate (p: 0.001), and right ventricular global longitudinal strain rate (p: 0.005) were found to be significantly higher in Group 1.
CONCLUSIONS: COPD and atherosclerosis have similar pathways such as inflammation and endothelial dysfunction, and the use of BB in COPD patients may have a positive effect on the improvement of right ventricular functions. This effect can be demonstrated by making use of the deformation analysis rather than conventional parameters.

Keywords

Right ventricle, Strain, Strain rate imaging.

Ethical Statement

The Erzurum Training and Research Hospital Clinical Research Ethics Committee granted approval for this study (date: 06.06.2022, number: 2022/07-84)

Supporting Institution

None

BETA BLOKER TEDAVİSİ KRONİK OBSTRÜKTİF AKCİĞER HASTALIĞI OLAN HASTALARDA SAĞ VENTRİKÜLER FONKSİYONLARI İYİLEŞTİRİR

Abstract

AMAÇ: Kronik obstrüktif akciğer hastalığı (KOAH), mortalite ve morbidite oranı yüksek bir klinik tablodur. KOAH hastalarında kardiyak tutulum sık görülür. Bu hastalıkta beta bloker (BB) tedavisi, hastalığı ağırlaştıracağı endişesiyle çoğu zaman yeterli dozda kullanılamaz. Ancak aterosklerotik kalp hastalığı olan hastalarda BB ana ilaç tedavisidir. Bu çalışmada BB tedavisi alan KOAH'lı hastalarda sağ ventrikül (RV) fonksiyonlarını speckle tracking ekokardiyografi ile değerlendirildi.
GEREÇ VE YÖNTEM: Çalışmaya KOAH tanısı ile izlenen hastalar dahil edildi. Üç ay ve üzeri BB tedavisi alan hastalar grup-1 olarak oluşturuldu ve benzer demografik ve klinik özelliklere sahip hastalardan propensity skor eşleştirme (PSM) analizi ile kontrol grubu oluşturuldu. Hastaların temel demografik ve klinik özellikleri karşılaştırıldı ve BB tedavisinin etkileri incelendi.
BULGULAR: Toplam 75 çift (BB tedavisi alan 75 hasta ve benzer özelliklere sahip 75 hasta) çalışmaya dahil edildi. Hastaların yaş ortalaması 70±4,6 olup %73,7'si erkekti. PSM analizinden sonra; sağ ventriküler serbest duvar gerilimi (p <0,001), sağ ventriküler global longitudinal gerilimi (p <0,001), sağ ventriküler serbest duvar gerilim hızı (p: 0,001) ve sağ ventriküler global longitudinal gerilim hızı (p: 0,005) grup-1'de anlamlı olarak yüksekti.
SONUÇ: KOAH ve ateroskleroz, inflamasyon ve endotel disfonksiyonu gibi benzer yollara sahiptir ve KOAH hastalarında BB kullanımı sağ ventrikül fonksiyonlarını iyileştirmede olumlu bir etkiye sahip olabilir. Bu etki, geleneksel parametrelerden ziyade deformasyon analizinde gösterilebilir.

Keywords

Sağ ventrikül, Gerilim, Gerilim hızı görüntüleme.

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