Geometria do ventrículo esquerdo em pacientes com DPOC: há associação com a limitação ao fluxo aéreo, capacidade funcional e força de preensão manual?
Heubel, Alessandro Domingues
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Introduction: Chronic obstructive pulmonary disease (COPD) and changes in left ventricular (LV) geometry often coexist. Conditions such as airflow limitation, decreased functional capacity and reduction of peripheral muscle strength are characteristic of COPD patients, but the relationship of these with LV geometry is unknown. Objective: To verify whether LV geometry is associated with airflow obstruction, functional capacity and handgrip strength in COPD patients. Methods: Thirty-seven COPD patients (GOLD II, III and IV) were assessed by transthoracic echocardiography and divided according to LV geometry: normal (n = 13), concentric remodeling (n = 8) and concentric LV hypertrophy (n = 16). Other evaluations included: (i) lung function; (ii) functional capacity, measured by Duke Activity Index (DASI); and (iii) handgrip strength, measured by hydraulic dynamometer. Intergroup comparison was performed using the Kruskal Wallis One-Way ANOVA test, followed by the appropriate post hoc. Correlations were obtained by the Pearson test. In all analyzes, the level of significance was set at 5%. Results: Concentric LV hypertrophy group presented lower DASI score (p = 0.045) and handgrip strength (p = 0.006) when compared to normal group. Correlations analysis showed the following results: relative wall thickness was negatively correlated with forced expiratory volume in the first second (FEV1) (r = -0.380; p = 0.025) and DASI score (r = -0.387, p = 0.018); LV mass index was negatively correlated with handgrip strength (r = -0.363, p = 0.038). Conclusion: In COPD patients, LV geometry is associated with airflow limitation, functional capacity and handgrip strength. Specifically, LV concentric remodeling is associated with increased airflow limitation and decreased functional capacity, and increased LV mass is associated with decreased handgrip strength.