Dynamic Changes in Right Ventricle and Pulmonary Artery Coupling Among COPD Patients With Acute Exacerbation

Condition(s) studied

Investigational drug(s) / intervention(s)

Echocardiography assessment: Echocardiography assessment with focus on pulmonary artery parameters, specially Pulmonary artery systolic pressure and tricuspid valve annular Plane Systolic Excursion

Study summary

Chronic obstructive pulmonary disease (COPD) is a common, preventable, and manageable disease characterized by persistent respiratory symptoms and airflow limitation. Acute exacerbations of COPD (AECOPD) are major events in the course of the disease and are associated with increased hospital admissions, accelerated decline in lung function, impaired quality of life, and increased mortality. Assessment of exacerbation risk remains a key component of COPD management according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD).

Beyond its respiratory manifestations, COPD may have important cardiovascular consequences. Chronic hypoxia, pulmonary vascular remodeling, inflammation, and increased pulmonary vascular resistance may contribute to elevated pulmonary artery pressures and right ventricular (RV) dysfunction. Pulmonary hypertension associated with chronic lung disease is clinically important because it may worsen symptoms, exercise tolerance, and prognosis.

During acute exacerbations, worsening hypoxemia, hypercapnia, dynamic hyperinflation, and increased respiratory workload may further increase pulmonary vascular resistance and RV afterload. Transthoracic echocardiography provides a practical non-invasive method for evaluating right ventricular function and pulmonary hemodynamics through parameters such as tricuspid annular plane systolic excursion (TAPSE), pulmonary artery systolic pressure (PASP), and the TAPSE/PASP ratio, a recognized marker of RV-pulmonary artery coupling.

Eligibility

Primary outcome measure(s)

• Change in TAPSE/PASP ratio between the acute exacerbation phase and the stable state (6-8 weeks after recovery) — 8 weeks
  Change in Tricuspid Annular Plane Systolic Excursion/Pulmonary Artery Systolic Pressure ratio between the acute exacerbation phase and the stable state (6-8 weeks after recovery)

Trial sites (1)

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