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State of the Art Review of the Right Ventricle in COPD Patients: It is Time to Look Closer

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Abstract

Since the first description of pulmonary circulation in the 16th century, the knowledge of the complex interaction between the heart and lungs has greatly improved. Hypoxemia plays a classical role in the development of complications such as pulmonary hypertension and right ventricle (RV) dysfunction in patients presenting with chronic obstructive pulmonary disease (COPD). However, more recent results have revealed the presence of RV vascular structural and functional changes even in patients with mild COPD, without hypoxemia or pulmonary hypertension at rest. Compared to the left ventricle, the anatomy of the RV is unique and complex, which makes its assessment more difficult during routine exams. Therefore, it is common that very little attention is paid to its study. In this article, the physiological aspects of pulmonary circulation and the RV, as well as their impairment in COPD patients, are presented. In addition, important aspects of the recommendations for RV assessment using echocardiography are approached and studies that used other complementary exams to evaluate RV structure and function are revisited. Finally, the findings of studies that assessed the impact of RV dysfunction in the prognosis of patients with COPD are described.

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Acknowledgements

The authors thank Dr. João Batista Masson Silva for providing the echocardiographic images and Fundação de Amparo à Pesquisa do Estado de Goiás (FAPEG) for the financial support (Process Number 201210267001130).

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  1. Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Goiás, Rua 235 c/1a. Avenida s/n, Setor Universitário, 74605-020, Goiânia, GO, Brazil

    Daniela Graner Schuwartz Tannus-Silva & Marcelo Fouad Rabahi

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Tannus-Silva, D.G.S., Rabahi, M.F. State of the Art Review of the Right Ventricle in COPD Patients: It is Time to Look Closer. Lung 195, 9–17 (2017). https://doi.org/10.1007/s00408-016-9961-5

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