الفهرس 
Surgical anatomy of the mitral valve.Only 14 pages are availabe for public view
 |  | from | 186 |  |  |
| | | from | 186 | | |
Abstract
This study was conducted to assess the cardiac functions before and after exercise in COPD patients.
Fifty subjects were the material of this study, classified into two groups, group I consists of (40) COPD patients and group II consists of (10) apparently healthy volunteers used as a control group. The patients were admitted at the Chest Department Benha University Hospital at the period from October,1996 to July, 1997. All were males with the age ranged
from 40-69 years.
Ventilatory pulmonary functions were done to COPD patients as well as to normal control subjects before bronchodilator to detect airway obstruction, and repeated 15 minutes after the administration of bronchodilator to the cases (group I), to detect irreversibility and confirm the diagnosis of
COPD.
Two Dimensional echocardiography was done to both groups before and 6 minutes after exercise to assess the cardiac function before and after exercise.
The right ventricular systolic function was assessed by measuring the right ventricular ejection fraction which was found to be normal in (33) patients out of (40) ( 82.5%), denoting preserved right ventricular systolic function at rest. When ejection fraction re-evaluated after exercise it was normal among (24) patients ( 60%) i. e. there was a deterioration of the right ventricular systolic function during exercise.
Also, the diastolic function of the right ventricle was assessed by measuring the E/A ratio, which was found to be reversed in (19) patients out of 40 ( 47.5%) i. e. right ventricular diastolic dysfunction. After exercise deterioration of the right ventricular diastolic function occurred in (24) patients ( 60 %).
The mean pulmonary pressure was assessed by detecting the acceleration time after measuring the trans-pulmonary flow velocity, it was high at rest and higher after exercise with a mean value of 34.07±10 mm Hg at rest, and 47.45±45 mm Hg after exercise.
The left ventricular functions were also assessed by echocardiography at rest and after exercise. Ejection fraction was measures as an indication of the left ventricular systolic function, it was normal in all patients at rest and after exercise.
The E/A ratio was estimated as an index of the left ventricular diastolic function. At rest it was reversed in (10) patients ( 25% ), these (10) patients had a deteriorated pulmonary function tests in comparison with the other (30) COPD patients with normal diastolic function.