Two-dimensional echocardiography using a subcostal approach in patients with COPD.

The aim of this study was to examine whether two-dimensional echocardiography (2-DE) using a subcostal window can provide reliable parameters for the assessment of pulmonary artery hypertension (PAH) in patients with chronic obstructive pulmonary disease (COPD). Fifteen patients with steady state COPD (mean age 58.8 +/- 7.7) and PAH (MPAP 37.2 +/- 15.2 mm Hg) were compared with 15 healthy control subjects, (mean age 30.5 +/- 4.6). The 2-DE examination was performed with a sectorscanner from the subcostal approach. Measurements were made of the inner and maximal end-diastolic dimensions of the tricuspid annulus (TA), the short axis of the right ventricle (RV), and the free right ventricular anterior wall (AW). The TA X RV + AW/body surface area (mm/m2, 2D-index) was 378.3 +/- 47.6 in control subjects vs 871.2 +/- 314.5 in patients provided the closest correlation with MPAP (r 0.9055, p less than 0.001). We conclude that these 2-DE parameters can quantify the morphologic changes of the right heart in COPD with PAH and are useful in the assessment of PAH.