Study of laboratory parameters in left ventricular diastolic dysfunction in patients with pulmonary arterial hypertension

 

 

Abstract              Background: Pulmonary arterial hypertension (PAH) is defined by right-heart catheterization (RHC) showing precapillary pulmonary hypertension with a mean pulmonary artery pressure (mPAP) of >25 mmHg and a normal pulmonary artery wedge pressure (PCWP) of <15 mmHg. The prevalence of PH in stable COPD varies from 20 to 91% depending on the definition of PH (mPAP > 20 versus >25mmHg), the severity of COPD (forced expiratory volume in the first second: FEV1), and the method of measuring the pulmonary artery pressure (echocardiography versus right heart catheterization) Amis and objectives: To study the laboratory parameters in left ventricular diastolic dysfunction in patients with pulmonary arterial hypertension. Materials and method: The present study was conducted in the department of Cardiology at Sher-I-KashmirInstitute of Medical Sciences, Soura, Srinagar for the two year duration. Thirty five consecutive patients of any age with different severity of pulmonary arterial hypertension due to chronic obstructive airway disease (emphysema and chronic bronchitis) constituted the study group (Group-I) and were labeled as "cases". Pulmonary arterial hypertension was diagnosed in them as presence of right ventricular systolic pressure of more than or equal to 40mmHg. Thirty five normal subjects who were matched for age and sex constituted the other group (Group-II or "controls"). Results: The laboratory parameters of the study group also revealed that cases had higher values of hemoglobin and hematocrit, as compared to the control group. Urea (mg/dl) and Creatinine (mg/dl) were also raised in case groups as compared to control groups and the difference observed was statistically significant. Similarly Bilirubin (mg/dl), AST and ALT were also raised in case group as compared to control with statistically significant difference. Similarly arterial blood gas analysis of the study group also showed that pco2 values were much higher in the cases as compared to the control population. Conclusion: Thus we conclude that the laboratory parameters of the study group had higher values of hemoglobin and hematocrit, as compared to the control group. The renal function and liver function was also deranged. A higher cardiothoracic ratio in the cases, along with enlarged mean right pulmonary artery diameter and prominent bronchovascular markings seen on chest x-ray. Obstructive pattern was seen on the pulmonary function tests among the cases.

Key Word: laboratory parameters, left ventricular diastolic dysfunction, pulmonary arterial hypertension