Hyperinflated lungs compress the heart during expiration in COPD patients: a new finding on dynamic-ventilation computed tomography [ Ссылка ], published in the International Journal of Chronic Obstructive Pulmonary Disease.

COPD is a heterogeneous disorder with significant extrapulmonary effects that contribute to disease severity. Obstruction of expiratory airflow and loss of lung elasticity lead to lung hyperinflation and elevated intrathoracic pressure, causing various cardiovascular sequelae. Increased intrathoracic pressure reduces venous return and thus reduces right ventricular output. Furthermore, hyperinflation is associated with reduced ventricular filling, reduced stroke volume, and lower cardiac output. In addition, Watz et al15 found that severe COPD is associated with smaller cardiac size on echocardiography.

It has previously been reported that, in patients with severe COPD or emphysema, the heart appears narrowed on chest radiography. Based on these observations and physiological theories, we hypothesized that changes in heart size throughout the respiratory cycle would differ between COPD patients and non-COPD subjects and that these differences would correlate with the severity of COPD (ie, airflow limitation).

The aims of this study were 1) to compare changes in heart size during the respiratory cycle in smokers with and without COPD using four-dimensional dynamic-ventilation CT and 2) to evaluate abnormal cardiac movements during ventilation in patients with COPD and determine the association of these abnormalities with the severity of obstructive lung disease.

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