Abstract Introduction: As the chronic obstructive pulmonary disease (COPD) progress, is usually accompanied by involvement of the both left ventricle (LV) and right ventricle (RV), and their systolic and diastolic function. Signs and symptoms of LV failure can be difficult to distinguish from those of COPD. Objective: The study was carried out to determine the prevalence of LV systolic dysfunction in the COPD patients and to assess the possible risk factor behind such development. Material and Methods: It is a prospective study of 60 cases of COPD patients with or without cor-pulmonale attending Manipal Teaching Hospital. Results: The prevalence of LV systolic dysfunction was found to be 26.7%, and the findings directly correlate with the severity of COPD i.e., the more the severity of the lung disease more the probability for the incidence of LV systolic dysfunction. These data are in support of the hypothesis that hypoxia and the excess accumulation of toxic metabolic products like lactic acid, significant right-to-left shunting through the bronchial circulation explains the diminished LV ejection fraction in severe COPD patients. Conclusion: Routine echocardiography investigation of the severe COPD patients is required for assessing the status of LV function and to rule out the possible association of LV systolic dysfunction. Key words: Chronic obstructive pulmonary disease, Cor-pulmonale, Hypoxia, LV systolic dysfunction hronic obstructive pulmonary disease (COPD) is a disease state characterized by the presence of airflow obstruction due to chronic bronchitis or emphysema which is progressive and is partially reversible. Right ventricular (RV) hypertrophy and dilatation secondary to pulmonary hypertension caused by COPD (i.e., cor pulmonale) is unrelated to the left side of the heart. With RV pressure overload, the septum tends to be displaced toward the left ventricle (LV) during systole, which causes a distortion of the LV 1 . Since the myocardial fibres of the RV free walls are connected with those of the septum and LV free wall, a pressure increase in the RV is accompanied by changes in the LV systolic function 2 . This might be a partial explanation for the LV involvement in the course of COPD, causing an increased morbidity and mortality of ischemic heart disease and LV dysfunction 3 . Understanding the relationship between RV hypertrophy and LV systolic function in patients with COPD will be helpful for the better patient management. Objective The main objective of this study is to determine the prevalence of LV systolic dysfunction in the COPD patients and to assess the possible risk factor behind such development
