In India still pulmonary tuberculosis is prevalent and stays as one
of the leading cause of death. The cause of the death in most of the
terminally ill pulmonary tuberculosis patient is corpulmonale and
related cardiac problem. With the increase in incidence of retro viral
infection and diabetes the prevalence of multi drug resistant pulmonary
tuberculosis is high .This leads to increase in the chances for the
corpulmonale.
In the rural areas poverty and malnutrition lead to increased
incidence and prevalence of tuberculosis. In the urban areas exposure to
the automobile gases and dust particles predisposes patients to
pulmonary diseases and COPD in later life.
COPD in the later stages lead to right ventricular dilatation and
corpulmonale. The development and implementation of the national
programs for the detection and treatment of the tuberculosis is trying to
treat the disease in the early stage itself to prevent such corpulmonale in
future. In this study we are going to find easy solution to diagnose the
lung disease related cardiac problem in the early stage itself without
making mistakes.
In corpulmonale patients right ventricular systolic dysfunction is
recognized to occur and it has been proved in many studies. But the
corpulmonale patients are symptomatic not only because of the lung
pathology and right heart failure, but also due to left ventricular
dysfunction in the form of left ventricular systolic and left ventricular
diastolic dysfunction .The dilated right ventricle pushes the
interventricular septum towards left ventricle and interferes with left
ventricular filling, which lead onto diastolic dysfunction of left
ventricle. The additional metabolic factors like hypoxia, hypercapnea
and acidosis lead on to direct myocardial depressant action and produce
myocardial dysfunction in both left and right ventricle.
AIMS & OBJECTIVES
1. To study the utility of newer echocardiographic parameters like
mitral annular plane systolic excursion, mitral annular systolic
velocity, tricuspid annular plane systolic excursion, tricuspid
annular systolic velocity, and ‘e’ propagation velocity in
identifying right ventricular systolic ,left ventricular systolic and
diastolic dysfunction in patients with corpulmonale.
2. To study the prevalence of right ventricular systolic, left
ventricular systolic and left ventricular diastolic dysfunction in
patients with corpulmonale.
CONCLUSION:
1. Left ventricular diastolic dysfunction occurred in about 50% of
the corpulmonale patients.
2. Left ventricular systolic dysfunction was observed in 10-20%
percent in the study which is higher than the published literature.
3. MAPSE and MASV are simple and useful parameter to assess
the left ventricular systolic dysfunction.
4. TAPSE and TASV are simple and useful index in corpulmonale
patients to assess right ventricular systolic dysfunction.
5. It is found that atleast some amount of right ventricular systolic
dysfunction was detected when the newer echocardiographic
parameters were used in most of the corpulmonale patients
