Electrocardiographic and Echocardiographic Changes in Patients with Chronic Obstructive Pulmonary Disease and Their Correlation with Disease Severity: A Cross-Sectional Study

Abstract

Background

Chronic obstructive pulmonary disease is a major cause of morbidity and mortality worldwide and is frequently associated with cardiovascular complications. Cardiac involvement, including pulmonary hypertension, cor pulmonale, arrhythmias, and ventricular dysfunction, significantly influences prognosis. Early detection of these abnormalities through ECG (Electrocardiography) and echocardiography may facilitate timely intervention and improve outcomes.

Methods

A hospital-based cross-sectional study was conducted in the Department of Medicine, Durgapur Steel Plant Hospital, over 18 months. One hundred diagnosed COPD patients aged above 40 years were enrolled. Disease severity was classified according to GOLD criteria using spirometry. All participants underwent standard 12-lead ECG and 2-D Doppler echocardiography. ECG and echocardiographic findings were analyzed and correlated with COPD severity and duration. Statistical analysis was performed using SPSS version 21.0, with p<0.05 considered significant.

Results

The mean age of participants was 61.58±5.47 years, and 90% were males. Smoking history was present in 93% of patients (59% current smokers and 34% ex-smokers). ECG abnormalities were observed in 69% of cases. The most common ECG findings were arrhythmias (46%), right-axis deviation of the P wave (44%), and P pulmonale (33%). Sinus tachycardia (28%) was the predominant arrhythmia. Echocardiographic abnormalities were present in 64% of patients. Common findings included valvular abnormalities (43%), pulmonary arterial hypertension (26%), right ventricular dilatation (23%), right atrial dilatation (21%), and reduced ejection fraction (<50%) in 23% of patients. Both ECG and echocardiographic abnormalities showed a significant positive correlation with COPD severity (p<0.01), whereas no significant association was found with disease duration.

Conclusion

Cardiac abnormalities are highly prevalent in COPD patients and increase with disease severity. Routine ECG and echocardiographic evaluation should be incorporated into COPD management protocols for early detection of subclinical cardiac dysfunction and improved patient outcomes.