Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Right Ventricle Ejection Fraction Contributes Severity of Dyspnea in Chronic Obstructive Pulmonary Disease (COPD)

만성폐쇄성폐질환 환자의 호흡곤란 평가에서 우심실 박출계수의 의의

  • Lee, Jung Eun (Department of Medicine, Keimyung University School of Medicine) ;
  • Min, Bo Ram (Department of Medicine, Keimyung University School of Medicine) ;
  • Park, Jae Seok (Department of Medicine, Keimyung University School of Medicine) ;
  • Park, Hun Pyo (Department of Medicine, Keimyung University School of Medicine) ;
  • Jun, Mi Jung (Department of Preventive Medicine, Keimyung University School of Medicine) ;
  • Won, Kyung Sook (Department of Nuclear Medicine, Keimyung University School of Medicine) ;
  • Choi, Won Il (Department of Medicine, Keimyung University School of Medicine)
  • 이정은 (계명대학교 의과대학 내과학교실) ;
  • 민보람 (계명대학교 의과대학 내과학교실) ;
  • 박재석 (계명대학교 의과대학 내과학교실) ;
  • 박훈표 (계명대학교 의과대학 내과학교실) ;
  • 전미정 (계명대학교 의과대학 예방의학교실) ;
  • 원경숙 (계명대학교 의과대학 핵의학교실) ;
  • 최원일 (계명대학교 의과대학 내과학교실)
  • Received : 2006.04.18
  • Published : 2006.06.30
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Abstract

Background: Patients with COPD generally complain of very different degrees of dyspnea regardless of their pulmonary function. The study, we assessed the right ventricular ejection fraction in relation to dyspnea in COPD patient. Methods: The pulmonary function including the diffusion capacity was measured. The right ventricle ejection fraction (RVEF) was measured using a first-pass radionuclide scan by multigated acquisition (MUGA). Forty patients with chronic obstructive pulmonary disease (COPD) were stratified for dyspnea according to the Medical Research Council (MRC) scale. Moderate dyspnea and severe dyspnea is defined as MRC 2/3 (n = 16) and MRC 4/5 (n = 24) respectively. Results: The baseline pulmonary function tests including DLCO and the resting arterial blood gas were similar in the moderate and severe dyspnea group, with the exception of the residual volume (% predicted) (moderate $160{\pm}27$, severe $210{\pm}87$, p < 0.03). The right ventricle ejection fraction was significantly (p < 0.001) lower in the severe dyspnea group ($25{\pm}8$) than in the moderate group ($35{\pm}6$). The independent factor assessed by multiple logistic regression revealed only the severity of dyspnea to be significantly associated with RVEF (p < 0.02). Conclusion: This study showed that the right ventricle ejection fraction would contributes to severity of dyspnea in patients with a similar pulmonary function.

배 경: 만성폐쇄성폐질환 환자의 호흡곤란은 일반적으로 폐활량에 반비례하나 유사한 폐기능에서도 서로 다른 호흡곤란을 호소한다. 본 연구는 만성폐쇄성폐질환 환자에서 우심실박출계수와 호흡곤란의 정도와 연관관계가 있는지를 알아보고자 한다. 방 법: 호흡곤란의 정도는 Medical Research Council (MRC) 호흡곤란척도로 분석하였고, MRC 4/5도인 중증군 24명과, MRC 2/3도인 중등증군 16명을 비교 분석하였다. 심전도게이트 일회통과법을 이용한 방사성동위원소 심조영술을 이용하여 우심실 박출계수를 구했으며, 안정시 동맥가스분석 및 폐기능검사를 시행하였다. 결 과: 기저 폐기능에서 잔기량의 예측치 평균이 (%) 중증군에서($210{\pm}87$) 중등증군($160{\pm}27$)에 비해 유의하게 증가되었으나(P < 0.03), 폐활량 및 확산계수 등에서는 유의한 차이가 관찰되지 않았다. 우심실 박출계수(%)는 중증군에서($25{\pm}8$) 중등증군($35{\pm}6$)에 비해 유의하게 감소되었으나(P < 0.001), 동맥혈가스는 두 군 사이에 유의한 차이가 관찰되지 않았다. 다중회귀분석을 통해 우심실 박출계수가 독립적으로 호흡곤란에 영향을 미치는 인자로 밝혀졌다. 결 론: 만성폐쇄성폐질환에서 우심실 박출계수가 호흡곤란의 정도에 영향을 미치는 것으로 보인다.

Keywords

References

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