Mevo Khan Zardari, Sikander Adil Mughal, Safdar Ali Shaikh, Muhammad Azhar Mughal.
Early detection of cardiac failure in chronic obstructive pulmonary disease patients.
Pak J Physiol Jan ;4(2):17-9.

Background: During the past 20 years the incidence of Chronic Obstructive Pulmonary Disease (COPD) has increased considerably. In most patients with severe COPD if they live long enough corpulmonale eventually developed. The present study was designed for detection of cardiac failure in COPD subjects by Valsalva manoeuvre, i.e., Valsalva ratio, may offer the best chance to check and decrease the rising trend of mortality due to COPD. Methods: A total of 120 male subjects were included during the course of present study. The patients suffering from COPD were selected from the Medical Department and Chest Medicine of Jinnah Postgraduate Medical Centre Karachi. The patients were selected on the basis of history and clinical examination and confirmed by x-ray chest and pulmonary function by Spirometry. Results: The mean value for the age subgroups B and C of control were significant when compared with age sub groups B and C of COPD subjects without cardiac failure except sub age group A. The mean values for all the three age subgroups of control were highly significant (p<0.001) when compared with the mean value of corresponding age subgroups of COPD subjects with cardiac failure. This study revealed that the Valsalva ratio in the control subject of all age groups and COPD without cardiac failure in young age subgroups was above 1.5 and slightly decreased with increasing age. All the COPD with cardiac failure subjects showed an abnormal Valsalva ratio. Conclusion: It is concluded that in the presence of Physician, arterial pressure response during Valsalva manoeuvre, i.e., Valsalva ratio is a simple safe and non-invasive technique in early detection of cardiac failure, which also provide a reliable estimation of its severity.

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