Echocardiographic Changes in Chronic Obstructive Pulmonary Disease Exacerbations: A Systematic Review of Pre- and Post-treatment Findings
Bibliographic record
Abstract
Chronic obstructive pulmonary disease (COPD) exacerbations can precipitate acute cardiac dysfunction, but the extent and reversibility of these changes remain incompletely defined. This Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA)‑compliant systematic review synthesised evidence from 11 prospective or observational cohort studies (2015-2025) that met predefined inclusion/exclusion criteria, enrolling ≥10 adults with acute exacerbations of COPD (AECOPD) diagnosed per Global Initiative for Chronic Obstructive Lung Disease (GOLD) or equivalent criteria, and undergoing transthoracic echocardiography pre‑treatment and post‑stabilisation. Echocardiographic parameters assessed included pulmonary artery systolic pressure (PASP), right ventricular (RV) size and systolic function, tricuspid regurgitation, and diastolic indices. Methodological quality, evaluated using the Newcastle-Ottawa Scale (NOS), was moderate (scores 5-8; Cohen's κ = 0.87). In exacerbations, PASP was frequently >50 mmHg, RV dilated, and tricuspid annular plane systolic excursion (TAPSE) reduced, indicating acute RV pressure overload. Post‑treatment, PASP reductions averaged 10-15 mmHg, and greater improvements correlated with shorter intensive care unit stays and reduced 30‑day readmissions; TAPSE recovery was also linked to earlier discharge. Subclinical diastolic dysfunction and functional tricuspid regurgitation were variably reversible, with persistent moderate-severe tricuspid regurgitation in 12-18% linked to structural annular dilation. Heterogeneity in protocols precluded meta‑analysis, prompting narrative synthesis and subgroup analyses by GOLD stage; publication bias was considered but not formally assessed because no outcome was reported by ≥10 studies. Findings highlight echocardiography's prognostic value in AECOPD and support the need for standardised imaging protocols, integration with biomarker profiling, and longitudinal studies to clarify the long‑term significance of persistent abnormalities.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.050 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.013 | 0.017 |
| Bibliometrics | 0.008 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".