RV dysfunction is common and frequently underrecognized in patients with COPD when assessed using advanced echocardiographic techniques. These findings were reported in a meeting abstract presented at the American Heart Association (AHA) 2025 Scientific Sessions.

The study enrolled 85 patients with COPD defined according to the 2023 Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines and 40 matched healthy controls. All participants underwent comprehensive transthoracic echocardiography, including two-dimensional imaging, tissue Doppler imaging, speckle-tracking strain analysis, and three-dimensional echocardiography. RV function was assessed using tricuspid annular plane systolic excursion (TAPSE), RV fractional area change (RV FAC), three-dimensional right ventricular ejection fraction (RVEF), right ventricular longitudinal strain (RVLS), and right ventricular free wall strain (RVFWS). Pulmonary function testing and the six-minute walk test (6MWT) were also performed.

Compared with controls, patients with COPD demonstrated significantly impaired RV mechanics, with lower RVLS, RVFWS, and RVEF (all P < 0.0001). RV dysfunction was identified in 61.2% of patients using RV FAC and in 78.8% using RVEF. Patients with severe COPD exhibited significantly worse RV strain and RVEF values compared with those with mild disease.

RVLS and RVFWS showed significant negative correlations with forced expiratory volume in one second (FEV₁), indicating a close relationship between worsening pulmonary function and right ventricular impairment.

These findings demonstrate that three-dimensional echocardiography and strain imaging effectively detect subclinical RV dysfunction in COPD, supporting improved cardiovascular risk stratification in this population.