M Ravindranath

Abstract

Background: Chronic Obstructive Lung Disease (COPD) is a condition where there is poor airflow to the lungs and over a period of time this condition worsen, resulting in severe morbidity. L-carnitine (LC) is a soluble qaurtenary amine and is essential for the tissues and lung tone to function normally. This study was therefore find out the association of L-carnitine in patients with chronic Obstructive Pulmonary Disease. Materials and Methods: 75 patients who came to the Department of Pulmonology of either sex between 40 to 75 years with confirmed COPD were included into patients group and 75 healthy patients were included into the control group. Blood was collected for Fasting blood sugar, AST, ALP, ALT, Urea, Creatinine, Albumin, pre-albumin, iron , magnesium, sodium, phosphorous, calcium, Acylcarnitines, total and free carnitine levels. X-rays were taken and pulmonary function test was done for all the patients. Results: The mean age of the patients in our study was 62.53 and 61.86 years among the patients and controls respectively. Among the controls the Ph and Fe levels were 3.1 ± 0.9mmol/L and 21.69 ± 3.19 mcg/dL respectively and among the patients the same levels were 2.6 ± 1.9mmol/L and 43.82 ± 8.22mcg/dL respectively. The albumin and the prealbumin in the patients were significantly lower in the patients with 21.81 ± 2.88 and 23.53 ±2.58 mg/dL and in controls they were 32.61 ±3.87 and 26.87 ± 1.93 mg/dL respectively. Conclusions: There was a considerable carnitine deficiencies in COPD patients when compared to the controls and since carnitine can be found in regular diet, people can be educated to have a proper intake of foods containing carnitine in their regular diet.   Keywords: Carnitine deficiency, Chronic Obstructive Lung Disease, Forced expiratory volume

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Abstract

Background: Pulmonary Hypertension is one of a life-threatening disease with high rate of patient mortality. Decreased cardiac output and tissue hypoxia is measured using Uric acid as a marker for assessment of pulmonary hypertension. Materials and Methods: 75 patients who were diagnosed with a mean pulmonary arterial pressure of >22mmHg were categorized as group A and 75 healthy patients were considered to be Group B. Blood was collected for Uric acid, creatinine and total Bilirubin estimation. Pulmonary arterial systolic pressure as well as the ventricular function of the patients was evaluated using Colour Doppler ECG and a value of ?50 mmHg, or a mean pulmonary arterial pressure (at rest) of ?25 mmHg was taken and the right arterial pressure was calculated. Using the Simpson’s formula, the right and left ventricular ejaculation factors (RVEF, LVEF) were calculated. Results: The serum uric acid levels among the patients were 8.3±1.4mg/dL, creatinine levels were 2.1 ± 0.5 mg/dL, and the total bilirubin levels were 1.9 ± 0.8 mg/dL all of which was significantly higher than the controls. The uric acid levels were also positively correlated to the NHYA class. The blood pressure and the pulmonary arterial pressure were also higher than that of the controls. The correlation was done between the elevated uric acid and ejection fractions and the correlation coefficients of MPAP, LVEF, RVEF and the NYHA class were all significantly associated and the values were 0.394, -0.513, -0.467 and 0.38 respectively. Conclusions: High serum uric acid levels is significantly associated with higher blood pressure, pulmonary arterial pressure and NYHA class. High serum uric acid levels can be a reliable prognostic marker for the detection of pulmonary hypertension. Early therapy may help in the reduction of mortality rate.   Keywords: Uric acid, Pulmonary arterial pressure, right ventricular ejection factor, left ventricular ejection factor

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