RESUMO
AIM: To study left ventricular structural and functional changes in patients with chronic obstructive pulmonary disease (COPD) and chronic cor pulmonale (CCP) at different stages of a cardiac remodeling process. SUBJECTS AND METHODS: Echocardiography was used to examine 98 patients with COPD complicated by the development of CCP in a number of cases. The significant signs of CCP were absent in 19 patients; the signs of compensated and decompensated CCP in 41 and 38 patients, respectively. RESULTS: In the patients with COPD, the formation of CCP during remodeling of the heart involves its left cavities whose changes lie in the occurrence of left ventricular (LV) diastolic dysfunction, mainly of the restrictive type, in ventricular spherization, higher myocardial systolic tension, in tendencies towards increases in LV mass index, left atrial sizes, and in the indices reflecting LV systolic dysfunction. The LV diastolic dysfunction correlates with the degree of right ventricular hypertrophy and dilatation and the presence of complete right bundle-branch block. CONCLUSION: Progressive worsening of diagnostic filling of the left ventricle and its systolic function is an additional factor aggravating hemodynamic disorders in patients with COPD and CCP, which should be kept in mind on choosing an appropriate therapy for patients with CCP.
Assuntos
Ventrículos do Coração/patologia , Doença Pulmonar Obstrutiva Crônica/patologia , Doença Cardiopulmonar/patologia , Função Ventricular Esquerda/fisiologia , Remodelação Ventricular , Adulto , Estudos de Casos e Controles , Diástole/fisiologia , Ecocardiografia , Ventrículos do Coração/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/diagnóstico por imagem , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Doença Cardiopulmonar/complicações , Doença Cardiopulmonar/diagnóstico por imagem , Doença Cardiopulmonar/fisiopatologia , Sístole/fisiologiaRESUMO
The authors examined 40 patients with chronic ischemic pancreatitis without concomitant pathology of the alimentary organs in order to define the features of the disease clinical picture and progress. It was found that patients with disseminated atherosclerosis, especially when it is coupled with essential hypertension, and with extravasal stenosis of the celiac trunk are predisposed to the development of chronic ischemic pancreatitis. Factors promoting pancreatic ischemia include abnormalities of the blood rheological properties seen in vascular pathology and alimentary hyperlipidemia.