[Pulmonary hypertension and right ventricular failure. Part IV. Chronic lung disease].

In a series of articles the authors discuss literature data concerning epidemiology of pulmonary hypertension, its modern classification; peculiarities of its pathogenesis and treatment in various diseases and conditions. In the forth lecture they present literature data on prevalence of chronic cor pulmonale among patients with congestive heart failure and its value for prognosis. The authors consider peculiarities of pathogenesis of pulmonary hypertension in patients with chronic obstructive pulmonary disease (COPD) and interstitial lung diseases. Attention is paid to the fact that chronic cor pulmonale develops mainly in bronchitic type of COPD and rarely is met in patients with emphysematous type of COPD. Pathogenetic mechanisms of right ventricular failure in COPD and the role of interaction of hemodynamic, renal, and neuro-humoral factors in pathogenesis of edematous syndrome in patients with chronic cor pulmonal are presented. The article also contains discussion of possibilities and limitations of clinical and instrumental diagnostics of pulmonary hypertension and right ventricular failure in patients with COPD.