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当左心室衰竭并发慢性阻塞性肺疾病时:缺氧起主要作用。

When left ventricular failure complicates chronic obstructive pulmonary disease: hypoxia plays the major role.

作者信息

Paudel B, Dhungel S, Paudel K, Pandru K, Paudel R

机构信息

Department of Medicine, Manipal Teaching Hospital, Pokhara, Nepal.

出版信息

Kathmandu Univ Med J (KUMJ). 2008 Jan-Mar;6(1):37-40.

Abstract

INTRODUCTION

As the chronic obstructive pulmonary disease (COPD) progress, is usually accompanied by involvement of the both left ventricle (LV) and right ventricle (RV), and their systolic and diastolic function. Signs and symptoms of LV failure can be difficult to distinguish from those of COPD.

OBJECTIVE

The study was carried out to determine the prevalence of LV systolic dysfunction in the COPD patients and to assess the possible risk factor behind such development.

MATERIAL AND METHODS

It is a prospective study of 60 cases of COPD patients with or without cor-pulmonale attending Manipal Teaching Hospital.

RESULTS

The prevalence of LV systolic dysfunction was found to be 26.7%, and the findings directly correlate with the severity of COPD i.e., the more the severity of the lung disease more the probability for the incidence of LV systolic dysfunction. These data are in support of the hypothesis that hypoxia and the excess accumulation of toxic metabolic products like lactic acid, significant right-to-left shunting through the bronchial circulation explains the diminished LV ejection fraction in severe COPD patients.

CONCLUSION

Routine echocardiography investigation of the severe COPD patients is required for assessing the status of LV function and to rule out the possible association of LV systolic dysfunction.

摘要

引言

随着慢性阻塞性肺疾病(COPD)的进展,通常会伴有左心室(LV)和右心室(RV)及其收缩和舒张功能的受累。左心衰竭的体征和症状可能难以与COPD的体征和症状相区分。

目的

开展本研究以确定COPD患者左心室收缩功能障碍的患病率,并评估这种情况发生背后可能的危险因素。

材料与方法

这是一项对60例在马尼帕尔教学医院就诊的伴有或不伴有肺心病的COPD患者的前瞻性研究。

结果

发现左心室收缩功能障碍的患病率为26.7%,且研究结果与COPD的严重程度直接相关,即肺部疾病越严重,左心室收缩功能障碍发生的可能性就越大。这些数据支持以下假设:缺氧以及乳酸等有毒代谢产物的过度积累、通过支气管循环的明显右向左分流解释了重度COPD患者左心室射血分数降低的原因。

结论

需要对重度COPD患者进行常规超声心动图检查,以评估左心室功能状态并排除左心室收缩功能障碍的可能关联。

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