Murphy M L, de Soyza N, Thenabadu P N
Chest. 1983 Nov;84(5):535-8. doi: 10.1378/chest.84.5.535.
This study examined the hearts of 55 patients dying of chronic obstructive pulmonary disease, with and without cor pulmonale, quantitated histologically the degree of myocardial fibrosis in the left and right ventricle, and determined the relationship to associated disease states. Comparison has been made to a control group of 17 patients free of cardiopulmonary disease. Patients with associated and advanced ischemic heart disease, as proved by marked atherosclerosis and myocardial infarction, have significantly increased myocardial fibrosis throughout all layers of the left ventricular wall in comparison to control patients or patients with chronic obstructive pulmonary disease free of associated cardiac disease. Right ventricular fibrosis was not significantly increased; however, one case showed a marked degree of fibrosis related to myocardial infarction. Subdivision of patients with chronic obstructive pulmonary disease into groups with definite anatomic right ventricular hypertrophy, a clinical diagnosis of cor pulmonale, or with chronic hypoxemia failed to show any difference in the percentage of myocardial fibrosis of the ventricles among these groups. Increased fibrosis of the right or left ventricle in patients with chronic obstructive pulmonary disease, therefore, is not related to the degree of myocardial hypertrophy pathologically, the hypoxemic state, or clinical heart failure, but to ischemic heart disease with myocardial infarction.
本研究检查了55例死于慢性阻塞性肺疾病的患者的心脏，这些患者伴有或不伴有肺心病，通过组织学方法对左、右心室心肌纤维化程度进行了定量分析，并确定了其与相关疾病状态的关系。同时与17例无心肺疾病的对照组患者进行了比较。经明显的动脉粥样硬化和心肌梗死证实患有相关晚期缺血性心脏病的患者，与对照组患者或无相关心脏疾病的慢性阻塞性肺疾病患者相比，左心室壁各层的心肌纤维化均显著增加。右心室纤维化没有显著增加；然而，有1例显示出与心肌梗死相关的明显纤维化程度。将慢性阻塞性肺疾病患者细分为具有明确解剖学右心室肥大、临床诊断为肺心病或患有慢性低氧血症的组，结果显示这些组中心室心肌纤维化百分比没有差异。因此，慢性阻塞性肺疾病患者左或右心室纤维化增加，与病理上的心肌肥大程度、低氧状态或临床心力衰竭无关，而是与伴有心肌梗死
