Jezek V
Cor Vasa. 1981;23(2):94-103.
Nineteen patients with chronic cor pulmonale, in which the coincidence with other cardiovascular disease was excluded by cardiac catheterization and coronary arteriography, were examined. Left ventricular hypertrophy, elevated filling pressure and reduced compliance were found in a part of the patients. The left ventricular ejection fraction was normal and had no correlation with the elevated filling pressures. These abnormalities were related to the degree of pulmonary hypertension; furthermore, the correlation between the left ventricular hypertrophy and reduced compliance has been found. The author concludes that chronic obstructive bronchopulmonary disease is not accompanied by left ventricular contractile insufficiency; the left ventricle is able to develop a normal systolic performance at rest. In a part of patients, however, this systolic performance is developed at certain abnormal haemodynamic conditions, particularly at elevated left ventricular filling pressure. Possible mechanisms responsible for these alterations are discussed.
对19例慢性肺心病患者进行了检查,这些患者经心导管检查和冠状动脉造影排除了合并其他心血管疾病的情况。部分患者存在左心室肥厚、充盈压升高和顺应性降低。左心室射血分数正常,且与升高的充盈压无关。这些异常与肺动脉高压程度有关;此外,还发现了左心室肥厚与顺应性降低之间的相关性。作者得出结论,慢性阻塞性支气管肺疾病不伴有左心室收缩功能不全;左心室在静息时能够产生正常的收缩功能。然而,在部分患者中,这种收缩功能是在某些异常血流动力学条件下产生的,特别是在左心室充盈压升高时。文中讨论了导致这些改变的可能机制。