Jacobstein M D, Hirschfeld S S, Winnie G, Doershuk C, Liebman J
Chest. 1981 Oct;80(4):399-404. doi: 10.1378/chest.80.4.399.
A variety of mechanisms have been implicated in the development of left ventricular dysfunction in patients with chronic cor pulmonale. A two-dimensional echocardiographic study of cystic fibrosis (CF) patients with severe cor pulmonale was undertaken to evaluate the effects of long-term pulmonary abnormalities on right and left ventricular geometry. Ten patients with severe obstructive pulmonary disease secondary to CF underwent evaluation by a mechanical sector scanner from the long axis, short axis, and four chambered views. All patients manifested right heart failure. Eight had clinical scores less than 40 and died within six months of the initial examination. All patients were receiving diuretics, and six were taking digoxin at the time of the study. The most striking echographic feature was flattening or compression of the left ventricle along its minor dimension by a massively dilated right ventricle. Compression of the left ventricle and additional abnormalities of interventricular septal motion resulted in dyskinetic contraction and relaxation that could contribute to a diminished stroke volume. Massive right ventricular enlargement appears to be a major factor producing left ventricular dysfunction in chronic cor pulmonale.
多种机制与慢性肺心病患者左心室功能障碍的发生有关。对患有严重肺心病的囊性纤维化（CF）患者进行了二维超声心动图研究，以评估长期肺部异常对右心室和左心室形态的影响。10例继发于CF的严重阻塞性肺疾病患者通过机械扇形扫描仪从长轴、短轴和四腔视图进行评估。所有患者均表现为右心衰竭。8例患者临床评分低于40，并在初次检查后6个月内死亡。所有患者均接受利尿剂治疗，研究时6例正在服用地高辛。最显著的超声心动图特征是巨大扩张的右心室沿其短轴使左心室变平或受压。左心室受压以及室间隔运动的其他异常导致运动障碍性收缩和舒张，这可能导致每搏输出量减少。巨大的右心室扩大似乎是慢性肺心病中导致左心室功能障碍的主要因素。
