[Pulmonary vascular resistance index as parameter for detecting right ventricular afterload].
We studied the pulmonary haemodynamics in 62 cases of chronic cor pulmonale due to chronic obstructive pulmonary disease (COPD). Present criteria for pulmonary hypertension are: pulmonary arterial mean pressure greater than 20 mmHg and/or pulmonary systolic pressure greater than 30 mmHg at rest and pulmonary mean pressure greater than 30 mmHg after exercise. We found that 24 of our 62 cases did not meet these criteria even after exercise despite clinical evidence of cor pulmonale. However, in all cases the pulmonary vascular resistance index (PVRI) was increased (greater than 177 dyn.s.m2.cm-5) and significantly elevated after exercise. It is suggested that 1) it is inappropriate to set the criteria based solely on pulmonary artery pressure to define pathologically increased right ventricular overload; 2) the measurement of PVRI allows the concept of relative and latent pulmonary hypertension to be introduced; 3) PVRI is a more sensitive index of right ventricular overload than pulmonary artery pressures, especially when referring to the result of exercise test.
Wang
C
C
Beijing Red Cross Chaoyang Hospital.
Zhang
H Y
HY
Weng
X Z
XZ
D000368:Aged; D001794:Blood Pressure; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology; D008173:Lung Diseases, Obstructive / Q000150:complications; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000503:physiopathology; D011660:Pulmonary Heart Disease / Q000209:etiology / Q000503:physiopathology*; D014655:Vascular Resistance; D016278:Ventricular Function, Right