Physiopathology and treatment of chronic cor pulmonale due to dysventilation syndrome.
133 patients with chronic cor pulmonale due to dysventilation syndrome were studied. Chronic obstructive pulmonary disease (COPD) was found, possibly for the first time in Japan, to be the most common etiological condition, occurring in 54% of the patients. Chronic cor pulmonale was clinically diagnosed as the appearance of right heart failure on admission. Patients were divided into two groups depending on clinical state, compensated and decompensated. There was a marked difference in arterial blood gases and electrocardiographic fluctuations between the states. Serial observations of these parameters and enlarged cardiac silhouette to the left on plain chest film provided diagnostic evidence for development to the decompensated state. Pulmonary artery pressure changes on exercise and during sleep at night has been considered to impair right heart function. Prognosis of chronic cor pulmonale largely depends on the concentrated therapy of the decompensated state. 85% of patients in the current study returned to the compensated state with active intensive therapy. Recent therapeutic progress has made control of this serious disease possible, despite the appearance of right heart failure. Laborious prolonged therapy appears to be essential in order to improve long-term prognosis.
Kunieda
T
T
Department of Medicine, National Cardiovascular Center, Suita, Osaka, Japan.
Naito
M
M
Yoshioka
T
T
Okubo
S
S
Nakanishi
N
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001237:Asphyxia / Q000150:complications*; D001784:Blood Gas Analysis; D002908:Chronic Disease; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000150:complications; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011660:Pulmonary Heart Disease / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D011669:Pulmonary Wedge Pressure; D012129:Respiratory Function Tests; D013577:Syndrome