Pulmonary hypertension and chronic cor pulmonale in COPD.
Hypoxia and endothelial dysfunction play a central role in the development of pulmonary hypertension. Cor pulmonale is a maladaptive response to pulmonary hypertension. The presence of peripheral edema in cor pulmonale is almost invariably associated with hypercapnia. Correction of abnormalities of gas exchange and ventilation can ameliorate pulmonary hypertension and improve survival. This review focuses on new information about the pathogenesis and treatment of pulmonary hypertension in COPD including information derived from lung volume reduction surgery, the role of brain natriuretic peptide, exhaled nitric oxide for diagnosis, and the treatment of cor pulmonale with recently available specific pulmonary vasodilators.
Shujaat
Adil
A
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, St. Luke's and Roosevelt Hospitals, Columbia University, New York, NY, USA.
Minkin
Ruth
R
Eden
Edward
E
D002908:Chronic Disease; D015897:Comorbidity; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology*; D045283:Natriuretic Agents; D020097:Natriuretic Peptide, Brain; D009569:Nitric Oxide; D018962:Phlebotomy; D029424:Pulmonary Disease, Chronic Obstructive; D011660:Pulmonary Heart Disease / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*
D045283:Natriuretic Agents; D020097:Natriuretic Peptide, Brain; D009569:Nitric Oxide