Russian Heart Failure Journal 2007year Peculiarities of right and left heart remodeling in patients with chronic obstructive lung disease and pulmonary heart disease


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2007/

Peculiarities of right and left heart remodeling in patients
with chronic obstructive lung disease and pulmonary heart disease

Strutynsky A. V., Glazunov A. B., Sivtseva A. I., Bakaev R. G., Banzelyuk E. N., Moshkova N. K., Golubeva G. Yu., Ryauzova R. G., Vinogradova D. V.

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Urgency. The process of heart remodeling underlying development of chronic pulmonary heart disease (CPHD) in patients with COLD is studied insufficiently, especially at the earliest (subclinical) steps of the process. Aim. Studying structure-activity changes in right and left heart at different steps of heart remodeling in patients with COLD and CPHD. Material and methods. Structure-activity changes in left and right heart were studied using echoCG in 98 patients with COLD. Nineteen patients had no significant signs of CPHD or CHF (Group 1); 41 patients displayed signs of compensated CPHD (Group 2); and 38 patients had decompensated CPHD (Group 3). Results. The process of heart remodeling and development of CPHD and CHF consistently goes through several sequential phases with structure-activity changes in RV at the earliest (preclinical) steps of disease. The following was observed in the course of heart remodeling in patients with COLD: 1) increased RV myocardial weight and absolute thickness of the frontal wall; 2) increased diastolic and systolic RV and RA dimensions with gradual reduction of the h / D index; 3) increased mean pulmonary artery pressure (mPAP); 4) development of pronounced diastolic and then also systolic RV dysfunction; 5) in some cases, development of tricuspid valve relative insufficiency; 6) disturbed LV diastolic filling and in severe cases, a moderate decrease in LV systolic function.

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