Acta Medica Medianae Vol. 46, No
4, December, 2007 UDK 61 YU ISSN 0365-4478
Contakt:
Milivoje Živković
Klinika za plućne bolesti i tuberkulozu
18204 Knez Selo
Srbija i Crna Gora
Tel.: +381-18-32-63-12
E-mail: mzivkovic@infosky.net
|
MORPHOLOGICAL CHANGES AND DIASTOLIC CHARACTERISTICS OF RIGHT
VENTRIcLE IN PATIENTS WITH cHRONIc OBSTRUcTIVE PULMONARY DISEASE
EVALUATED BY DOPPLER EcHOcARDIOGRAPHY
Milivoje Živković1, Milan Pavlović2, Milan
Radović1 i Nela Perhoč1
Klinika za plućne bolesti i tuberkulozu u Knez Selu1
Klinika za kardiovaskularne bolesti Kliničkog centra u Nišu2
Chronic
obstructive pulmonary disease (COPD), which is characterized by
significant long-term airway obstruction associated with the
impaired inflammatory response, represents a progressive disease
disturbing the structure and function of the heart, finally leading
to cor pulmonale (CP). Pulmonary vascular reduction - pulmonary
hypertension lies in etiopathogenesis of CP. The adaptation process
of right ventricle (RV) begins with structural changes, followed by
hypertrophy of the free wall and interventricular septum. Such
changed myocardium, in the presence of hypoxia of varying intensity,
may result in diastolic dysfunction of RV in these patients.
The aim of the study was to investigate diastolic dysfunction of RV
in patients with COPD, by ascertaining the correlation between
diastolic dysfunction and charge model of RV depending of bronchial
obstruction level. We have proved that aging influences dyastolic
characteristic of RV, mostly disturbances of diastolic relaxation.
In the third group of patients with significant remodeled RV, there
is not any correlation between age and dyastolic function of RV.
Diastolic dysfunction of RV and disturbances in charging according
to the model of prolonged relaxation are registred in the second
group, while in the third one they are more marked. Flow changes in
hepatic vein at the retrograde flow rate in the atrial contraction
phase show lower compliance of RV at the end of diastole, while
anterograde flow limitation in diastole and rise of speed of PA wave
in the second group of patients point to the moderate disturbance of
RV relaxation. Diastolic dysfunction of RV begins before systole and
patients with COPD must be examined
by ultrasound in an early stage of disease for the presence of
diastolic dysfunction, so that the adequate treatment could prevent
cardiac failure. Acta Medica Medianae 2005;44(4): 5 – 12.
Key words: COPD, diastolic dysfunction, right ventricle |