[Pulmonary diseases and heart function]

Internist (Berl). 2007 Mar;48(3):276-82. doi: 10.1007/s00108-006-1763-z.
[Article in German]

Abstract

The most severe cardiac sequel to lung disease is the load on the right ventricle due to pulmonary hypertension with the development of a cor pulmonale. This is characterized by hypertrophy and/or dilatation of the right ventricle because of a primary impairment of lung function and/or lung structure. The most important pathomechanisms for the development of pulmonary hypertension are vessel obliteration, mechanical lesions, primary vascular or extra-vascular inflammation and hypoxic vasoconstriction. Chronic obstructive pulmonary disease (COPD) is one of the most important reasons for chronic cor pulmonale. A further very common reason is obstructive sleep apnea syndrome, especially if combined with a COPD. In this case, the prevalence of cor pulmonale can reach 80%. The development of a chronic cor pulmonale is the most striking negative prognostic factor for these patients. Only 30% of COPD patients with cor pulmonale survive longer than 5 years, and only early detection of the disturbances to respiration which might potentially lead to cor pulmonale and their subsequent therapy are able to improve the patient's prognosis. Furthermore, pulmonary diseases may also have an impact on the left heart side in terms of an impairment of left heart function or by inducing severe arrhythmias . Thus, lung diseases may have both a significant impact on right and left heart performance.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Arrhythmias, Cardiac / diagnosis
  • Arrhythmias, Cardiac / therapy
  • Humans
  • Hypertension, Pulmonary / complications*
  • Hypertension, Pulmonary / diagnosis
  • Hypertension, Pulmonary / therapy
  • Hypertrophy, Right Ventricular / diagnosis
  • Hypertrophy, Right Ventricular / therapy
  • Lung Diseases / complications*
  • Lung Diseases / diagnosis
  • Lung Diseases / etiology
  • Lung Diseases / therapy
  • Prognosis
  • Pulmonary Disease, Chronic Obstructive / complications
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / therapy
  • Pulmonary Heart Disease / diagnosis*
  • Pulmonary Heart Disease / therapy
  • Sleep Apnea, Obstructive / complications
  • Sleep Apnea, Obstructive / diagnosis
  • Sleep Apnea, Obstructive / therapy
  • Ventricular Dysfunction, Left / diagnosis
  • Ventricular Dysfunction, Left / therapy