RESUMO
A follow-up study was carried on in a series of 20 patients with chronic obstructive pulmonary disease. The parameters analyzed were forced expiratory volume in the first second (FEV1), maximum voluntary ventilation (MVV), forced expiratory flow (FEF), vital capacity (VC), and diffusing capacity of lung (DL). Considering the importance of the parameter changes observed, each of these parameters were divided in three groups. The period of observation was of two and a half years in 9 patients, and between two years and seven months to four years in 11 patients. The follow-up was characterized by stability of the parameters in cases with the greatest degree of changes, and a definite deterioration of the parameter values in patients with minor degree of basal changes. It was observed an excellent correlation between FEV1 and MVV and FEF. As to CV and DL, the relationship was only good. These findings lead us to believe that MVV and FEF values can be predicted about from the FEV1 results.
Assuntos
Pneumopatias Obstrutivas/fisiopatologia , Enfisema Pulmonar/fisiopatologia , Dióxido de Carbono/análise , Fluxo Expiratório Forçado , Volume Expiratório Forçado , Humanos , Pulmão/fisiopatologia , Ventilação Voluntária Máxima , Capacidade de Difusão Pulmonar , Capacidade VitalRESUMO
Left heart diseases, in particular mitral stenosis, are often associated with anatomic and functional alterations of the lung. According to the pulmonary structures involved they could be named chronic secondary intersticial and vascular lung diseases. Congenital heart diseases with pre- or post-tricuspid shunts are also often associated with anatomic and functional alterations of the lung. This condition also constitutes a chronic secondary vascular lung disease (atrial septal defect) or a chronic primary vascular lung disease ( ventricular septal defect, patent ductus arteriosus). Primary lung diseases (interstitial pulmonary fibrosis, pulmonary emphysema, recurrent pulmonary embolism) are often associated with right ventricular hypertrophy with or without dilation, a condition commonly named chronic cor pulmonale. On the whole the interrelationships between heart and lung diseases are as follows: a) anatomic and functional alterations of the lung due to left heart diseases are mediated through pulmonary venous hypertension; b) anatomic and functional alterations of the lung due to congenital heart diseases are mediated through the increased pulmonary blood flow with or without transmission of the systemic blood pressure to the pulmonary vasculature, and c) anatomic and functional alterations of the right ventricle due to primary or secondary lung diseases are mediated through arterial pulmonary hypertension. In summary, the interrelationships between heart and lung diseases are mainly mediated through the pulmonary venous or pulmonary arterial hypertension.
Assuntos
Cardiopatias/fisiopatologia , Pneumopatias/fisiopatologia , Pressão Sanguínea , Cardiopatias/complicações , Ventrículos do Coração/fisiopatologia , Humanos , Hipertensão/complicações , Hipertensão Pulmonar/complicações , Pneumopatias/complicações , Pneumopatias/etiologiaRESUMO
Different radiologic indexes and measurements proposed in the evaluation of pulmonary artery hypertensión (PAH) were reviewed. The postero-anterior chest roentgenograms of 250 subjects were studied. In all cases the pulmonary artery pressure was known from cardiac catheterization. The diameter of the right pulmonary artery was larger than 1.7 mm. in 45% of cases with PAH. The pulmonary-lobar-transverse-thoracic index (PL/T) was abnormal (+38%) in 74% of cases with PAH, and normal in cases with increased pulmonary flow. The index of Ozawa, distance between the midline and the more prominent portion of the pulmonary arch, related to the transverse diameter of the left hemithorax overestimated the mean pulmonary pressure when normal and underestimated the same with PAH. A new index is described. The relation of the right pulmonary artery with the transverse diameter of the hemithorax on the same side (r/h index). It was abnormal in 24% of the cases with PAH and it was always normal in cases with increased pulmonary flow. The more sensitive and specific measurement seems to be the PL/T index.