Kor Pulmonale

Kor Pulmonale, akciğer yapı ve/veya fonksiyonunu etkileyen hastalıklara bağlı gelişen pulmoner arteryel hipertansiyona yanıt olarak meydana gelen sağ ventrikül genişlemesi (hipertrofi ve/veya dilatasyon) ve sağ ventrikül yetmezliğidir. En sık nedeni kronik obstrüktif akciğer hastalığıdır. Pulmoner hipertansiyon kor pulmonalenin en önemli komponentidir. Spesifik olmayan bulgu ve belirtiler kor pulmonalenin klinik tanısını zorlaştırmaktadır. Tedavi hedefi oksijenasyonu ve sağ ventrikül kontraktilitesini arttırmak, pulmoner vasküler rezistans ve vasokonstrüksiyonu azaltmaktır.

-

Cor pulmonale is, enlargement (hypertrophy and/or dilatation) and failure of right ventricule resulting from diseasesaffecting the function and/or the structure of the lungs. Chronic obstructive pulmonary disease is the most commoncause of cor pulmonale. Pulmonary hypertension is the most important component of cor pulmonale. Therapeutic targetis to increase oxygenation and right ventricular contractility and to reduce pulmonary vascular resistance andvasoconstriction. Clinical assessment of cor pulmonale is difficult due to non-specific signs and symptoms

___

  • Weitzenblum E. Chronic Cor Pulmonale. Heart 2003; 89(2): 225-30.
  • Bhattacharya A. Cor Pulmonale. JIACM. 2004; 5(2): 128Gomberg-Maitland M, Thenappan T, Ryan JJ, Goel A, Cipriani N. Cor Pulmonale. Yuan J.X.-J., Editors. Textbook of Pulmonary Vascular Disease. 1st.ed. New York/Dordrecht/Heidelberg/London: Springer; 2011. p. 1355MacNee W. Pathophysiology of cor pulmonale in chronic obstructive pulmonary disease. Part one. Am J Respir Crit Care Med. 1994; 150(3): 833-52. Magee F, Wright JL, Wiggs BR, Pare PD, Hogg JC. Pulmonary vascular structure and function in chronic obstructive pulmonary disease. Thorax. 1988; 43(3): 183Towers MK. Chronic cor pulmonale. Postgrad Med J. 1966; 42(490): 506-12.
  • Badesch DB, Abman SH, Simonneau G, Rubin LJ, McLaughlin VV. Medical therapy for pulmonary arterial hypertension: updated ACCP evidence-based clinical practice guidelines. Chest. 2007; 131(6): 1917
  • Han MK, McLaughlin VV, Criner GJ, Martinez FJ. Pulmonary diseases and the heart. Circulation. 2007; 116(25): 2992-3005.
  • Budev MM, Arroliga AC, Wiedemann HP, Matthay RA. Cor pulmonale: an overview. Semin Respir Crit Care Med. 2003; 24(3): 233-44.
  • Tachman DB, Fishman AP. Pulmonary Hypertension and Cor Pulmonale. In: Fishman AP, Elias JA, Fishman JA, Grippi MA, Senior RM, Pack AI, Editors. Fishman’s Pulmonary Disease and Disorders. 4th ed. New York: Mc Graw Hill; 2008. p. 1359-422.
  • Matthay RA, Schwarz MI, Ellis JH Jr, Steele PP, Siebert PE, Durrance JR et al. Pulmonary artery hypertension in chronic obstructive pulmonary disease: determination by chest radiography. Invest Radiol. 1981; 16(2): 95-100.
  • Guidelines for the diagnosis and treatment of pulmonary hypertension. European Heart Journal. 2009; 30: 2493-537.
  • Berger HJ, Matthay RA, Loke J, Marshall RC, Gottschalk A, Zaret BL. Assessment of cardiac performance with quantitative radionuclide angiocardiography: right ventricular ejection fraction with reference to findings in chronic obstructive pulmonary disease. Am J Cardiol. 1978; 41(5): 89790
  • Atwood CW, McCrory D, Garcia JG, Abman SH, Ahearn GS. American College of Chest Physicians. Pulmonary artery hypertension and sleep-disordered breathing: ACCP evidence-based clinical practice guidelines. Chest. 2004; 126(1 Suppl): 72-7.
  • Barbera JA, Peinado VI, Santos S. Pulmonary hypertension in chronic obstructive pulmonary disease. Eur Respir J. 2003; 21(5): 892-905.
  • Reihman DH, Farber MO, Weinberger MH. Henry DP, Fineberg NS, Dowdeswell IR et al. Effect of hypoxemia on sodium and water excretion in chronic obstructive lung disease. Am J Med. 1985; 78(1): 87-94.
  • Heinemann HO. Right-sided heart failure and the use of diuretics. Am J Med. 1978; 64(3): 367-70.
  • Mathur PN, Powles AC, Pugsley SO, McEwan MP, Campbell EJ. Effect of long-term administration of digoxin on exercise performance in chronic airflow obstruction. Eur J Respir Dis. 1985; 66(4): 273-83.
  • Thabut G, Dauriat G, Stern JB, Logeart D, Levy A, Marrash-Chahla R et al . Pulmonary hemodynamics in advanced COPD candidates for lung volume reduction surgery or lung transplantation. Chest. 2005; 127(5): 1531