Prognosis in chronic pulmonary disease and cor pulmonale

Abstract

Echocardiography and cardiac catheterization were performed in 30 patients of chronic pulmonary disease and cor pulmonale. We studied the relation of echo-cardiographic data and pulmonary hemodynamics to prognosis in these patients. In the nonsurvival group (12 patients) the extent of dyspnea was worse significantly (p less than 0.05), PaO2 was decreased significantly (p less than 0.05, 7 +/- 8.2 Torr), right ventricular preejection period (RPEP)/right ventricular ejection time (RVET) ratio increased significantly (p less than 0.05, 0.51 +/- 0.07), left ventricular diastolic diameter index (LVDdI) was shortened significantly (p less than 0.05, 23.5 +/- 3.1 mm/m2), and pulmonary capillary wedge mean pressure (PCWm) rose significantly (p less than 0.05, 11.9 +/- 6.9 mmHg) in comparison with the survival group (12 patients). In the survival group PaO2, RPEP/RVET ratio, LVDdI and PCWm averaged 60.9 +/- 12.8 Torr, 0.41 +/- 0.09, 27.5 +/- 5.1 mm/m2, 6.2 +/- 3.3 mmHg, respectively. The rate of survival was decreased significantly (p less than 0.05) in pulmonary vascular resistance (PVR) of greater than 400 dyne.sec.cm-1 or stroke volume index (SVI) of less than 35 ml/m2. These factors and 3 factors of obesity, %VC and pulmonary artery mean pressure (PAPm) differentiated nonsurvivors from survivors with linear discriminant function.