Right ventricular hypertrophy and its relationship to chronic bronchitis and emphysema

Abstract

Right ventricular hypertrophy may or may not be present in fatal chronic bronchitis. If patients are grouped according to the severity of right ventricular hypertrophy then those with radiographic evidence of emphysema fall mainly into the group with no or mild right ventricular hypertrophy; those with no radiographic evidence of emphysema fall mainly in the group in which right ventricular hypertrophy is severe. The pathological findings confirm this generalization: in patients with severe right ventricular hypertrophy the lungs were mostly normal structurally. Centriacinar emphysema was an uncommon finding and no relationship was found between centriacinar emphysema and right ventricular hypertrophy. While severe panacinar emphysema, widespread through the lungs, does not preclude the development of severe right ventricular hypertrophy (over 100 g) as assessed here, it is striking that most of the patients with this condition had no right ventricular hypertrophy and, if the latter was present, it was usually mild or moderate. A right ventricle over 100 g in weight was always associated with a packed cell volume of 55% or more. Right ventricular weights up to 8o g were not associated with a packed cell volume over 48%.