SECONDARY PULMONARY HYPERTENSION: SOME ASPECTS OF PATHOGENESIS

被引:0
作者
Neklyudova, G. V. [1 ]
Avdeev, S. N. [1 ]
Tsareva, N. A. [1 ]
Chernyaev, A. L. [1 ]
Samsonova, M. V. [1 ]
Nuumenko, Zh K. [1 ]
Mikhaleva, L. M. [2 ]
机构
[1] Pulmonol Res Inst, Moscow 105077, Russia
[2] Human Morphol Res Inst, Moscow, Russia
关键词
pulmonary hypertension; endothelial dysfunction; chronic obstructive pulmonary disease; idiopathic pulmonary fibrosis; NITRIC-OXIDE; ARTERIAL-PRESSURE; LUNG; INHALATION; THERAPY;
D O I
暂无
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aim. To study morphofunctional condition of pulmonary vessels in chronic obstructive pulmonary disease (CORD) and idiopathic pulmonary fibrosis (IPF), to specify the rule of endothelial dysfunction in pathogenesis of secondary pulmonary hypertension (SPH). Material and methods. Functional examination of cardiovascular and respiratory systems, measurement of systolic pressure (SP) in the pulmonary artery were made in 178 patients: 99 with COPD (8 females and 91 males, mean age 57.2 +/- 9.8 years), 79 with IPF (58 females and 21 mules, mean age 54.1 +/- 12.7 years). The examination has detected echocardiographic signs of pulmonary hypertension (PH). Then 45 PH patients (22 with CORD and 23 with IPF) were tested far vasoreactivity in response to inhalation of O-2, NO in combination with O-2 and iloprost (prostacycline i(2)) with O-2. Next stage of the study was morphometric and immunohistochemical examinations of small brunches of the pulmonary artery (PA). Results. PA SP in COPD patients was 42.8 +/- 11.1 mmHg, in IPF patients - 41.8 +/- 12.6 mmHg. Elevation of PA SP above 35 mmHg was registered in 48.5% patients with COPD and in 43.0% with IPF Patients of both groups responded to a vasodilating impact of inhalatory NO and iloprost while reaction to O-2 inhalation was absent. Morphological study of PA small branches revealed marked changes in the structure of vascular wall which were most manifest in the intima. Conclusion. The findings evidence for an essential role of endothelial dysfunction in formation and progression of PH in pulmonary pathology.
引用
收藏
页码:22 / 28
页数:7
相关论文
共 39 条
[11]   Guidelines for the diagnosis and treatment of pulmonary hypertension [J].
Galie, Nazzareno ;
Hoeper, Marius M. ;
Humbert, Marc ;
Torbicki, Adam ;
Vachiery, Jean-Luc ;
Albert Barbera, Joan ;
Beghetti, Maurice ;
Corris, Paul ;
Gaine, Sean ;
Gibbs, J. Simon ;
Angel Gomez-Sanchez, Miguel ;
Jondeau, Guillaume ;
Klepetko, Walter ;
Opitz, Christian ;
Peacock, Andrew ;
Rubin, Lewis ;
Zellweger, Michael ;
Simonneau, Gerald .
EUROPEAN HEART JOURNAL, 2009, 30 (20) :2493-2537
[12]   Inhaled nitric oxide therapy in adults:: European expert recommendations [J].
Germann, P ;
Braschi, A ;
Della Rocca, G ;
Dinh-Xuan, AT ;
Falke, K ;
Frostell, C ;
Gustafsson, LE ;
Hervé, P ;
Jolliet, P ;
Kaisers, U ;
Litvan, H ;
Macrae, DJ ;
Maggiorini, M ;
Marczin, N ;
Mueller, B ;
Payen, D ;
Ranucci, M ;
Schranz, D ;
Zimmermann, R ;
Ullrich, R .
INTENSIVE CARE MEDICINE, 2005, 31 (08) :1029-1041
[13]   Significance of pulmonary arterial pressure and diffusion capacity of the lung as prognosticator in patients with idiopathic pulmonary fibrosis [J].
Hamada, Kunio ;
Nagai, Sonoko ;
Tanaka, Shigeru ;
Handa, Tomohiro ;
Shigematsau, Michio ;
Nagao, Taishi ;
Mishima, Michiaki ;
Kitaichi, Masanori ;
Izumi, Takateru .
CHEST, 2007, 131 (03) :650-656
[14]   Nitric oxide in adult lung disease [J].
Hart, CM .
CHEST, 1999, 115 (05) :1407-1417
[16]   Predictive factors of hospitalization for acute exacerbation in a series of 64 patients with chronic obstructive pulmonary disease [J].
Kessler, R ;
Faller, M ;
Fourgaut, G ;
Mennecier, B ;
Weitzenblum, E .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1999, 159 (01) :158-164
[17]   NONINVASIVE ESTIMATION OF RIGHT ATRIAL PRESSURE FROM THE INSPIRATORY COLLAPSE OF THE INFERIOR VENA-CAVA [J].
KIRCHER, BJ ;
HIMELMAN, RB ;
SCHILLER, NB .
AMERICAN JOURNAL OF CARDIOLOGY, 1990, 66 (04) :493-496
[18]   CONTINUOUS INHALATION OF NITRIC-OXIDE PROTECTS AGAINST DEVELOPMENT OF PULMONARY-HYPERTENSION IN CHRONICALLY HYPOXIC RATS [J].
KOUYOUMDJIAN, C ;
ADNOT, S ;
LEVAME, M ;
EDDAHIBI, S ;
BOUSBAA, H ;
RAFFESTIN, B .
JOURNAL OF CLINICAL INVESTIGATION, 1994, 94 (02) :578-584
[19]  
LANDYSHEVA IV, 1980, KHRON LEGOCHN SERDTS, P173
[20]   Nitric oxide production in the hypoxic lung [J].
Le Cras, TD ;
McMurtry, IF .
AMERICAN JOURNAL OF PHYSIOLOGY-LUNG CELLULAR AND MOLECULAR PHYSIOLOGY, 2001, 280 (04) :L575-L582