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Patterns of cardiovascular dysfunction in chronic obstructive lung disease.

Abstract A longitudinal seven-year study of 50 patients with chronic airway obstruction, whose cardiovascular function had been evaluated by cardiac catheterization when their condition was stable, showed that their survival was inversely related to pulmonary vascular resistance. Fourteen patients with high vascular resistances showed two different patterns of cardiovascular abnormality. Nine had relatively normal blood gases, low cardiac outputs, and near normal resting pulmonary-artery pressures; they had an emphysematous type of lung disease. The five with more severe blood gas abnormalities who had a more bronchitic type of disease, had well maintained cardiac outputs and more severe pulmonary hypertension. They more regularly presented the classic clinical and electrocardiographic features of cor pulmonale. Left ventricular dysfunction appeared to be an important determinant of pulmonary hypertension in only one patient.