| Improved recognition of cor pulmonale in patients with severe chronic obstructive pulmonary disease. | |
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MedLine Citation:
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PMID: 3364448 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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To compare sensitivity of clinical methods (physical examination, electrocardiogram, and chest radiograph) to echocardiography in the detection of cor pulmonale, and to determine the role of nocturnal oxygen desaturation in its development, 33 non-hypoxemic patients who had severe chronic obstructive pulmonary disease (COPD) were evaluated by clinical methods, echocardiography, and overnight ear oximetry. Compared to 25 age-matched control subjects, COPD patients had higher peak pulmonary systolic pressures by contrast-enhanced Doppler (40 +/- 13 versus 22 +/- 5 mm Hg, or 5.3 +/- 1.7 versus 2.9 +/- 0.7 kPa) and ratios of right to left ventricular volume (1.1 +/- 0.6 versus 0.6 +/- 0.1, both p less than 0.05). Defining cor pulmonale as pulmonary hypertension, right ventricular enlargement, or right ventricular hypertrophy, 25 COPD patients (75 percent) had cor pulmonale by echocardiography and 13 (39 percent) by clinical methods (p less than 0.05). Nocturnal desaturation was present in only 21 percent of patients. Echocardiographic measurements were similar between patients with emphysema and patients with bronchitis, and between patients with and without sleep desaturation. In patients who have severe COPD without waking hypoxemia, cor pulmonale is detected nearly twice as often by echocardiography as by clinical methods, but is usually not associated with sleep desaturation. |
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Authors:
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R B Himelman; S N Struve; J K Brown; P Namnum; N B Schiller |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: The American journal of medicine Volume: 84 ISSN: 0002-9343 ISO Abbreviation: Am. J. Med. Publication Date: 1988 May |
Date Detail:
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Created Date: 1988-06-09 Completed Date: 1988-06-09 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0267200 Medline TA: Am J Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 891-8 Citation Subset: AIM; IM |
Affiliation:
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Cardiovascular Research Institute, University of California, San Francisco 94143. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Echocardiography Electrocardiography Female Humans Lung Diseases, Obstructive / complications* Male Oximetry Physical Examination Pulmonary Heart Disease / diagnosis*, etiology Sleep / physiology Spirometry |
| Grant Support | |
ID/Acronym/Agency:
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HL07192/HL/NHLBI NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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