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clinmed/2000070005v1 (August 21, 2000)
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Pulmonary hypertension and cor pulmonale due to obliterative bronchiolitis (OB)
Jyotsna M Joshi
Pulmonary hypertension (HT) and cor pulmonale is an important complication of chronic respiratory disorders. This study was a retrospective analysis to evaluate obliterative bronchiolitis- (OB) as a cause of pulmonary HT and cor pulmonale. Cases with chronic respiratory symptoms with clinical, radiographic or electrocardiograph (ECG) evidence of pulmonary HT, that was confirmed by Two-dimensional echocardiography (2 D ECHO) with continuous and pulsed wave Doppler studies, were included. A detailed evaluation was done to establish the etiology, which included history, physical examination, chest radiography, spirometry, arterial blood gas (ABG) analysis, high resolution computed tomography (HRCT) with expiratory scans, ventilation perfusion scans, sleep studies and lung biopsy as required. OB was diagnosed in presence of chronic airflow limitation forced expiratory volume (FEV1) < 60% of predicted, in the absence of asthma, chronic bronchitis, emphysema or other causes of chronic airflow limitation and HRCT showing mosaic attenuation with exaggeration on expiratory scans. Out the total cases (n=70) there were 43 males and 27 females, age range 17-71years, mean age 41.45 years. Chronic airways diseases (CAD), 43/70, 61.4%of the total cases were the commonest causes identified for pulmonary HT and cor pulmonale. These included chronic obstructive pulmonary disease –COPD (n=18), 25% of the total cases and postinfectious obliterative bronchiolitis-OB (n=16), 22.85% of the total cases. OB is an important cause for pulmonary HT and cor pulmonale and HRCT with expiratory scans should be included in the diagnostic algorithm of pulmonary HT.