[Prognosis in cor pulmonale: predictive value of two-dimensional echocardiography]

Cor pulmonale is a common complication and frequent cause of death in COLD. No published records are as yet available on the prognostic ranking of two-dimensional echo-cardiography in this group of patients. In 79 of 85 (93%) consecutively echocardiographically examined COLD patients it was possible to effect apical imaging of the four-chamber view to assess the size of the right ventricle, as well as a subcostal imaging to analyse the respiratory performance of the vena cava inferior (vci). Among the exclusion criteria of this prospective series were a diseased condition of the left heart or other associated cardiac diseases. The patients were classified into two risk groups (RG 0 and RG 1) depending upon whether they had a normal-sized right ventricle or a complete inspiratory collapse of the vci, or not. In RG 1 the pO2 values were lower (56.8 +/- 9.2 vs 66.0 +/- 8.8 mmHg, p less than 0.0005) whereas the values for the respiratory passage resistance were higher (8.01 +/- 3.92 vs 6.22 +/- 2.87 cm H2O/l/s; p less than 0.025) than with RG 0, the values for the intrathoracic gas volume not being significantly different from each other. Fatal cardiopulmonary results were covered over a period of 2-48 months (median 24 months) to perform life table analyses according to Breslow and Mantel. Patients with an enlarged right ventricle or incomplete respiratory collapse of the vci have a lower survival rate (43.7% respectively 61.9%) than patients with a normal-size right ventricle or complete respiratory collapse of the vci (90.5% respectively 88%).(ABSTRACT TRUNCATED AT 250 WORDS)