[Treatment of cor pulmonale as a sequela of pulmonary tuberculosis]

Cor pulmonale is an important cause of death in patients with pulmonary tuberculosis. However, the treatment of cor pulmonale is difficult and its result is usually miserable. Many factors are considered to be responsible for the development of cor pulmonale. We intended to clarify the factors promoting progress of cor pulmonale.

Diagnosis of cor pulmonale was done using echocardiogram and ECG. Patients with cor pulmonale who have been examined with right side catheterization were analyzed. Patients were divided into two groups according to their survival periods. a) surviving group: patients who survived more than 18 month after right side catheterization. b) non-surviving group: patients who died within 18 month after right side catheterization. Analyzed items were as follows; grade of Hugh-Jones dyspnea criteria, grade of obesity, arterial blood O2 and CO2, pulmonary function, echocardiogram and right side catheterization finding.

Grade of obesity, PaO2, Stroke volume index were significantly higher in surviving group than in non-surviving group. Hugh-Jones grade, RPEP/RET and Pcw were significantly higher in non-surviving group than in surviving group. PaCO2, %FVC, FEV1.0%, RVth, %FS, PPA and PVR showed no difference between the two groups. Multifactorial analysis was performed and the following discrimination function was obtained: Z = 3.34 (H-J degrees) + (-0.44) (obesity %) + (-0.57) (PaO2 torr) + 0.04 (%VC) + 67.95 (RPEP/RET) + (-0.8) (PAP) + 0.61 (SVl) + 0.9 (PCW) + 0.03 (PVR) + (-0.9) (LVDdi) + 24.83.(ABSTRACT TRUNCATED AT 250 WORDS)