[Current problems in the diagnosis, prevention and treatment of chronic cor pulmonale]

Problems of early diagnosis, prophylaxis and therapy of chronic cor pulmonale (CCP) were discussed. It was pointed out that the right ventricular hypertrophy could not be regarded as the main diagnostic sign of CCP as it was recognized at late stages of diseases when therapy was of low efficacy. The authors proposed to specify CCP clinico-functional definition with 4 functional classes with relation to the expression of disturbances of ventilation function of the lungs and hemodynamics. The results of isoket and corinfar therapy of 250 patients with obstructive bronchitis of various gravity of ventilation and hemodynamic disturbances were presented. They showed that the use of prolonged nitrates was found appropriate in the patients of the 3rd-4th functional classes with signs of developed CCP. The use of prolonged nitrates in the patients of the 1st-2nd functional classes resulted in an increase of pulmonary functional shunting of the blood. Calcium antagonists made a balanced effect on the bronchial permeability and pulmonary hemodynamics. Their use was indicated at early stages of the process when functional mechanisms played the leading role in the pathogenesis of disturbances.