[Development of chronic cor pulmonale in restrictive and obstructive pulmonary dysfunctions]

Area of Science:

• Cardiology
• Pulmonology
• Immunology

Background:

• Pulmonary tuberculosis and bronchial asthma are complex respiratory conditions.
• Understanding their impact on cardiovascular and respiratory hemodynamics is crucial.

Purpose of the Study:

• To investigate the systemic vascular and hemodynamic responses in patients with pulmonary tuberculosis and bronchial asthma.
• To explore the role of cyclic adenosine monophosphate (CAMP) and immune complexes in these conditions.

Main Methods:

• Studied 2840 patients with pulmonary tuberculosis and bronchial asthma.
• Analyzed systemic vascular responses, including pulmonary artery systolic pressure and venous spasms.
• Assessed sympathoadrenal system activation, beta-adrenoreceptor function, and CAMP levels.
• Correlated CAMP levels with cardiac output, pulmonary systolic pressure, and circulating immune complexes.

Main Results:

• Antigens induced elevated pulmonary artery systolic pressure and venous spasms, activating the sympathoadrenal system.
• Lower CAMP levels correlated with desensitized beta-adrenoreceptors.
• Direct correlations were found between CAMP and cardiac output, and between CAMP and pulmonary systolic pressure in tuberculosis.
• Allergic reactions in severe tuberculosis led to paresis of pulmonary circulation and hypokinetic hemodynamics.
• Bronchial asthma showed impaired microcirculation due to antigenic exposure and increased intrathoracic pressure.
• Restrictive processes in asthma resulted in higher CAMP, right-to-left shunt, and hypoxemia.
• Obstructive pulmonary diseases caused hypoxemia via hypoventilation and ventilation-perfusion mismatch.

Conclusions:

• Systemic vascular and hemodynamic alterations are significant in pulmonary tuberculosis and bronchial asthma.
• CAMP plays a critical role in modulating cardiovascular function and oxygenation in these diseases.
• Understanding these pathophysiological mechanisms can inform clinical management strategies for patients with tuberculosis and asthma.