On the pathogenesis of heart failure in patients with pulmonary emphysema

The main direct cause of the development of right ventricular heart failure in patients with obstructive pulmonary emphysema is an increase in pressure in the pulmonary artery system. According to our colleague Yu. N. Steinhardt, with pulmonary emphysema, not complicated by heart failure, the pressure in the pulmonary artery at rest is increased only in 1/3 of patients and, moreover, is usually insignificant (mean pressure 21-42, on average 25 mm ); somewhat more often, at normal pressure at rest, there is a more distinct increase in pressure during exercise than in healthy people. In patients with emphysema with heart failure, pulmonary arterial hypertension was always, and usually significant. Thus, the mean pressure in 17 studied patients varied within 28-75 mm (on average - 47 mm). The degree of hypertension corresponded to the degree of circulatory insufficiency (mean pressure 32, 47 and 55 mm with insufficiency of I, II and III degrees, respectively).