Abstract
Edwards, C. W. (1973). Thorax, 29, 75-80. Left ventricular hypertrophy in emphysema. The role of systemic hypertension in 10 emphysematous subjects with left ventricular hypertrophy was investigated. The medial thickness of the internal mammary artery was used as a parameter of raised systemic blood pressure during life. The pulmonary vasculature, ventricular weights, and the type and severity of emphysema in these patients were also studied. A group of 10 normotensive subjects and a group of 10 subjects with systemic hypertension were used as controls. The medial thickness of the internal mammary artery was significantly greater in the group of patients with systemic hypertension. Using this criterion it was found that four of the 10 patients with emphysema and left ventricular hypertrophy showed evidence of systemic hypertension. In these patients the pulmonary arterioles and arteries were normal. Three of the remaining six patients with emphysema and left ventricular hypertrophy showed the changes of hypoxic pulmonary vascular disease. In the other three the pulmonary vasculature showed no abnormality. The left ventricular weights and total ventricular weights in the patients with emphysema and left ventricular hypertrophy were significantly higher than in the group of patients with systemic hypertension only. There was no correlation between ventricular weights and the type or severity of emphysema. There appears to be a definite syndrome characterized by emphysema, normal systemic blood pressure, and enlargement of the left as well as the right ventricle. Hypoxic pulmonary vascular disease is not always present.