Abstract
The hearts and lungs of 36 patients dying of cystic fibrosis have been studied to establish the relationship between right ventricular hypertrophy (RVH), pathological changes in the pulmonary circulation, and the clinical features. The presence and degree of RVH were measured by Fulton's technique of weighing the ventricles separately. Of the subjects who died after the age of 3 years, one in six had no RVH, although the mean age of this group was not significantly different from that of the remainder. There was no correlation between duration of cyanosis, haemoglobin levels, and RVH. Although not statistically significant, the cases without RVH tended to have had clubbing of the finger-nails for longer periods before death. The electrocardiogram was useful in the diagnosis of RVH. Right ventricular hypertrophy was common in children with lungs of large volume as judged by the radiographic centile of lung length. Cases with RVH show reduced background haze in the arteriogram and fewer arteries per unit area of lung. For the first time thickening of the medial muscle layer proportional to the degree of RVH has been demonstrated, only in the smaller arteries. Arterial subintimal fibrosis is more common in cases with RVH, as is thickening of the walls of small pulmonary veins. The implications of these findings are discussed.
Full text
PDF







Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Caplan A., Gross S. Hematologic and serologic studies in cystic fibrosis. J Pediatr. 1968 Oct;73(4):540–547. doi: 10.1016/s0022-3476(68)80269-0. [DOI] [PubMed] [Google Scholar]
- Davies G., Reid L. Growth of the alveoli and pulmonary arteries in childhood. Thorax. 1970 Nov;25(6):669–681. doi: 10.1136/thx.25.6.669. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Esterly J. R., Oppenheimer E. H. Observations in cystic fibrosis of the pancreas. 3. Pulmonary lesions. Johns Hopkins Med J. 1968 Feb;122(2):94–101. [PubMed] [Google Scholar]
- FULTON R. M., HUTCHINSON E. C., JONES A. M. Ventricular weight in cardiac hypertrophy. Br Heart J. 1952 Jul;14(3):413–420. doi: 10.1136/hrt.14.3.413. [DOI] [PMC free article] [PubMed] [Google Scholar]
- GOLDRING R. M., FISHMAN A. P., TURINO G. M., COHEN H. I., DENNING C. R., ANDERSEN D. H. PULMONARY HYPERTENSION AND COR PULMONALE IN CYSTIC FIBROSIS OF THE PANCREAS. J Pediatr. 1964 Oct;65:501–524. doi: 10.1016/s0022-3476(64)80286-9. [DOI] [PubMed] [Google Scholar]
- Hislop A., Reid L. New pathological findings in emphysema of childhood. 1. Polyalveolar lobe with emphysema. Thorax. 1970 Nov;25(6):682–690. doi: 10.1136/thx.25.6.682. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kelminson L. L., Cotton E. K., Vogel J. H. The reversibility of pulmonary hypertension in patients with cystic fibrosis. Observations on the effects of tolazoline hydrochloride. Pediatrics. 1967 Jan;39(1):24–35. [PubMed] [Google Scholar]
- Mearns M. B., Hunt G. H., Rushworth R. Bacterial flora of respiratory tract in patients with cystic fibrosis, 1950-71. Arch Dis Child. 1972 Dec;47(256):902–907. doi: 10.1136/adc.47.256.902. [DOI] [PMC free article] [PubMed] [Google Scholar]
- RECAVARREN S., ARIAS-STELLA J. GROWTH AND DEVELOPMENT OF THE VENTRICULAR MYOCARDIUM FROM BIRTH TO ADULT LIFE. Br Heart J. 1964 Mar;26:187–192. doi: 10.1136/hrt.26.2.187. [DOI] [PMC free article] [PubMed] [Google Scholar]
- ROYCE S. W. Cor pulmonale in infancy and early childhood; report on 34 patients, with special reference to the occurrence of pulmonary heart disease in cystic fibrosis of the pancreas. Pediatrics. 1951 Aug;8(2):255–274. [PubMed] [Google Scholar]
- Siassi B., Moss A. J., Dooley R. R. Clinical recognition of cor pulmonale in cystic fibrosis. J Pediatr. 1971 May;78(5):794–805. doi: 10.1016/s0022-3476(71)80350-5. [DOI] [PubMed] [Google Scholar]
- Simon G., Reid L., Tanner J. M., Goldstein H., Benjamin B. Growth of radiologically determined heart diameter, lung width, and lung length from 5-19 years, with standards for clinical use. Arch Dis Child. 1972 Jun;47(253):373–381. doi: 10.1136/adc.47.253.373. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Symchych P. S. Pulmonary hypertension in cystic fibrosis. A description and morphometric analysis of the pulmonary vasculature. Arch Pathol. 1971 Dec;92(6):409–414. [PubMed] [Google Scholar]
- WEIBEL E. R., GOMEZ D. M. A principle for counting tissue structures on random sections. J Appl Physiol. 1962 Mar;17:343–348. doi: 10.1152/jappl.1962.17.2.343. [DOI] [PubMed] [Google Scholar]

