Morphogenesis of postresection of cor pulmonale
DOI:
https://doi.org/10.11603/2414-4533.2017.3.8130Keywords:
lung resection, postresection arterial pulmonary hypertension, pulmonary heart disease.Abstract
Development of pulmonary heart disease produces a number of compensatory and adaptive processes in all body structures that play an important role in decompensation of this disorder. Various physiological processes that unfold during this process can be objectively evaluated with the help of morphometry, which allows visualizing the results of morphology studies, sequentially interpret morphogenesis mechanisms in the damaged organs, and determine adaptive reserves and capability for corrective response. Irreversible pathological processes in the pulmonary tissue are a cause of resection of the lungs. It is one of the most traumatic surgical interventions, frequently accompanied by complications due to the sudden increase in pulmonary blood pressure caused by decrease in its volume. Insufficient deployment of adaptive and compensatory resources by the myocardium can cause acute right ventricular heart failure or acute pulmonary heart disease. Removal of more than one third of pulmonary tissue may lead to the development of a number of disorders. Among them there is a right ventricular hyperdynamic syndrome; dilatation at the stage of decompensation of the chronic pulmonary heart; arterial hypertension in the pulmonary circle; and pulmonary heart disease, which is characterized by increased mass and enlarged chambers of the heart with dominating hypertrophy and dilatation of the right ventricle and right atrium,thickening of arterial walls, narrowing of arterial lumen, decrease in the flow capability, increased number of damaged endothelial cells, reactive hyperaemia the capillary venules and venules, deterioration of secretory activity of the atrium myoendocrine cells, dystrophy, necrobiosis of cardiomyocytes, endothelial cells, and stromal structures, infiltrative and sclerotic processes. This study utilized morphometry to show that long-term effects of right-sided pulmonectomy in Vietnamese breed pigs and laboratory white male rats result in a pronounced remodeling of heart chambers characterized by unbalanced, disproportional growth their mass and expansion of the chambers. Additionally, in post-surgical period, the pulmonary heart reveals marked structural reorganization of predominantly small arteries of the ventricles and atrium, and expressed remodeling of microhemocirculatory vessels of the heart ventricles and atrium. As decompensation of hypertrophied heart occurs, the secretory activity of myoendocrinocytes decreases. The stages of hypertrophied myocardial morphogenesis, such as compensated and decompensated pulmonary heart, can be characterized using cardiometric parameters. The most informative are the indicators that highlight imbalance and disproportionality of hypertrophic and hyperplastic processes on all structural levels of the heart muscle.
References
Belovol, A.N. (2017). Personifitsirovannyy podhod k antitromboticheskoy terapii pri ishemicheskoy bolezni serdtsa [Personalised approach to antithrombotic theraphy in ishemic heart disease]. Ukrainskyi erapevtychnyi zhurnal – Ukrainian Therapeutic Journal, 2, 20-25 [in Russian].
Kovalenko, V.M., & Kornatskyi, V.M. (2010). Demografiia i stan zdorovia narodu Ukrainy [Demography and the state of health of people of Ukraine]. (Analitychno-statystychnyi posibnyk) “Instytut Kardiolohii im. M.D Strazheska – (analytical and statistical guide “Institute of Cardiology named after Strazhesko“, Kyiv [in Russian].
Amosova, K.M., Konopliova, L.F., & Mazur, I.D. (2009). Klinichnyi perebih ta stan miokarda vnaslidok khronichnoi obstruktuvnoi patolohii lehen zalezhno vid naiavnosti lehenevoi hipertenzii [Clinical course and condition of myocardium depending on chronic obstructive pulmonary disease and pulmonary hypertension]. Sertse i sudyny – Heart and Vessels, 2, 48-52 [in Ukrainian].
Konopliova, L.F.(2011). Khronicheskoe legochnoe serdtse: problemy klassifikatsii, diagnostiky i lecheniya [Chronical cor pulmonale: the problems of classification of diagnosis and treatment]. Zdorovia Ukrainy – Health of Ukraine, 1, 24-26 [in Russian].
Noreyko, B.V., & Noreyko, S.B. (2011). Khronicheskoe legochnoe serdtse [Chronical cor pulmonale]. Novosti meditsyny i farmatsii – News of Medicine and Pharmacy, 9 (364), 14-17 [in Russian].
Tatarchuk, L.V. (2011). Morfometrychnyi analiz remodeliuvannia kamer sertsia pislia pulmonektomii [Morphometric analysis of remodeled heart chambers after pulmonectomy]. Zdobutky
klinichnoi ta eksperymentalnoi medytsyny – Achievements in Clinical and Experimental Medicine, 2 (15), 123-126 [in Ukrainian].
Herasymiuk, I.Ye., Fedoniuk, Ya.I., & Flekei, P.P. (2006). Vplyv postrezektsiinoi lehenevoi arterialnoi hipertenzii na arterio-venozni spivvidnoshennia lehenevykh sudun [The effect of post-resection pulmonary arterial hypertension on the arteryvenous ratio of pulmonary vessels]. Visnyk morfolohii – Journal of Morphology, 13 (2), 476-477 [in Ukrainian].
Zaiachkivskyi, S.A., Fedoniuk, Ya.I., & Herasymiuk, I.Ye. (2006). Osoblyvosti strukturno-prostorovoi orhanizatsii krovonosnoho rusla sertsia sobak za umov khirurhichnoi korektsii postrezektsiinoi lehenevoi arterialnoi hipertenzii [Characteristics of the structural-spatial organization of the blood vessels of the
heart of dogs in the condition of correction of post-resection pulmonary arterial hypertension]. Visnyk naukovykh doslidzen – Bulletin of Scientific Researches, 3, 36-37 [in Ukrainian].
Avtandilov, G.G. (2002). Osnovy kolichestvennoy patologicheskoy anatomii. [Fundamentals of quantitative pathological anatomy]. Moscow: Meditsina [in Russian].
Sarkisov, D.S. (1997). Strukturnye osnovy adaptatsyi i kompensatsyi narushennykh funktsyy [Structural basis adaptation and compensation disturbance functions]. Moscow: Meditsina [in Russian].
Rivas, D., Femandes, R., & Torra, M. (2014). Single-port thoracoscopic lobectomy in a nonintubated patient: a list invasive procedure for major lung resection. Interact. Cardiovasc. Thorac. Surg., 4, 552-555.
Vereshchako, R.I. (2015). Lobektomiia z rezektsiieiu ta plastukoiu bronkhiv i lehenevoi arterii –shliakh do pidvyshchennia rezektabelnosti raku lehen [Lobectomy with resection and plastic of the bronchi and pulmonary artery pathway to increase resectability of lung cancer]. Khirurhiia Ukrainy – Surgery of Ukraine, 1 (53), 60-53 [in Ukrainian].
Hnatiuk, M.S., & Slabyi, O.B. (2016). Morfometrychna otsinka osoblyvostei remodeliuvannia kamer sertsia z riznymy typamy krovopostachannia [Morphometric evaluation of the features of remodeling of chambers of cor pulmonale with different types of blood supply]. Zdobutky klinichnoi ta eksperymentalnoi medytsyny – Achievements of clinical and experimental medicine, 1, 17-20 [in Ukrainian].
Barnes, P.J., Shapiro, D., & Pamwels, R.A. (2013). Chronic obstructive pulmonare disease molecular and cellular mechanisms. Eur. Respirat., 22, 672-678.
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish their work in Hospital Surgery. Journal by L. Ya. Kovalchuk agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)
