This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Han, M. K. Articles by Martinez, F. J. Search for Related Content PubMed PubMed Citation Articles by Han, M. K. Articles by Martinez, F. J. Related Collections Pulmonary circulation and disease

(Circulation. 2007;116:2992-3005.)
© 2007 American Heart Association, Inc.

Cardiovascular Involvement in General Medical Conditions

Pulmonary Diseases and the Heart

MeiLan K. Han, MD, MS; Vallerie V. McLaughlin, MD; Gerard J. Criner, MD; Fernando J. Martinez, MD, MS

From the University of Michigan Health System (M.K.H., V.M., F.J.M.), Ann Arbor, Mich, and Temple University School of Medicine (G.C.), Philadelphia, Pa.

Correspondence to Fernando J. Martinez, MD, MS, 1500 E Medical Center Dr, 3916 Taubman Center, Ann Arbor, MI. E-mail fmartine{at}umich.edu

The complex nature of interactions between the pulmonary and cardiovascular systems is becoming increasingly appreciated. Pulmonary vascular abnormalities are frequently present in patients with respiratory disorders, including chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, sarcoidosis, neuromuscular or chest wall disorders, and disorders of ventilatory control including sleep apnea syndromes and obesity hypoventilation syndrome. Pulmonary hypertension, classified as group III in the World Health Organization classification scheme for pulmonary hypertension, may result in severe right ventricular dysfunction caused by lung disease, also known as cor pulmonale. The development of cor pulmonale is generally associated with poorer prognosis and increased death. Systemic manifestations of lung disease, particularly obstructive disorders, are also particularly relevant because they are associated with increased cardiac death and impaired health status. This article will discuss the most common pulmonary diseases and disorders of ventilatory control that cause pulmonary vascular abnormalities and cor pulmonale, with particular concentration on how treatment of these diseases may affect the heart. In addition, the complex nature of cardiac and lung disease will also be explored, particularly with respect to the relationship between chronic obstructive pulmonary disease, systemic inflammation, atherosclerosis, and cardiovascular death, which is currently a very active focus of research.

Key Words: pulmonary heart disease • pulmonary disease, chronic obstructive • hypertension, pulmonary • inflammation

This article has been cited by other articles:

				V. V. McLaughlin, S. L. Archer, D. B. Badesch, R. J. Barst, H. W. Farber, J. R. Lindner, M. A. Mathier, M. D. McGoon, M. H. Park, R. S. Rosenson, et al. ACCF/AHA 2009 Expert Consensus Document on Pulmonary Hypertension: A Report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents and the American Heart Association Developed in Collaboration With the American College of Chest Physicians; American Thoracic Society, Inc.; and the Pulmonary Hypertension Association J. Am. Coll. Cardiol., April 28, 2009; 53(17): 1573 - 1619. [Full Text] [PDF]

				Writing Committee Members, V. V. McLaughlin, S. L. Archer, D. B. Badesch, R. J. Barst, H. W. Farber, J. R. Lindner, M. A. Mathier, M. D. McGoon, M. H. Park, et al. ACCF/AHA 2009 Expert Consensus Document on Pulmonary Hypertension: A Report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents and the American Heart Association: Developed in Collaboration With the American College of Chest Physicians, American Thoracic Society, Inc., and the Pulmonary Hypertension Association Circulation, April 28, 2009; 119(16): 2250 - 2294. [Full Text] [PDF]

				T. E. Sussan, T. Rangasamy, D. J. Blake, D. Malhotra, H. El-Haddad, D. Bedja, M. S. Yates, P. Kombairaju, M. Yamamoto, K. T. Liby, et al. From the Cover: Targeting Nrf2 with the triterpenoid CDDO- imidazolide attenuates cigarette smoke-induced emphysema and cardiac dysfunction in mice PNAS, January 6, 2009; 106(1): 250 - 255. [Abstract] [Full Text] [PDF]

				F. Luppi, F. Franco, B. Beghe, and L. M. Fabbri Treatment of Chronic Obstructive Pulmonary Disease and Its Comorbidities Proceedings of the ATS, December 1, 2008; 5(8): 848 - 856. [Abstract] [Full Text] [PDF]

				G. Calmettes, V. Deschodt-Arsac, E. Thiaudiere, B. Muller, and P. Diolez Modular control analysis of effects of chronic hypoxia on mouse heart Am J Physiol Regulatory Integrative Comp Physiol, December 1, 2008; 295(6): R1891 - R1897. [Abstract] [Full Text] [PDF]

				A. Chaouat, R. Naeije, and E. Weitzenblum Pulmonary hypertension in COPD Eur. Respir. J., November 1, 2008; 32(5): 1371 - 1385. [Abstract] [Full Text] [PDF]

				M. Humbert Update in Pulmonary Arterial Hypertension 2007 Am. J. Respir. Crit. Care Med., March 15, 2008; 177(6): 574 - 579. [Full Text] [PDF]