What cardiac pathologic condition contributes to ventricular remodeling?

A. Left heart failure: COPD primarily affects the lungs and increases pulmonary vascular resistance, leading to right-sided heart strain rather than left heart failure. Left heart failure is more commonly associated with conditions such as hypertension, myocardial infarction, and valvular diseases, which impair the heart’s ability to pump blood systemically.

B. Restrictive cardiomyopathy: Restrictive cardiomyopathy is a condition where the heart muscle becomes stiff and loses its ability to relax and fill properly, often due to infiltrative diseases such as amyloidosis or sarcoidosis. COPD does not directly lead to restrictive cardiomyopathy, as its primary cardiovascular complication is increased pulmonary resistance causing right heart strain.

C. Hypertrophic cardiomyopathy: Hypertrophic cardiomyopathy is characterized by abnormal thickening of the heart muscle, usually due to genetic mutations. It primarily affects the left ventricle and impairs diastolic filling. COPD does not cause hypertrophic cardiomyopathy, as its cardiovascular effects are due to pulmonary hypertension and right ventricular overload rather than structural abnormalities of the myocardium.

D. Right heart failure: Chronic COPD leads to persistent pulmonary hypertension due to hypoxic vasoconstriction and remodeling of pulmonary vessels. This increased pulmonary vascular resistance forces the right ventricle to work harder to pump blood into the lungs, leading to right ventricular hypertrophy and eventual right heart failure, also known as cor pulmonale. Symptoms include peripheral edema, jugular vein distention, and hepatomegaly due to systemic venous congestion.

A. Administration of broad-spectrum antibiotics: Broad-spectrum antibiotics are not a primary treatment for asthma, as asthma is an inflammatory condition and not primarily caused by bacterial infections. Antibiotics may be used for coexisting infections but are not the most successful initial treatment for chronic asthma.

B. Administration of drugs that decrease airway inflammation: While decreasing airway inflammation is important in managing asthma, the most successful long-term treatment begins with addressing the underlying causes and triggers. Reducing inflammation is part of the treatment strategy but is not the first action.

C. Avoidance of the causative agent: Avoiding the causative agent or trigger of asthma is the most successful initial treatment. Identifying and eliminating exposure to allergens or irritants, such as pollen, smoke, or pet dander, can significantly reduce the frequency and severity of asthma attacks, making it the foundational step in asthma management.

D. Administration of drugs that reduce bronchospasm: Medications that reduce bronchospasm, such as bronchodilators, are essential for immediate relief of asthma symptoms. However, they do not address the underlying inflammation and triggers, making avoidance of causative agents the most successful initial treatment for chronic asthma.