الفهرس 
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Abstract
Chronic obstructive pulmonary disease (COPD) is a common respiratory condition involving the airways and characterized by airflow limitation. It affects more than 5 percent of the population and is associated with high morbidity and mortality. It is the third-ranked cause of death in the United States, killing more than 120,000 individuals each year.
Cor pulmonale was classically defined as “hypertrophy of the right ventricle resulting from diseases affecting the function and/or structure of the lungs except when these pulmonary alterations are the result of diseases that primarily affect the left side of the heart”. Since this definition does not indicate the presence of right heart failure, and since the presence of edema does not always imply underlying right heart failure in stable COPD patients, the terms core pulmonale and right heart failure are not synonymous.
Pulmonary hypertensio secondary to chronic obstructive pulmonary disease (COPD) is placed in group 3 of the WHO classification of PAH, that is, PAH associated with lung diseases and/or hypoxemia.
BNP has been shown to increase in hypoxemic patients with chronic obstructive pulmonary disease (COPD) and it is significantly increased in patients with cor pulmonale when compared to patients with COPD alone. It is especially increased in proportion to the degree of right ventricular (RV) dysfunction.
CRP (C-reactive protein) is an acute phase reactant and its concentration is increased in inflammatory diseases.
CRP play a role in the pathogenesis of pulmonary hypertension associated COPD.
plasma CRP levels correlated significantly with systolic pulmonary artery pressure.
A recent study demonstrated that CRP levels correlated with pack-years of smoking and predicted all-cause mortality in patients with mild to moderate COPD. In COPD patients with pulmonary hypertension, serum CRP level was higher compared to those without pulmonary hypertension.
The aim of this study is to provide that BNP and CRP levels increase in COPD patients with pulmonary hypertension (core pulmonale) as they are markers for pulmonary hypertension.
To found significant correlation between BNP and echocardiography determined PASP.
Identify whether the inflammatory process in stable COPD patients is powerful enough to produce significant changes in the selected inflammatory marker.
In the present study which was conducted on 30 patients and 10 control healthy subjects.
The patients are classified in to two groups
• Group І 20 patients COPD core pulmonale
• Group ІІ 10 patients stable COPD
For all ,assessment were done including history taking physical examination, pulmonary function test echocardiography, serum CRP and BNP measuring.
There was high significant increase in CRP and BNP levels among core pulmonale compared with stable group without pulmonary hypertension.
This confirms that CRP and BNP are important markers of pulmonary hypertension.
Also there is strong positive correlation between pulmonary artery pressure, BNP and CRP.
Negative correlation had been reported between CRP, BNP and FVE1 supporting the fact that when pulmonary function worsens CRP and BNP increase.