Characteristics of the Functional and Structural-Functional State of the Сardiovascular System of Patients with Ischemic Heart Disease and Obesity

Abstract

The purpose of the study was to determine the changes in the functional and structural-functional state of the cardiovascular system of individuals with ischemic heart disease against the background of obesity. Materials and methods. 105 people of the diagnostic group were examined: 70 people with ischemic heart disease and obesity (1st diagnostic group) and 35 patients with ischemic heart disease without obesity (2nd diagnostic group), who were treated in the municipal non-commercial enterprise «City Clinical Hospital No. 27» of Kharkiv Regional Council. In the 1st diagnostic group, the majority of patients with I (26 (37.1%) degree of obesity, unlike II (24 (34.3%) and III (20 (28.6%). The control group was formed by 35 healthy persons without any diseases of the cardiovascular system. In the 1st diagnostic group there were 51 (72.9%) ill female and 19 (27.1%) male, in the 2nd – 24 (68.6%) male and 11 (31.4%) female. Age of the 1st and 2nd diagnostic groups amounted to 63.6±8.8 and 69.7±7.9 years respectively, and the control group – 35.2±4.9 years. Body weight and body weight index (p < 0.001) was higher in the 1st diagnostic group (respectively 101.3±15.8 kg and 36.2±4.4 kg/m2) compared to the 2nd (respectively 71.9±8.8 kg and 24.2±1.4 kg/m2) and control (respectively 64.3±7.4 kg and 22.1±1.2 kg/m2). Results and discussion. The presence of arrhythmic disorders of cardiovascular system in coronary heart disease was noted, especially against the background of obesity. The predominance of the cardiovascular system characteristics of the functional state in coronary heart disease with obesity in comparison with the monocurrent coronary heart disease has been determined: accordingly, diastolic arterial pressure is 91.7±7.8 and 89.3±9.1 mmHg; heart frequency – 81.9±11.2 and 78.8±9.5 b/min and pulse 81.2±9.8 and 78.2±9.6 b/min. The advantage of cardiovascular system characteristics in obesity of the III degree in comparison with the II and I degrees is fixed: accordingly, systolic arterial pressure is 160.0±15.9, 158.8±16.1 and 152.7±11.8 mmHg; diastolic arterial pressure – 93.5±8.1, 91.9±8.8 and 90.19±6.6 mmHg; heart rate – 82.0±7.4, 81.4±10.6 and 82.3±14.2 b/min and pulse – 82.0±7.4, 81.0±10.3 and 80.8±11.2 b/min. Conclusion. A reliable possibility of provoking significant reductions in the characteristics of the heart functional state in patients with coronary heart disease and obesity compared with the control group was determined. There is a significant advantage of changes in the structural characteristics of the heart in coronary heart disease and obesity and monocurrent coronary heart disease in contrast to the control group. Significant (p < 0.001) increase in aortic diameter was determined in patients with single coronary heart disease (3.30±0.33 cm) and on the background of obesity (3.22±0.29 cm) compared with the control group (2.86±0.14) and intentionally comparable values of E and A and their ratios in the 1st and 2nd groups (respectively E 0.71±0.18 and 0.69±0.17 cm/s (p = 0.463); A – 0.81±0.19 and 0.85±0.24 cm/s (p = 0.342) and E/A – 0.90±0.27 and 0.82±0.27 (p = 0.102). The predominance of the structural and functional state of the heart values in III and II degrees of obesity compared to I degree was intentionally determined