Treatment of comorbid chronic obstructive pulmonary disease and cardiovascular disease

Ватутин, Н. Т.; Смирнова, А. С.

doi:10.18093/0869-0189-2016-26-3-364-371

Cited by 7 publications

(1 citation statement)

References 33 publications

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“…Difficulties of CHF diagnosis in patients with COPD, the choice of tactics and therapy methods in recent years determine an excessive scientific interest to the study of the cardio-respiratory continuum [8,9]. The comorbidity rate, according to various data, makes from 25 to 42% aggravating significantly the outcome of the disease [10][11][12][13].…”

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confidence: 99%

Cardiac Biomarkers in Patients with Isolated and Combined Course of Chronic Obstructive Pulmonary Disease and Chronic Heart Failure

Khaletskaya¹,

Kuznetsov²,

Bolshova³

et al. 2018

Sovrem Tehnol Med

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The aim of the study was to define cardiac biomarkers in patients with isolated and combined chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF), to assess their level and diagnostic value in order to optimize the tactics of managing these patients. Materials and Methods. The study included 184 patients aged 38-85 years who were divided into 3 comparison groups: group 1 (n=68) was composed of patients with I-III stage COPD (GOLD, 2017); group 2 (n=64) patients with I-III functional class CHF; group 3 (n=52) patients with a combined course of COPD and CHF. Specific cardiac biomarkers were evaluated in 80 patients (in group 1 in 26, in group 2 in 27, and in group 3 in 27 patients). Patients' blood serum obtained by centrifuging was used for cardiac biomarker investigations. Results. NT-proBNP (F=0.59; p=0.0490) was found to be the most sensitive biomarker for determining the severity degree of the heart damage in the combined course of COPD and CHF. ST2 biomarker reliably reflects the severity of the isolated CHF (F=0.76; p=0.0285), while in the combined course of COPD and CHF, the value of this marker decreases (F=0.76; p=0.4718). A direct correlation has been established between the level of cardiac biomarker NT-proBNP and CHF functional class both in the isolated and combined course of COPD and CHF. In patients highly adherent to therapy, statistically significant reduction in the values of ST2 (F=3.22; p=0.0453) and NT-proBNP (F=12.20; p=0.0000) is observed which enables the physicians to control patient adherence to the administered therapy. The levels of biomarkers have been established at which a high risk of COPD progressing to one step or higher and/or CHF to one functional class and higher is noted in comorbid COPD and CHF course. Conclusion. The obtained data about the diagnostic value of cardiac biomarkers in comorbid course of COPD and CHF is reasonable to use for therapy optimization in order to improve the quality of patient's life and decrease the risk of unfavorable outcomes.

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Section: Introductionmentioning

confidence: 99%

Cardiac Biomarkers in Patients with Isolated and Combined Course of Chronic Obstructive Pulmonary Disease and Chronic Heart Failure

Khaletskaya¹,

Kuznetsov²,

Bolshova³

et al. 2018

Sovrem Tehnol Med

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Chronic obstructive pulmonary disease as a predictor of poor outcome of surgery for chronic thromboembolic pulmonary hypertension

Логинова

Kamenskaya

Chernyavskiy

et al. 2017

Pulʹmonologiâ (Mosk.)

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Хроническая тромбоэмболическая легочная гипер тензия (ХТЭЛГ) -достаточно редкое осложнение острой тромбоэмболии легочной артерии (ТЭЛА), которое, по разным данным, встречается в 0,4-9,1 % случаев и имеет крайне негативный долгосрочный прогноз [1][2][3]. Клинические признаки хронической ТЭЛА, особенно в случае поражения мелких ветвей легочной артерии (ЛА), малоспецифичны, связаны РезюмеЦель. Оценка влияния вентиляционных и диффузионных нарушений функции внешнего дыхания (ФВД) на результаты тромбэндар терэктомии (ТЭЭ) из ветвей легочной артерии (ЛА). Материалы и методы. В исследование включены пациенты с хронической тромбо эмболической легочной гипертензией (ХТЭЛГ), разделенные затем на 2 группы в зависимости от наличия (1 я группа; n = 43) или отсут ствия (2 я группа; n = 88) сопутствующей хронической обструктивной болезни легких (ХОБЛ). Всем пациентам выполнены бодипле тизмография и оценка диффузионной способности легких (DLCO) за 1 сутки до предполагаемого хирургического вмешательства в объ еме ТЭЭ из ветвей ЛА. Анализировались клинические периоперационные характеристики, осложнения и госпитальная летальность па циентов. Результаты. Установлено, что частота встречаемости ХОБЛ в исследуемой группе пациентов с ХТЭЛГ практически в 2 раза пре вышает частоту наличия диагноза ХОБЛ в анамнезе. По результатам функциональных легочных тестов закономерно показаны более выраженные нарушения ФВД у пациентов с ХТЭЛГ с сопутствующей ХОБЛ, включая более выраженное снижение DLCO. При наличии ХОБЛ у пациентов с ХТЭЛГ достоверно повышаются риск возникновения дыхательной недостаточности (ДН) в раннем послеопераци онном периоде (отношение шансов (ОШ) -2,1 (1,25-4,76); p = 0,020), длительность госпитализации (p = 0,02) и риск госпитальной ле тальности (ОШ -4,4 (1,21-16,19); p = 0,023). При анализе DLCO показана независимая предикторная ценность в отношении риска раз вития ДН в раннем послеоперационном периоде (ОШ -1,8 (1,08-3,57); p = 0,050). Заключение. При ХОБЛ у пациентов с ХТЭЛГ зна чительно увеличивается риск неблагоприятного исхода ТЭЭ из ветвей ЛА. Ключевые слова: хроническая тромбоэмболическая легочная гипертензия, хроническая обструктивная болезнь легких, диффузионная способность легких.Для цитирования: Логинова И.Ю., Каменская О.В., Чернявский А.М., Ломиворотов В.В. Хроническая обструктивная болезнь легких как предиктор неблагоприятного прогноза хирургического лечения хронической тромбоэмболической легочной гипертензии. AbstractAim. The aim of this study was to investigate an influence of pulmonary ventilation and diffusion disorders on outcome of pulmonary endarterecto my. Methods. The study involved patients with chronic thromboembolic pulmonary hypertension (CTEPH) with (n = 43) or without (n = 88) chron ic obstructive pulmonary disease (COPD). Body plethysmography and lung diffusing capacity measurement were performed in all patients before pulmonary endarterectomy. We analyzed perioperative clinical characteristics, complications and in hospital mortality. Results. COPD was diag nosed twice more often in patients wi...

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Influence of microcirculatory disorders in patients with moderate chronic obstructive pulmonary disease and systemic arterial hypertension on acid-base and gas balance of blood.

2018

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Material and methods. The clinical study involved 240patients (228 men and 12 women) aged 40 to 55, they were divided into 3 groups based on the duration of the disease. Patients of the first group suffered COPD disease up to 5 years, in the second group it was up to 10 years and in the third group it was more than 10 years. The degree of disturbance of microcirculation processes was investigated using laser Doppler flowmetry at the multifunction laser diagnostic complex “LAKK-M” (Russia, 2011). The following parameters were evaluated: the average perfusion value, saturation of mixed (capillary) blood, saturation of arterial blood, relative volume of the erythrocyte fraction in the skin of the middle fingertip, the index ofperfusion oxygen saturation in the microcirculation, the index of specific oxygen consumption in the tissue. The following parameters were also calculated: the efficiency of oxygen exchange, the fluorescence indicator of oxygen consumption; analysis of the frequency spectrum in the zone of myogenic, neurogenic and respiratory fluctuations of the blood flow. Results. As part of the study it was found that the increase in the prevalence of hypertension is increased in patients with COPD, depending on the duration of the disease: 2.5 times in patients of the 2nd group and 3.7 times in patients of the 3rd group compared with the patients of the 1st group. Based on the analysis of laser Doppler flowmetry data, the microcirculation index significantly changes in patients with COPD and AH in comparison with patients with isolated COPD by 5.7% (p <0.05) in the 1st group, by 11.8% (p <0.01) and 23.5% (p<0.001) in 2 and 3rd groups, respectively. Conclusion. The role of microcirculatory disorders was established in patients with comorbid pathology in the development of disorders in the gas composition parameters and acid-base balance of blood in patients with chronic obstructive pulmonary disease and systemic arterial hypertension, as well as the relationship between the duration of the anamnesis of comorbid pathology and the severity of the revealed disorders.

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Treatment of comorbid chronic obstructive pulmonary disease and cardiovascular disease

Cited by 7 publications

References 33 publications

Cardiac Biomarkers in Patients with Isolated and Combined Course of Chronic Obstructive Pulmonary Disease and Chronic Heart Failure

Cardiac Biomarkers in Patients with Isolated and Combined Course of Chronic Obstructive Pulmonary Disease and Chronic Heart Failure

Chronic obstructive pulmonary disease as a predictor of poor outcome of surgery for chronic thromboembolic pulmonary hypertension

Influence of microcirculatory disorders in patients with moderate chronic obstructive pulmonary disease and systemic arterial hypertension on acid-base and gas balance of blood.

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