V.M. GAZIZYANOVA, O.V. BULASHOVA, E.V. KHAZOVA, N.R. KHASANOV, V.N. OSLOPOV

Kazan State Medical University, Kazan

  Contact details:

Gazizyanova V.M. ― Assistant of the Department of the Propaedeutics of Internal Diseases

Address: 49 Butlerov St., Kazan, Russian Federation, 420012, e-mail: sunny.gazizyanova@list.ru

 Relevance. Multimorbidity is a characteristic feature of patients with chronic heart failure, contributes to the clinical course of the disease and significantly aggravates the prognosis of the syndrome, which predisposes to social and economic losses and makes adjustments at the stage of pharmacotherapy.

Objective ― to investigate the respiratory function and parameters of echocardiography in patients with chronic heart failure in comorbidity with chronic obstructive pulmonary disease.

Material and methods. By the inclusion/exclusion criteria, 183 patients with chronic heart failure were selected, including 105 with chronic heart failure in combination with chronic obstructive pulmonary disease. The clinical variant was studied by belonging to the functional class, the severity of chronic obstructive pulmonary disease. All patients experienced the walk test, spirometry, echocardiography, testing on the scale of the clinical condition, their the quality of life was studied.

Results. The clinical variant of heart failure in comorbidity with COPD was characterized by a high frequency of smoking, low tolerance to physical exertion and quality of life. In men with CHF without COPD, left ventricular myocardium hypertrophy was the most pronounced in comparison with CHF in the absence of lung disease. The type of respiratory dysfunction in CHF in comorbidity with COPD was characterized by a mixed type of disorders (68.4%), in CHF without chronic obstructive pulmonary disease ― restrictive (25.6%).

Conclusion. The results showed that chronic obstructive pulmonary disease makes a significant contribution to the clinical phenotype of chronic heart failure in terms of integrating cardiovascular and respiratory systems, which demonstrates the need for a personalized approach to the differential diagnosis and individualization of pharmacotherapy.

Key words: comorbidity, chronic heart failure, chronic obstructive pulmonary disease, echocardiographic parameters, spirometry.

REFERENCES

1. Korreya L.L., Lebedev T.Yu., Efremova O.A. et al. The problem of polymorbidity with a combination of chronic obstructive pulmonary disease and certain cardiovascular diseases. Nauchnye vedomosti. Seriya Meditsina i farmatsiya, 2013, no. 4 (147), iss. 21, pp. 12-17 (in Russ.).
2. Oganov R.G., Denisov I.N., Simanenkov V.I. et al. Comorbid pathology in clinical practice. Clinical recommendations. Kardiovaskulyarnaya terapiya i profilaktika, 2017, no. 16 (6), pp. 5-56 (in Russ.).
3. Rushton C.A., Satchithananda D.K., Jones P.W. Noncardiovascular comorbidity, severity and prognosis in non-selected heart failure populations: a systematic review and meta-analysis. Int. Journal of Cardiology, 2015, vol. 196, pp. 98-106.
4. Canepa M., Temporelli P.L., Rossi A. et al. Prevalence and prognostic impact of chronic obstructive pulmonary disease in patients with chronic heart failure: data from the GISSI-HF Trial. Cardiology, 2017, vol. 136 (2), pp. 128-137.
5. Chen W., Thomas J., Sadatsafavi M. et al. Risk of cardiovascular comorbidity in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. Lancet Respiratory Medicine, 2015, Aug, vol. 3 (8), pp. 631-9.
6. Rutten F.H., Cramer M.J., Grobbee D.E. et al. Unrecognized heart failure in elderly patients with stable chronic obstructive pulmonary disease. European Heart Journal, 2005, vol. 26 (18), pp. 1887-94.
7. Mannino D.M., Buist A.S. Global burden of COPD: risk factors, prevalence, and future trends. Lancet, 2007, vol. 370, pp. 765-773.
8. Rutten Frans H. β-blockers may reduce mortality and risk of exacerbations in patients with chronic obstructive pulmonary disease. Arch. Internal. Med, 2010, vol. 170 (10), pp. 880-887.
9. Hawkins N.M., Huang Z., Pieper K.S. et al. Chronic obstructive pulmonary disease is an independent predictor of death but not atherosclerotic events in patients with myocardial infarction: analysis of the Valsartan in Acute Myocardial Infarction trial (VALIANT). European Journal of heart failure, 2009, vol. 11, pp. 292-298.
10. O’Kelly N., Robertson W., Smith J. et al. Short-term outcomes in heart failure patients with chronic obstructive pulmonary disease in the community. World Journal Cardiology, 2012, vol. 4 (3), pp. 66-71.
11. Plesner L.L., Dalsgaard M., Schou M. et al. The prognostic significance of lung function in stable heart failure outpatients. Clinical Cardiology, 2017, pp. 1-7.
12. Hawkins N.M. Chronic obstructive pulmonary disease and heart failure in Europe — further evidence of the need for integrated care. European Journal of Heart Failure, 2018, vol. 20, pp. 111-113.
13. Honda Y., Watanabe T., Otaki Y. et al. Impact of reduced forced expiratory volume on cardiac prognosis in patients with chronic heart failure. Heart vessels, 2018, pp. 1-9.
14. Barnes P.J., Celli B.R. Systemic manifestations and comorbidities of COPD. Eur. Respir. J., 2009, vol. 33, pp. 1165-85. doi: 10.118309031936.00128008.
15. Klester E.B., Plinokosova L.A., Lychev V.G. et al. Features of structural and functional myocardial remodeling, depending on the etiological cause of chronic heart failure. Serdechnaya nedostatochnost’, 2014, no. 15 (6), pp. 355-360 (in Russ.).
16. Mareev V.Yu., Ageev F.T., Arutyunov G.P. et al. National recommendations of VNOK and OSSN on the diagnosis and treatment of CHF (third review). Serdechnaya nedostatochnost’, 2010, no. 11 (1), pp. 3-62 (in Russ.).