V.M. GAZIZYANOVA^1,2, O.V. BULASHOVA, ¹, E.V. KHAZOVA¹, M.I. MALKOVA^1,2

¹Kazan State Medical University, 49 Butlerov Str., Kazan, Russian Federation, 420012

²City Clinical Hospital No. 7 54 Chuikov Str., Kazan, Russian Federation, 420132

Contact:

Gazizyanova V.M. — post-graduate student of the Department of Propedeutics of Internal Diseases, tel. +7-927-037-73-41, e-mail: violettakoshka2006@rambler.ru

Bulashova O.V. — D. Med. Sc., Professor of the Department of Propedeutics of Internal Diseases, tel. (843) 296-14-03, e-mail: boulashova@yandex.ru

Khazova E.V. — Cand. Med. Sc., Associate Professor of the Department of Propedeutics of Internal Diseases, tel. (843) 236-04-61, e-mail: hazova_elena@mail.ru

Malkova M.I. — Cand. Med. Sc., Assistant Lecturer of the department of Propedeutics of Internal Diseases, Head of the Functional Diagnostics Department, tel. +7-960-051-61-16, e-mail: marimalk@yandex.ru

The issues of comorbid pathology are of interest for many researchers due to the high prevalence, infavorable course and prognosis. One of the most common combinations in clinical practice is heart failure and chronic obstructive pulmonary disease. There are data of the presence of common risk factors and pathogenesis links, one of which is the neurohormonal disbalance. The research objective is to assess the heart rate variability in patients with chronic heart failure combined with chronic obstructive pulmonary disease in terms of clinical and functional characteristics. Materials and methods. 183 chronic heart failure patients of I-IV functional class (FC) were selected, including 105 patients with chronic obstructive pulmonary disease. All patients underwent spirometry and holter monitoring of the electrocardiogram. Results. The group of CHF patients with concomitant COPD is characterized by a decrease in the standard deviation of normal RR intervals — SDNN (p = 0.031), SDNN index (p = 0.005), an increase in the mean heart rate (p = 0.001), compared to the patients without pulmonary pathology. It was shown that with the progression of CHF (increase in the FC of CHF and a decrease in the left ventricular ejection fraction), SDNN values ​​decrease (p <0.05). Conclusion. The patients with CHF in combination with COPD show a pronounced vegetative imbalance, compared to the patients without COPD. The decrease of heart rate variability parameters predisposes to unfavorable course of heart failure both in patients with heart failure and COPD, with the increase of bronchial obstruction aggravating the reduction of HRV parameters. Supposedly, the SDNN parameter can be used as a marker of an unfavorable course of heart failure.

Key words: comorbidity, chronic heart failure, chronic obstructive pulmonary disease, heart rate variability.

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