Functional condition of platelets and blood rheology in patients with chronic heart failure with cardiopulmonary pathology


DOI: https://dx.doi.org/10.18565/therapy.2018.7-8.96-105

V.V. Evdokimov, E.V. Kovalenko, A.G. Evdokimov, N.Yu. Klevtsova, E.Yu. Yushchuk, K.I. Tebloev

1 Department of hospital therapy No. 2 of the General Medicine Faculty of «A.I. Evdokimov Moscow State University of medicine and dentistry» FSAEI HE of the Ministry of Healthcare of Russia; 2 Moscow regional perinatal center (Moscow region, Balashikha); 3 Department of clinical functional diagnostics of the general medicine faculty of «A.I. Evdokimov Moscow State University of medicine and dentistry» FSAEI HE of the Ministry of Healthcare of Russia
According to the opinion of some authors, the combination of ischemic heart disease (IHD) and chronic obstructive pulmonary disease (COPD) leads to the syndrome of mutual complication and requires a special approach to the treatment of this cardiopulmonary pathology, the final stage of which is the development of chronic heart failure (CHF). The purpose of the study is to estimate the clinical status, quality of life, changes in platelet chain of hemostasis and blood rheological properties in case of CHF II-III functional class (FC) in ischemic heart disease patients in combination with COPD II-III degree and the possibility of their correction. Material and methods. 158 patients were examined – 128 (78,8%) men and 30 (21,2%) women. Patients of the 1st group received enalapril and nebivolol in addition to the baseline therapy, patients of the 2nd group received nebivolol and losartan, patients of the 3rd group received standard CHF therapy without nebivolol addition. Results. In patients of all groups, on the phone of the combined therapy, one could see an improvement in the clinical course of the disease, quality of life, which was expressed in decrease of FC CHF, degree of dyspnea, increase of exercise tolerance and life quality improvement. At the same time, in the 1st and 2nd groups there was a significantly more expressed decrease in the frequency (-47.1% and -46.9% against -29.9%) and the total duration (-45.2% and -47.1 % vs. -34.8%) of ischemia episodes compared with the control group. Also, by the end of the observation, there was a significant decrease in platelet aggregation activity in all groups, which was more expressed in the first and second groups. Conclusion. In patients with CHF of ischemic genesis in combination with COPD stage II–III, the intake of nebivolol in combination with enalapril or losartan in equally doses improves the quality of life, increases exercise tolerance, reduces the frequency and duration of painless ischemia, leads to normalization of the daily blood pressure profile, improves platelet aggregation activity, blood rheological properties and lipid metabolism.
Keywords: chronic heart failure, coronary heart disease, chronic obstructive pulmonary disease, platelet aggregation, blood viscosity, nebivolol, enalapril, losartan
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    • About the Autors

    Vladimir V. Evdokimov, PhD, associate professor of the Department of hospital therapy No. 2, faculty of general medicine, «A.I. Evdokimov Moscow State Medical University». Address: 127473, Moscow, 20, bld.1, Delegatskaya St. Tel. +7 (495) 609-67-00.
    Elena V. Kovalenko, PhD, associate professor of the Department of hospital therapy No. 2, faculty of general medicine, «A.I. Evdokimov Moscow State Medical University». Address: 127473, Moscow, 20, bld.1, Delegatskaya St. Tel. +7 (495) 609-67-00.
    Anna G. Evdokimova, MD, professor of the Department of hospital therapy No. 2, faculty of general medicine, «A.I. Evdokimov Moscow State Medical University». Address: 127473, Moscow, 20, bld.1, Delegatskaya St.
    Tel.: +79039614419. E-mail: Aevdokimova@rambler.ru.
    Elena N. Yushchuk, MD, professor of the Department of clinical functional diagnostics of faculty of general medicine, «A.I. Evdokimov Moscow State Medical University». Address: 127473, Moscow, 20, bld.1, Delegatskaya St. Tel. +7 (495) 609-67-00.
    Konstantin I. Tebloev, MD, professor, head of the Department of hospital therapy No. 2 of the faculty of general medicine, «A.I. Evdokimov Moscow State Medical University». Address: 127473, Moscow, 20, bld.1, Delegatskaya St. Tel. +7 (495) 609-67-00.
    Natalya Yu. Klevtsova, PhD, cardiologist of consultative and diagnostical Department of the Moscow regional perinatal center. Address: 143900, Moscow Region, Balashikha, 12 Shosse Enthuziastov St. Tel.+7 (495) 529-50-13.

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