Peculiarities of chronic heart failure in COPD patients


DOI: https://dx.doi.org/10.18565/therapy.2019.5.53-61

Karoli N.A., Borodkin A.V., Rebrov A.P.

V.I. Razumovsky Saratov State medical University of the Ministry of Healthcare of Russia
The aim of the study was to identify the clinical features of chronic heart failure (CHF) in patients with chronic obstructive pulmonary disease (COPD).
Materials and methods. An open non-randomized study of 127 patients with CHF decompensation and / or COPD exacerbation was performed: 88 patients with the presence of COPD, 39 without COPD. All patients underwent the procedure of determination of the levels of the N-terminal fragment of the natriuretic peptide, galectin-3, highly sensitive C-reactive protein (rf-CRP), echocardiography.
Results. Patients with COPD and CHF were characterized by a more severe condition comparatively with patients without bronchial obstruction, which was manifested by a more expressed impaired exercise tolerance (p <0,01), hypoxemia (p <0,001), and an increase in heart rate (p <0,001) , expressed systemic inflammation (increased CRP, p <0,05).
There was a significant underestimation of the functional class (FC) of CHF in patients with COPD and CHF compared with patients in the comparison group, especially in the case of high FC of CHF. Patients with COPD and CHF without previous myocardial infarction (MI) were characterized by a longer duration and intensity of smoking, more pronounced hypoxemia and systemic inflammation, a tendency to tachycardia with a significantly higher ejection fraction of the left ventricle. In patients with COPD and CHF without myocardial infarction in the anamnesis, manifestations of CHF were significantly more often only in a large circle than in people with COPD, CHF and myocardial infarction.
Conclusion. CHF in patients with COPD is characterized by a more severe course, the predominant lesion of a large circle of blood circulation comparatively with patients with isolated CHF. There are features of the course of chronic heart failure in patients with COPD, depending on its genesis.
Keywords: comorbidity, chronic obstructive pulmonary disease, chronic heart failure
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About the Autors

Nina A. Karoli, MD, professor of the Department of hospital therapy of faculty of medicine of V.I. Razumovsky Saratov State medical University of the Ministry of Healthcare of Russia. Address: 410012, Saratov, 112 Bolshaya Kazachya Str. Tel.: +7 (845) 249-14-37.
Andrei V. Borodkin, graduate student of the Department of hospital therapy of V.I. Razumovsky Saratov State medical University of the Ministry of Healthcare of Russia. Address: 410012, Saratov, 112 Bolshaya Kazachya Str. Tel.: +7 (845) 249-14-37.
Andrei P. Rebrov, MD, professor of the Department of hospital therapy of faculty of general medicine of V.I. Razumovsky Saratov State medical University of the Ministry of Healthcare of Russia. Address: 410012, Saratov, 112 Bolshaya Kazachya Str. Tel.: +78452491437. E-mail: andreyrebrov@yandex.ru


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