Treumova S. I., Trybrat T. A., Shut S. V., Redchytsʹ I. V., Kazakov Yu. M.
The cause of chronic pulmonary heart disease (СPHD) as a complication is chronic obstructive pulmonary disease. This is one of the most important medical and social problems. According to the current data, there are 600 million patients with chronic obstructive pulmonary disease (COPD) in the world, increasing with age. About 3 million people die annually from this disease (mainly smokers). Taking into account the high prevalence of COPD, the number of patients with chronic pulmonary heart disease (CPHD) has increased. With the increase in the prevalence of bronchopulmonary and cardiovascular pathology of population aging, the increased number of patients with comorbidity is expected. COPD comorbidity with cardiovascular pathology remains the most important coronary heart disease (CHD) among COPD patients, under the data reported in literature it is 53.3% reported in the literature. The aim of the study was to evaluate echocardiographic indices of systolic and diastolic function of the left ventricular of elderly patients with bronchopulmonary genesis in combination with coronary heart disease. 96 elderly patients of average age 68.4 ± 2.0 years (the main group) were examined, among of the compensation stage was detected in 32 (33.3%) patients and it was the 3rd grade without clinical signs of heart failure (HF), stage of decompensation was at 64 (66.7%) patients with HF signs. The comparison group included 64 patients with CPHD without CHD, and 32 (50.0%) of them was at the compensation stage (grade 1) without HF signs, 32 (50.0%) was at decompensation stage with HF signs (grade 2). The state of the intracardiac hemodynamics of the LV was examined by the following parameters: diameter of the left atrium (LA, mm); cardiac (l/min. m2 ), beat index (ml/ m2 ), thickness of the posterior wall of the LV (PWT(D), mm), ejection fraction (EF,%). diastolic function of LV was estimated by the Doppler`s transmitral blood flow, maximum peak velocities of early E (m/sec) and late A (m/sec) diastolic filling was examined, E/A ratio (um), isovolumic relaxation time (IRT, sec); thickening of the interventricular septum (IBE, mm). Results and discussion. Among the examined patients the most significant changes in the linear parameters of the LV were found out at patients with comorbid pathology, namely CPHD+CHD. So, these patients at the compensation stage had the reduced beat index for 6,0±0.4 ml/m2 ; systolic for 0,6±0,001 l/min., m2 (Р1˂0,05) at the decompensation stage, accordingly, for 10,0±0,8 ml/m2 ; 0,7±0,002 l/min., m2 (Р2 ˂0,05) in comparison with the patients with isolated CPHD. The ejection fraction`s decreased depending on the disease`s severity, co-morbidity, but it remained within normal limits. All this indicates a decrease in LV`s contractile function to a greater extent with combined pathology, which can be explained by the influence of CHD. The following changes and diastolic function of the LV was found out: indicators of early and late diastolic filling decreased, but more at patients of grade 4 up to 0.4±0.003 m/sec resulting in a decrease in their ratio. This was at the same time accompanied by an increase in isovolumic relaxation time up to 0.16±0.002 sec, which should be considered as a hypertrophic type of insufficient relaxation. The thickening of PWT(D) was found, dilatation of LP for 2.6±0.3 mm (Р2 ˂0,05) at the patients of grade 4 and for 2.0±0,2 mm (Р1 ˂0,05) at patients of the 3 grade in comparison with compared groups. Thus, during the studying of LV`s indexes the reliable echocardiographic difference between patients with CPHD and CPHD was found out that indicates about significant abnormalities of LV of the patients with comorbid pathology, which should be counted in the choice of therapeutic tactics
chronic pulmonary heart, chronic obstructive pulmonary disease, echocardiographic indices of systolic and diastolic function of the left ventricle, coronary heart disease, comorbidity.
«Bulletin of problems biology and medicine» Issue 1 (155), 2020 year, 208-211 pages, index UDK 616.124.2 – 073.4./97:616.131 – 008.331.1 – 06:616.127–005.4]053.9
