Diagnosis of chronic heart failure in patients with chronic obstructive pulmonary disease

Abstract

Aim. To identify methods for diagnosing early signs of heart failure in patients with chronic obstructive pulmonary disease.

Methods. We examined 54 patients with chronic obstructive pulmonary disease without exacerbation. Patients were divided into two groups: group 1 - 26 patients with chronic obstructive pulmonary disease in combination with chronic heart failure; group 2 - 28 patients with chronic obstructive pulmonary disease without chronic heart failure. The groups were comparable by age and severity of chronic obstructive pulmonary disease. Electrocardiography, echocardiography were performed with additional determination of the right heart chamber parameters, spirometry, X-ray, pulse oximetry. The level of highly sensitive C-reactive protein, blood acid-base composition and brain natriuretic peptide was evaluated.

Results. Patients with comorbidity have decreased exercise tolerance according to the 6-minute walk test and mMRS scale, higher body mass index and dyspnea intensity, larger linear dimensions of the heart chambers and their volume parameters. Heart failure with preserved ejection fraction was observed in 21 (80%) of patients in group 1, therefore, the signs of heart failure can be explained by diastolic dysfunction of the right and left ventricles. Among patients with chronic obstructive pulmonary disease and chronic heart failure in our study, extended linear dimensions and structural changes in the ventricles, indicating pre- and postcapillary hypertension, were significantly more common.

Conclusion. The use of tissue Doppler study allows more accurately determining the diastolic function of the right and left ventricles; the brain natriuretic peptide study is a sensitive marker of early forms of diastolic chronic heart failure.

Keywords

chronic obstructive pulmonary disease / chronic heart failure / diastolic dysfunction of the right and left ventricles

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RIGHTS & PERMISSIONS

Koliev V.I., Sarapulova I.E., Ryabova L.V.