2014


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2014/№2

Chronic heart failure and external respiratory function in patients with ischemic heart disease

Karaskov A.M., Kamenskaya O.V., Klinkova A.S., Chernyavsky A.M.

Keywords: CAD, pulmonary hypertension, prognosis, external respiratory function, CHF

DOI: 10.18087 / rhfj.2014.2.1913

Background. In patients with IHD, CHF progression associated with reduced myocardial reserve and increased left atrial after-load results in development of passive pulmonary hypertension. In this process, both restrictive and obstructive ventilatory disorders become more likely. Aim. To study features of the external respiratory function (ERF) in IHD patients with progressive CHF. Materials and methods. 110 IHD patients with FC II–IV CHF were evaluated. In all patients, ERF was studied using body plethysmography, resting oxygen consumption was recoded, and efficiency of pulmonary gas exchange was evaluated by the oxygen utilization coefficient (OUC, ml / l). LV dimensions and volumes were measured by echocardiography. Results. Two groups of patients were isolated: group 1 with FC II CHF and group 2 with FC III–IV CHF. Patients of group 2 had more significant impairment of airway conductance in both large and small bronchi associated with pronounced dilatation of left heart chambers, reduced LV filling and contractility, and increased pulmonary artery pressure. These patients also had lower OUC values than patients of group 1. Conclusion. In IHD patients with reduced myocardial reserve and increased LV dilatation, progression of pulmonary hypertension associated with CHF progression facilitates development of ERF disorders and reduces pulmonary ventilation efficiency.
  1. Dickstein K, Cohen-Solal A, Filippatos G et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur Heart J. 2008;29 (19):2388–2442.
  2. Оганов Р. Г. Диагностика и лечение хронической сердечной недостаточности. В сб. «Национальные клинические рекомендации». – МЕДИ Экспо, 2010. – 67–160.
  3. Татаркина Н. Д., Татаркин А. А., Бондарева Ж. В. и др. Гемо­динамика при хронической сердечной недостаточности. Тихо­океанский медицинский журнал. 2008;3:61–64.
  4. Караськов А. М., Каменская О. В., Юргель Е. Н. и др. Состояние микроциркуляции в стенках камер сердца у пациентов пожилого возраста с аортальным стенозом в сочетании с ишемической болезнью сердца. Журнал Патология кровообращения и кардиохирургия. 2012;2:39–44.
  5. Щекочихин Д. Ю., Копылов Ф. Ю., Козловская Н. Л. и др. Кардиоренальный синдром при декомпенсированной сердечной недостаточности. Журнал Сердечная недостаточность. 2012;13 (4):248–252.
  6. Celli BR, MacNee W; ATS / ERS Task Force. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS / ERS position paper. Eur Respir J. 2004;23 (6):932–946.
  7. Ребров А. П., Кароли Н. А. Хроническое легочное сердце у больных бронхиальной астмой. Журнал Сердечная недостаточность. 2002;3 (3):120–123.
  8. Бодров В. Е., Тюкавин А. И. Легочное кровообращение у больных ишемической болезнью сердца в сочетании с гипетртонической болезнью. Журнал Регионарное кровообращение и микроциркуляция. 2006;5 (2):27–31.
  9. Бокарев И. Н., Аксенов М. Б., Великанов В. К. Сердечная недостаточность острая и хроническая. – М., «Медицина», 2006. 17–23, 45–46.
  10. Осипова О. А., Афанасьев Ю. И., Нестеров В. Г. и др. Геомет­рические показатели и диастолическая дисфункция левого желудочка при хронической сердечной недостаточности у больных постинфарктным кардиосклерозом. Журнал Успехи современного естествознания. 2007;1:80.
Karaskov A.M., Kamenskaya O.V., Klinkova A.S. et al. Chronic heart failure and external respiratory function in patients with ischemic heart disease. Russian Heart Failure Journal. 2014;83 (2):90–94

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