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Features of structural and functional myocardial remodeling in patients with chronic obstructive pulmonary disease and CHF

Karoli N. A.1, Borodkin A. V.1, Lukjyanova L. V.2, Rebrov A. P.1
1 – State Budgetary Educational Institution of Higher Professional Education, “V. I. Razumovsky Saratov State Medical University” of the RF Ministry of Health Care, Bolshaya Kazachjya 112, Saratov 410012
2 – State Health Care Institution, “Regional Clinical Hospital”, Smirnovskoe Ushchelje 1, Saratov 410053

Keywords: chronic obstructive pulmonary disease, pulmonary hypertension, pulmonary heart disease, myocardial remodeling, CHF

DOI: 10.18087/rhfj.2015.5.2112

Background. In Russia, COPD is one of the most important causes for development of CHF (13 % of cases). Different authors have reported that CHF is observed in 62 % of older-age patients with COPD. Aim. To study features of structural and functional myocardial remodeling in COPD patients with and without CHF and in presence of CHF of different origins. Materials and method. In accordance with the study aim, 210 men with COPD were evaluated. Patients were selected as a random sample. 112 (36.2 %) of the evaluated COPD patients had signs of HF. Patients with CHF signs were divided into two groups, with (75 patients) and without (37 patients) a history of MI. Results. In COPD patients with CHF, pulmonary systolic pressure was significantly higher than in COPD patients without CHF. Hypertrophy of the RV anterior wall was observed in the vast majority of COPD patients both with and without CHF. RV EDR was significantly greater in COPD patients with HF than in healthy individuals. 75.6 % of COPD patients without CHF and 81 % of patients with CHF had impaired RV diastolic function. LV EF was significantly lower in COPD patients with CHF than in patients without CHF. In CHF patients with a history of MI, LV EF was significantly lower than in CHF patients without a history of MI. Disorders of LV diastolic function were observed in 77.8 % of patients without CHF and 79.5 % of patients with CHF. Conclusion. The obtained data indicated significance of RV diastolic dysfunction in development of HF in COPD patients with stable pulmonary hypertension. Alterations in LV were moderate and were not determinant in the clinical picture of disease. However LV dysfunction can aggravate already existing hemodynamic disorders of both systemic and pulmonary circulation.
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Karoli N. A., Borodkin A. V., Lukjyanova L. V., Rebrov A. P. Features of structural and functional myocardial remodeling in patients with chronic obstructive pulmonary disease and CHF. Russian Heart Failure Journal. 2015;16 (5):279–287

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