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Contribution of chronic obstructive pulmonary disease to remodeling of target organs in patients with arterial hypertension and ischemic heart disease associated with chronic heart failure

Koziolova N. A., Masalkina O. V., Kozlova E. V., Surovtseva M. V.
Federal State Budgetary Educational Institution of Higher Education, "Academician E. A. Vagner Perm State Medical University" of the Ministry of Health of the Russian Federation, Petropavlovskaya 26, Perm 614000

Keywords: chronic heart failure, chronic obstructive pulmonary disease

DOI: 10.18087/rhfj.2017.3.2354

Background. High prevalence of chronic obstructive pulmonary disease (COPD) among patients with cardiovascular diseases, common features of their pathogenetic mechanisms, and the negative influence on prognosis of the disease predetermine the interest to remodeling of target organs in patients with chronic heart failure (CHF) associated with AH and IHD in combination with bronchial obstruction. Aim. To determine specific features of the development and the structural and functional remodeling of kidneys and arterial vasculature in patients with AH and IHD associated with CHF and COPD. Materials and methods. Based on inclusion and exclusion criteria 120 patients with IHD, AH and FC II-III CHF were evaluated and divided into two equal groups: group 1, patients with COPD and group 2, patients without bronchial obstruction. Parameters reflecting features of CHF development and structural and functional status of arteries and kidneys were compared between group. Results. In patients with AH and IHD associated with CHF, presence of COPD was related with development of more pronounced LV diastolic dysfunction (p=0.027 by E/A) with preserved EF and a higher level of N-terminal fragment of natriuretic peptide (p=0.012). More severe disturbance of kidney filtration function (p=0.027 by cystatin C), more pronounced genuine arterial stiffness (p<0.001 by CAVI1 index) at increased TIMP-1 (p=0.045) and surfactant А (p<0.001) levels were observed in patients with cardiac pathology and COPD. Conclusion. More severe CHF with preserved LV EF develops in the presence of COPD. In patients with AH and IHD complicated with CHF, remodeling of target organs in bronchial obstruction was characterized with specific changes in the structural and functional status of arterial vasculature and kidneys. One mechanism of these changes is shifting the balance of collagenolytic processes towards fibrosis.
  1. Macchia A, Rodriguez Moncalvo JJ, Kleinert M, Comignani PD, Gimeno G, Arakaki D et al. Unrecognised ventricular dysfunction in COPD. European Respiratory Journal. 2012;39(1):51–8. DOI:10.1183/09031936.00044411.
  2. Мареев В. Ю., Агеев Ф. Т., Арутюнов Г. П., Коротеев А. В., Мареев Ю. В., Овчинников А. Г. и др. Национальные рекомендации ОССН, РКО и РНМОТ по диагностике и лечению ХСН (четвертый пересмотр). Утверждены на Конгрессе ОССН 7 декабря 2012 года, на Правлении ОССН 31 марта 2013 и Конгрессе РКО 25 сентября 2013 года. Журнал Сердечная Недостаточность. 2013;14(7):379–472. DOI:10.18087/rhfj.2013.7.1860 [Mareev V. Yu., Ageev F. T., Arutyunov G. P., Koroteev A. V., Mareev Yu. V., Ovchinnikov A. G. i dr. Naczional`ny`e rekomendaczii OSSN, RKO i RNMOT po diagnostike i lecheniyu XSN (chetverty`j peresmotr). Utverzhdeny` na Kongresse OSSN 7 dekabrya 2012 goda, na Pravlenii OSSN 31 marta 2013 i Kongresse RKO 25 sentyabrya 2013 goda. Zhurnal Serdechnaya Nedostatochnost`. 2013;14(7):379–472. DOI:10.18087/rhfj.2013.7.1860].
  3. Vestbo J, Hurd SS, Agustí AG, Jones PW, Vogelmeier C, Anzueto A et al. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease: GOLD Executive Summary. American Journal of Respiratory and Critical Care Medicine. 2013;187(4):347–65. DOI:10.1164/rccm.201204-0596PP.
  4. Koziolova NA, Masalkina OV, Kozlova EV. Regularities in development of chronic heart failure in patients with ischemic heart disease and chronic obstructive pulmonary disease associated with multiple comorbidity. Russian Heart Failure Journal. 2016;17(3):151–63. DOI:10.18087/rhfj.2016.3.2222.
  5. Valk M, Broekhuizen B, Mosterd A, Zuithoff NPA, Hoes A, Rutten F. COPD in patients with stable heart failure in the primary care setting. International Journal of Chronic Obstructive Pulmonary Disease. 2015;1219. DOI:10.2147/COPD.S77085.
  6. Iversen KK, Kjaergaard J, Akkan D, Kober L, Torp-Pedersen C, Hassager C et al. Chronic obstructive pulmonary disease in patients admitted with heart failure. Journal of Internal Medicine. 2008;264(4):361–9. DOI:10.1111/j.1365-2796.2008.01975.x.
  7. Mentz RJ, Kelly JP, von Lueder TG, Voors AA, Lam CSP, Cowie MR et al. Noncardiac Comorbidities in Heart Failure With Reduced Versus Preserved Ejection Fraction. Journal of the American College of Cardiology. 2014;64(21):2281–93. DOI:10.1016/j.jacc.2014.08.036.
  8. Paulus WJ, Tschöpe C. A novel paradigm for heart failure with preserved ejection fraction: comorbidities drive myocardial dysfunction and remodeling through coronary microvascular endothelial inflammation. J Am Coll Cardiol. 2013;62(4):263–71. DOI:10.1016/j.jacc.2013.02.092.
  9. Navratilova Z, Zatloukal J, Kriegova E, Kolek V, Petrek M. Simultaneous up-regulation of matrix metalloproteinases 1, 2, 3, 7, 8, 9 and tissue inhibitors of metalloproteinases 1, 4 in serum of patients with chronic obstructive pulmonary disease: Serum MMP and TIMP in COPD. Respirology. 2012;17(6):1006–12. DOI:10.1111/j.1440-1843.2012.02197.x.
  10. Linder R, Rönmark E, Pourazar J, Behndig A, Blomberg A, Lindberg A. Serum metalloproteinase-9 is related to COPD severity and symptoms - cross-sectional data from a population based cohortstudy. Respiratory Research. 2015;16(1):28. DOI:10.1186/s12931-015-0188-4.
  11. Zhou Y, Wang H, Xing J, Liu Y, Cui X, Guo J et al. Expression Levels of Surfactant-Associated Proteins and Inflammation Cytokines in Serum and Bronchoalveolar Lavage Fluid Among Coal Miners: A Case-Control Study. Journal of Occupational and Environmental Medicine. 2014;56(5):484–8. DOI:10.1097/JOM.0000000000000169.
  12. Cottin V. [Genetic pulmonary fibrosis]. Rev Prat. 2014;64(7):930–1.
  13. Yoshizawa T, Hosokawa Y, Hashimoto S, Okada K, Furuichi S, Ishiguro T et al. Prevalence of chronic kidney diseases in patients with chronic obstructive pulmonary disease: assessment based on glomerular filtration rate estimated from creatinine and cystatin C levels. International Journal of Chronic Obstructive Pulmonary Disease. 2015;1283. DOI:10.2147/COPD.S80673.
  14. Chen R, He W, Zhang K, Zheng H, Lin L, Nie R et al. Airflow obstruction was associated with elevation of brachial-ankle pulse wave velocity but not ankle-brachial index in aged patients with chronic obstructive pulmonary disease. Atherosclerosis. 2015;242(1):135–40. DOI:10.1016/j.atherosclerosis.2015.06.052.
  15. Aykan A ç., Gökdeniz T, Boyacı F, Gül I, Hatem E, Kalaycıoğlu E et al. Assessment of arterial stiffness in chronic obstructive pulmonary disease by a novel method: Cardio-ankle vascular index. Herz. 2014;39(7):822–7. DOI:10.1007/s00059-013-3902-3.
  16. Bhatt SP, Cole AG, Wells JM, Nath H, Watts JR, Cockcroft JR et al. Determinants of arterial stiffness in COPD. BMC Pulmonary Medicine. 2014;14(1). DOI:10.1186/1471-2466-14-1.
Koziolova N. A., Masalkina O. V., Kozlova E. V., Surovtseva M. V. Contribution of chronic obstructive pulmonary disease to remodeling of target organs in patients with arterial hypertension and ischemic heart disease associated with chronic heart failure. Russian Heart Failure Journal. 2017;18(3):201–207

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