PECULIARITIES OF SOME STRUCTURAL-FUNCTIONAL INDICATORS OF VENTRICLES IN PATIENTS WITH CHRONIC OBSTRUCTIVE LUNG DISEASE IN CONDITIONS OF COMORBIDITY WITH ARTERIAL HYPERTENSION
DOI:
https://doi.org/10.11603/1811-2471.2018.v0.i2.8937Keywords:
chronic obstructive pulmonary disease, comorbidity, myocardial dysfunction.Abstract
The comorbidity of chronic obstructive pulmonary disease (COPD) and arterial hypertension (AH) has been and remains an important problem. It is believed that a violation of the structural and functional state of the right ventricle (RV) increases the risk of fatal complications in such patients. Left ventricular dysfunction (LV) is an independent prognostic negative factor.
The aim of the study was to examine the features of the structural and functional indices of the ventricles in patients with COPD in comorbidity with hypertension.
Material and Methods. An echocardiographic study was conducted (Toshiba SSA, 380A Powerwision, Japan) in 32 patients with COPD (stage II) with comorbid hypertension (grade 2). The results were compared with similar 32 patients with COPD (stage II) and practically healthy persons (n=15).
Results. In patients with COPD in combination with AH, there was a decrease in the rate of early, late diastolic filling of the ventricles and their ratio (P <0.001). The time of isovolumic relaxation of the RV and the LV exceeded in patients with COPD, respectively, by 75 % and 44 %. In comorbid patients, a reduction in the fraction of truncation of the RV (by 12 %) was detected, by 33 % – the velocity of blood flow in the output tract compared to practically healthy individuals (P <0.001). In contrast to patients with COPD, in comorbid patients there was a decrease in the maximum flow velocity in the output tract of the left ventricle by 20 % (P <0.001), a decrease in the LV ejection fraction by 7.8 % and 13 % – stroke volume (P <0.001) with a tendency to decrease the cardiac index.
Conclusions. In patients with COPD and comorbid AH, there are signs of severe diastolic ventricular dysfunction and early development of systolic dysfunction, which is a predictive-negative factor and should be taken into account in the strategy and tactics of treatment of such patients.
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