Assessment of the pulmonary ventilation function in the development of pulmonary hypertension in patients with bronchial asthma in conjunction with impaired endothelium­-dependent vasodilation

Abstract

Objective — to assess the state of pulmonary ventilation function in the development of pulmonary hypertension (PH) in patients with bronchial asthma (BA) in conjunction with the impaired endothelium­-dependent vasodilation at the dynamics of complex nebivolol treatment.Materials and methods. The investigation involved 56 patients with BA diagnosis. The control group included 30 healthy volunteers without signs of the cardiopulmonary pathology. The patients were divided into two groups depending on the disease severity: 1st group included subjects with BA of 2—3 degree of severity, and 2nd group consisted of patients with BA of 4 degree. The patients were also divided depending on the used method of treatment: 27 BA patients (15 subjects from 1st group and 12 from the 2nd) received basic therapy (in accordance with GINA 2016); and 29 BA patients (16 subjects from 1st group and 13 from the 2nd) were administered nebivolol in a dose of 2.5—5 mg a day against the background of basic therapy.Results and discussion. The impairment of the peripheral mechanisms of regulation of the vascular tone developed earlier in a greater degree in patients with PH at the BA of 4 degree of severity in acomparison with the BA of 2—3 degree. The nebivolol use against the basis therapy of patients with BA and PH resulted in our study not only to the reduction of the mean pulmonary arterial pressure, but also was accompanied with the positive dynamics in the ventilation and perfusion pulmonary capacity of the external respiratory function in the 2nd group of patients by 10.5 % (р < 0.01). The mean pulmonary arterial pressure after the treatment in the 2nd group decreased by 15.7 % (the significance of the difference with the indices before treatment р < 0.05).Conclusions. Complex treatment of patients with BA and PH with nebivolol inclusion resulted in the reduction of the pulmonary vascular tone and at the same time improved the peripheral endothelium­dependent vasodilation of peripheral vessels.