Abstract
Objective.To identify clinical and functional correlations in patients with myocardial infarction against the background of the chronic obstructive pulmonary disease with various phenotypes.Materials and methods.188 patients were examined, from which the following groups were formed: control group – 50 patients, group 1–50 patients with myocardial infarction (MI), group 2–25 patients with MI against the background of the chronic obstructive pulmonary disease (COPD) with emphysematous phenotype, group 3–20 patients with MI + COPD with chronic bronchitis phenotype, group 4–22 patients with MI + COPD with mixed phenotype and group 5–21 patients with MI + COPD with the phenotype with eosinophilia and bronchial asthma. Clinical examination of patients included assessment of complaints, medical history and history of life. Spirography on apparatus SP-100 Schiller (Switzerland) was used for the assessment of respiratory function. Echocardiography was performed on Acuson-Sequoia 512 echo scanner (Siemens). Statistical analyses were performed using Statistica 12.0 (Stat Soft).Results.The highest frequency of symptoms such as chest pain, nausea/vomiting, fatigue, tachycardia, cough with sputum was observed among patients with MI + COPD with chronic bronchitis phenotype. In this group of patients, the level of systolic blood pressure in the pulmonary artery and the left ventricular ejection fraction were the lowest.Conclusion.Chronic bronchitis phenotype of COPD in patients with MI is the most prognostically unfavorable. It is associated with the severity of clinical manifestations, with signs of pulmonary hypertension and dysfunction of the left heart, that makes necessary to take into account the phenotypes of COPD in the care of patients with MI against the background of COPD and the allocation of chronic bronchitis phenotype as a criterion for an unfavorable prognosis of MI.
Highlights
Echocardiography was performed on Acuson-Sequoia 512 echo scanner
cough with sputum was observed among patients with myocardial infarction (MI)
It is associated with the severity of clinical manifestations
Summary
Введение В последнее время проблема коморбидности инфаркта миокарда (ИМ) и хронической обструктивной болезни легких (ХОБЛ) привлекает все большее внимание клиницистов и исследователей [1, 2, 3, 7, 8]. Это обусловлено широкой распространенностью кардиореспираторной коморбидности, большой частотой встречаемости осложнений, увеличением числа стационарных койко-дней, а также возникновением сложностей в постановке диагноза и ведении коморбидных пациентов [4, 10]. В связи с невозможностью полностью описать клинические особенности пациентов с ХОБЛ стало актуальным фенотипирование данной патологии. Выделяют более пяти фенотипов ХОБЛ: бронхитический, эмфизематозный, смешанный, с эозинофилией и бронхиальной астмой, с частыми обострениями и др.
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