Abstract

Background: Pulmonary hypertension (PH), heart failure (RHF) and heart rhythm disorders (HRD), a common complications of COPD, are associated with worse clinical outcome. Aim: To study the hemodynamic effects of Diltiazem in COPD stage II-III (GOLD), complicates with secondary PH, RHF and HRD. Material and Methods: 49 patients with COPD, secondary PH, RHF and HRD, were divided into 2 groups, comparable by age, sex, duration and stage of the disease, the degree of PH and RHF and the the character of HRD. Patients in group 1 (n=35), administered Diltiazem 60 mg 3 times a day for 4 weeks on the background of treatment with Beta2-agonists and diuretics. Patients in group 2 (n=20) received only treatment with Beta2-agonists and diuretics. Results: In groups 1 and 2 the pulmonary arterial pressure decreased respectively from 48,7±1,7 to 31,0±2,3 mm Hg (p 0.05), the pulmonary vascular resistance – from 692,4±31,2 to 483,3±37,1 dynes.s.cm-5 (p 0.05), the cardiac index increased from 2,3±0,2 to 3,0±0,2 l.min.m2 (p 0.05). The frequency of various heart rhythm disorders (supraventricular extrasystoles, paroxysms of supraventricular tachycardia, ventricular extrasystoles) decreased with 65% and 45% respectively. Conclusion: The use of Diltiazem in the treatment of patients with COPD complicated by secondary PH, RHF and HRD improve pulmonary hemodynamics and heart rhythm. The drug is well tolerated by patients.

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