Klinički relevantni obrasci kardiovaskularnih komorbiditeta kod bolesnika sa HOBP - da li su uopšte važni?

Abstract

The association of chronic obstructive pulmonary disease and cardiovascular disease was observed during the study of the systemic effects of this disease. Among these patients, the incidence as well as the mortality from cardiovascular disease are significantly higher, while the reduction of cardiovascular risk is an important target for the reduction of the overall mortality from COPD. The complex pathophysiological mechanisms of the interaction of the respiratory and cardiovascular system during COPD exacerbation have not yet been sufficiently studied, but their clinical manifestations are an increasing challenge within modern diagnostics and therapy. Studies have shown that intensification of systemic inflammatory response in acute exacerbation of COPD results in endothelial dysfunction, activation of atherosclerotic plaques, increased susceptibility to rupture and thrombus formation, which is indirect but very significant cause of acute cardiovascular events. Acute exacerbations of COPD can be the triggers of an acute cardiovascular event; however, they can be triggered by previous cardiovascular events as well. Despite an improved diagnostic-therapeutic procedure, this two-way association often remains unrecognized. The effect of COPD treatment on the coexisting vulnerability of the cardiovascular system is still not fully understood. Despite the reliable evidence confirming the link between COPD and cardiovascular disease, modern therapeutic options for targeted treatment of these diseases are still in the testing phase, with no more relevant randomized clinical trials in this field. The first results of the Summit study promise a more appropriate treatment of these patients.