The effect of chronic obstructive pulmonary disease on the clinical and functional state of myocardium in patients with ischemic heart disease

Abstract

The objective: the goal of the study was to investigate clinically functional characteristics of the myocardium in patients with chronic obstructive pulmonary disease combined with ischemic heart disease.Materials and methods. We examined 68 patients with chronic obstructive lung disease and ischemic heart disease. The 1st group included 22 patients with ischemic heart disease with stable angina of II–III functional class; the 2nd group included 22 patients with chronic obstructive pulmonary disease; the 3rd one – 24 subjects with comorbidity. All the patients were undergone clinical examination. Also, investigation of the distance at 6-minute walk, daily electrocardiogram monitoring, respiratory function test, pulse oximetry, Doppler were performed.Results. Based on the obtained data, at subjects with comorbid pathology at 73,2% of cases a characteristic feature of angina clinical course was the typical pain syndrome together with shortness of breath and palpitation. Lipid profile in patients with the comorbid pathology changes in lipid metabolism matched type IIA dyslipidemia A. Fredrikson classification. The data analysis of daily monitoring of the electrocardiogram was observed more frequent presence of arrhythmias in patients with combined pathology; also it was noted a significantly greater number of episodes of silent ischemia, which was confirmed by the decrease of the integral parameter of the functional status of patients during the tests with the 6-minute walk and the by the results of the analysis of blood gas composition.Conclusion. Thus, in patients with comorbidity typical pain accompanied by shortness of breath and palpitations, more frequently registered the presence of various arrhythmias and painless form of ischemia, as well as more expressed systolic dysfunction of the left ventricle due to the presence of mixed (circulatory, hypoxic and tissue) type of hypoxia.