The role of systemic inflammation and endothelial dysfunction in the development of left ventricular dysfunction in patients with chronic obstructive pulmonary disease

Abstract

Summary. The aim of the study – to identify the role of systemic inflammation and endothelial dysfunction in the development of left ventricular dysfunction in patients with chronic obstructive pulmonary disease (COPD). Endothelium-dependent vasodilatation of brachial artery (EDVD), echocardiography parameters of left and right heart chambers, the concentration of pro-inflammatory and anti-inflammatory cytokines and circulating immune complexes (CIC) in plasma were studied in patients with moderate COPD. COPD patients showed a reduction of left ventricular contractile activity compared to the control group. Reducing EDVD was found in 72 % of patients with COPD. In the development of left ventricular failure involved a violation of interventricular interaction. Correlation analysis of the relationship of molecular indicators of inflammatory activity and echocardiography parameters were identified: correlation between the concentration of the CIC and the pulmonary artery systolic pressure (PASP), between the level of IL-1β and PASP, between the concentration of IL-8 and the PASP. COPD patients at an early stage of the disease to detect violations of vasoactive endothelial function, an imbalance of pro-and anti-inflammatory cytokines, increasing the concentration of CIC. Developing systemic inflammation and endothelial dysfunction contribute not only to the formation of pulmonary hypertension and chronic cor pulmonale, but also the development of left ventricular failure.