Influence of concomitant chronic obstructive pulmonary disease on left ventricular-arterial interaction in patients with ischemic cardiomyopathy
https://doi.org/10.15829/1560-4071-2019-2-38-43
Abstract
Aim. To assess the influence of concomitant chronic obstructive pulmonary disease (COPD) on the parameters of left ventricular-arterial interaction in patients with ischemic cardiomyopathy (ICMP).
Material and methods. We examined 130 patients with ICMP and 42 patients with ICMP and COPD. All patients underwent transthoracic echocardiography using the MyLab 70 (Italy) according standard method, followed by calculation of the left ventricular-arterial interaction and left ventricular (LV) energy. Statistical data processing was performed using the program “Statistica 12.0” (Stat Soft, Inc., USA).
Results. We found that patients with isolated ICMP and in combination with COPD often have a functional imbalance between the activity of LV and arterial system, as evidenced by an increase in the left ventricular-arterial interaction ratio. The increase in the left ventricular-arterial interaction ratio is due to an insufficient increase in left ventricular stiffness, but not a change in the elastic properties of the arterial system. This is indicated by a pronounced decrease in left ventricular elasticity against the background of the relative constancy of arterial elasticity. At the same time, in patients with ICMP and COPD we detected significantly more severe impairment in the parameters of left ventricular-arterial interaction and LV energy than in isolated pathology.
Conclusion. The presence of COPD in patients with ICMP allows us to consider it as a significant negatively modifying factor that has a negative impact on the functionality of LV and parameters of left ventricular-arterial interaction.
About the Authors
E. I. MyasoedovaRussian Federation
Competing Interests:
nothing to declare
Yu. G. Schwarz
Russian Federation
Competing Interests:
nothing to declare
O. S. Polunina
Russian Federation
Competing Interests:
nothing to declare
L. P. Voronina
Russian Federation
Competing Interests:
nothing to declare
References
1. Korreya LL, Lebedev TYu, Efremova OA. The problem of polymorbidity in the combination of chronic obstructive pulmonary disease and some cardiovascular diseases. Belgorod State University Scientific Bulletin. 2013;4( 147): 12-7. (In Russ.)
2. Mullerova H, Agusti A, Erqou S, et al. Cardiovascular comorbidity in chronic obstructive pulmonary disease: systematic literature review. Chest. 2013;144:1163-78. doi:10.1378/chest.12-2847.
3. Gurevich MA, Dolgova EV, Kuzmenko NAh. Chronic obstructive pulmonary disease, hypertension and coronary heart disease: features of pathogenesis, clinical picture and therapy. Russkij medicinskij zhurnal. 2016;16(24):1098-102. (In Russ.)
4. Gainetdinova VV, Bakirov AB, Kalimullin DH, et al. The combination of COPD with cardiovascular diseases: clinical features, respiratory function and the structural-functional state of the heart. Occupation health and human ecology. 2016;1:51-61. (In Russ.)
5. Chuchalin AG, Kucenko MA. The paradigm of comorbidity: entropia COPD and coronary artery disease. Russkij medicinskij zhurnal. 2014;5:389-92. (In Russ.)
6. Moiseev VS, Kiyakbaev GK. Cardiomyopathy and myocarditis. M.: GE'OTAR. 2013:352. (In Russ.) ISBN6 978-5-9704-1973-1.
7. Samko AN, Merkulov EN, Mironov VM, Filatov DN. Coronary angioplasty and stenting in patients with ischemic cardiomyopathy. Vestnik rentgenologii i radiologii. 2014;3:20-3. (In Russ.)
8. Ursulenko VI, Jacob LV. Ischemic cardiomyopathy: immediate and long-term results of surgical and medical treatment. Serdce i sosudy. 2012;4(40):33-40. (In Russ.)
9. Aleksandrova EA, Pryakhin AS, Andreev SL, et al. Ergospirometry in clinical practice in patients with surgical treatment of ischemic cardiomyopathy. Sibirskij medicinskij zhurnal. 2016;2(31):71-5. (In Russ.)
10. Gulya MO, Zavadovsky KV, Andreev SL, et al. Perfusion-metabolic myocardial scintigraphy in prognosis of left ventricular remodeling after complex surgical treatment of ischemic cardiomyopathy. Kardiologia. 2017;10(57):56-64. (In Russ.) doi:10.18087/cardio.2017.10.10032.
11. Zhuk OA, Titova ON, Kuzubova NA, et al. Structural, functional and electrophysiological features of cardiac remodeling in patients with COPD, affecting the severity of the disease. Russian Heart Journal. 2017;1(16):20-5. (In Russ.)
12. Akramova EG. The clinical value of the study of the heart in patients with COPD. Russian Journal of Cardiology. 2012; 17( 1):41-7. (In Russ.)
13. Chirinos JA. Ventricular-arterial coupling: invasive and noninvasive assessment. Artery Res. 2013;7:2-14. doi:10.1016/j.artres.
14. Guarracino F, Baldassarri R, Pinsky MR. Ventricular-arterial decoupling in acutely altered hemodynamic states. Critical Care. 2013;17:213-20. doi:10.1186/cc12522.
15. Kobalava ZhD, Kotovskaja JuV, Bogomaz AV. New methods for assessing subclinical changes in the cardiovascular system in arterial hypertension. Racional'naja Farmakoterapija v Kardiologii. 2016;3(12):317-24. (In Russ.) doi:10.20996/1819-6446-2016-12-3-317-324.
16. Ky B, French B, May Khan A, et al. Ventricular-arterial coupling, remodeling, and prognosis in chronic heart failure. J. Am. Coll. Cardiol. 2013;62:1165-72. doi:10.1016/j.jacc.2013.03.085.
17. Saba PS, Cameli M, Casalnuovo G, et al. Ventricular-vascular coupling in hypertension: methodological considerations and clinical implications. J. Cardiovasc. Med. (Hagerstown). 2014;15(11):773-87. doi:10.2459/JCM.0000000000000146.
18. Mahamat IK, Medvedev DA, Efimova VP, et al. Morphofunctional features of the left ventricle and left ventricular-arterial interaction in young people with type 1 diabetes. Trudny'j pacient. 2017;4-5(15):12-7. (In Russ.)
19. Karpov JuA. Diagnosis and treatment of chronic coronary artery disease. Kardiologicheskij vestnik. 2015;3(10):3-33. (In Russ.)
20. Mareev VYu, Ageev FT, Arutyunov GP, et al. National recommendations PRAS cardiology and internal medicine on the diagnosis and treatment of chronic heart failure (fourth revision). Journal of Cardiac Failure. 2013;14(7):379-472. (In Russ.)
21. Chuchalin AG, Avdeev SN, Ajsanov ZR, et al. Russian respiratory society. Federal clinical guidelines for the diagnosis and treatment of chronic obstructive pulmonary disease. Pul'monologija. 2014;3:15-54. (In Russ.) doi:10.18093/0869-0189-2014-0-3-15-54.
22. Goncharov I, Akhmetov R, Alexandria L. Ventricular-arterial coupling and arterial stiffness in hypertensive subjects with diastolic heart failure. Eur Heart J. 2012;33:799.
23. Shapovalova TG, Shelobanova NV, Volkova MV, et al. Features of heart remodeling in patients with chronic obstructive pulmonary disease, combined with coronary heart disease. Saratovskij nauchno-medicinskij zhurnal. 2009;3(5):352-5. (In Russ.)
24. Zafiraki VK, Kosmacheva ED. Clinical features of manifestations of myocardial ischemia in patients with stable angina in combination with chronic obstructive pulmonary disease. Kubanskij nauchnyj medicinskij vestnik. 2017;6(24):48-53. (In Russ.) doi:10.25207/1608-6228-2017-24-6-48-53.
25. Nekrasov AA, Mel'nichenko OV, Kruglova IS. Heart remodeling in patients with chronic obstructive pulmonary disease. Medicinskij al'manah. 2011;3:112-5. (In Russ.)
Review
For citations:
Myasoedova E.I., Schwarz Yu.G., Polunina O.S., Voronina L.P. Influence of concomitant chronic obstructive pulmonary disease on left ventricular-arterial interaction in patients with ischemic cardiomyopathy. Russian Journal of Cardiology. 2019;(2):38-43. (In Russ.) https://doi.org/10.15829/1560-4071-2019-2-38-43