Архивъ внутренней медицины (Jan 2020)
Status of cardiovascular system in patients with chronic obstructive pulmonary disease according to the results of a pulse wave contour analysis
Abstract
The combination of chronic obstructive pulmonary disease and cardiovascular disease is an urgent public health problem, that determines more severe disease progression, worse prognosis for the patient. The aim of the work was to evaluate the status of the cardiovascular system performing a pulse wave contour analysis in patients with chronic obstructive pulmonary disease depending on the severity of bronchial obstruction. Material and Methods. Applanation tonometry was performed in 60 patients (56 men, age 63.5 [IQR 59; 70] years) with chronic obstructive pulmonary disease to assess central hemodynamic parameters. The severity of obstructive disorders was determined by spirometry after taking bronchodilator. Results. In case of progression of bronchial obstruction, a decrease in parameters characterizing coronary blood flow was detected, mainly determined by an increase in heart rate and by a decrease in the duration of diastole. In addition, higher values of augmentation pressure, corrected by heart rate of 75 bpm, pulse pressure, central pulse height at the point of maximum rise of direct pulse wave were determined in patients with more severe bronchial obstruction. These parameters indicate higher values of arterial stiffness in this group of patients. Conclusion. In patients with chronic obstructive pulmonary disease and high values of bronchial obstruction there is an imbalance in the ratio of myocardial load and actual blood supply, and increased arterial stiffness with impaired aortic damping function, that contributes to the development of cardiovascular disease in this group of patients. These factors may explain high prevalence of cardiovascular disease in this group of patients.
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