FORECASTING CORONARY EVENTS BASED ON THE ANALYSIS OF THE DYNAMICS OF MORPHOFUNCTIONAL PARAMETERS OF THE CARDIOVASCULAR SYSTEM IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN THE NORTH

Abstract

In modern society, chronic obstructive pulmonary disease has been isolated relatively recently in an independent nosological unit and, along with cardiovascular diseases, constitutes the leading group of socially significant chronic diseases, being one of the most important medical and social problems of pulmonology.The aim of the study was to determine the possibility of predicting and early diagnosis of coronary heart disease in patients with chronic obstructive pulmonary disease living in the North on the basis of evaluation of morphofunctional parameters of the cardiovascular system.Materials and methods. During the prospective five-year follow- up, an in-depth instrumental examination of 182 patients with chronic obstructive pulmonary disease was conducted to identify the five-year dynamics of the morphofunctional parameters of the cardiorespiratory system at various levels of coronary risk taking into account gender differences. In 66 patients (mean age 64.0 ± 1.1 years) (comparison group), nonfatal coronary events were recorded during follow-up.The conclusion. 1. In the North, cardiac remodeling in patients with chronic obstructive pulmonary disease includes changes in the right divisions due to persistent obstructive disorders and a decrease in pulmonary volume, as well as an increase in left chambers, a decrease in myocardial contractility, and progressive left ventricular hypertrophy. 2. In the course of prophylaxis in case of outpatient examination of patients with chronic obstructive pulmonary disease, it is necessary to determine the criteria for predicting high and very high coronary risk according to the formula d = 0.000108 (Systematic Corоnary Risk Evaluation × “Northern Experience” × frequency of exacerbations of chronic obstructive pulmonary disease × terminal diastolic size of the left ventricle (mm) × systolic blood pressure in the pulmonary artery (mm)) for women and d = 0.000078 (Systematic Coronary Risk Evaluation × frequency of exacerbations of chronic obstructive pulmonary disease × diastolic left ventricular size (mm) × reserve expiratory volume (%)) for men. A high and very high risk can be determined at d≥ 27.5 for women; at d≥ 16.2 for men.

Keywords

• chronic obstructive pulmonary disease
• coronary risk
• ischemic heart disease
• comorbidity