THE PECULIARITIES OF CHRONIC CARDIAC INSUFFICIENCY ON THE BACKGROUND OF ISCHEMIC HEART DISEASES IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY

The aim of the investigation was to study the peculiarities of the course and multifunctional condition of myocardium in patients with chronic cardiac insufficiency (CCI) on the background of ischemic heart disease(IHD) in combination with chronic obstructive pulmonary disease (COPD). 134 patients aged from 45 to 78 were supervised, with CCI of functional class (FC) II and III of ischemic origin. The main group consisted of patients with CCI of FC II and III with concomitant COPD of II and III stages (n=74). The control group was represented by patients with CCI of FC II and III without impaired external respiration function (ERF). We estimated the structural and functional parameters of cardiovascular system by echocardiography method, we also took into account life quality of the patients, dyspnea intensity degree by the developed scales, biochemical and clinical blood analysis, ERF investigation and saturation of blood by oxygen. The investigation results showed life quality deterioration in all investigated patients (according to Minnesota questionnaire) and in patients with combined pathology it was reasonably lower. The basic factors of cardiovascular risk which significantly differred the group of patients with CCI of ischemic origin in combination with COPD from the isolated one were tobacco smoking and Arterial hypertension. The study of concomitant COPD comparing to the patients with CCI without COPD pointed on the significant increase in the right atrium (RA), right ventricle(RV), mean diameter of pulmonary artery (MDPA) size. Besides, we noticed other features, such as arterial hypertension was more frequent, left ventricular hypertrophy (LVH), predicted unfavorable types of LV remodeling (concentric and eccentric), the number of people with “delayed” type of left ventricle diastolic dysfunction (LVDD) at the expense of increase in number of patients with intermediate “pseudonormal” LVDD disturbance. At the equal FC of CCI, the patients with concomitant COPD comparing to the patients with CCI without COPD, have more increased volume of haemoglobin and erythrocyte.Thus, with the signs of the right parts of the heart increase in patients with CCI on the background of IHD with preserved systolic function of the left ventricle. We can assume concomitant COPD and continue the investigation to specify the diagnosis.