Chronic heart failure associated with chronic obstructive pulmonary disease in elderly and senile patients: clinical parallels
In recent decades, the leading trend in the development of modern society is the aging of the population, as well as an increase in the proportion of elderly and senile people. Aging has a significant impact on the clinical characteristics, course and prognosis of diseases, changes the management tactics and treatment standards. As a rule, these patients are highly comorbid, which must be taken into account in terms of pharmacotherapy of the underlying and competing diseases. The purpose was to study the clinical characteristics of elderly and senile patients with chronic heart failure (CHF) in association with chronic obstructive pulmonary disease (COPD). Material and methods. The study included 104 patients with CHF, mainly of ischemic etiology, in combination with COPD, who were divided into 3 groups: 1 - younger than 60 years old, 2 - 60-79 years old, 3 - over 80 years old. To verify the clinical condition, the following studies were carried out: a 6-minute walk test, an assessment on the clinical condition scale, spirometry, echocardiography (Echo-KG), and an assessment of the quality of life according to the Minnesota questionnaire. Results. Patients older than 80 years old differed from those younger than 60 years old by high scores on assessment scale (p = 0,038), left ventricular ejection fraction (LVEF), (p = 0,007), and low heart rate (p = 0,021). The echocardiography parameters of patients over 80 years old were characterized by low values of systolic pressure in the pulmonary artery (PAP) and end diastolic size (EDS) in comparison with those under 60 years of age (p = 0,004 and p = 0,038). When studying the respiratory function, it was noted that in patients with CHF in combination with COPD, the forced expiratory volume in the first second decreases with increasing age (FEV10 and functional vital capacity of the lungs (FVC), as well as Tiffno index. Conclusion. The study results demonstrated that the clinical profile of a patient with CHF in combination with COPD differs depending on age, which requires an integral approach to patient management tactics and stratification of the risk of adverse events.