CONDITION OF CARDIAC HEMODYNAMICS IN MALE PATIENTS WITH COMORBIDITY OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ARTERIAL HYPERTENSION
The aim of the research. To assess the state of hemodynamics of the cardiovascular system in males with chronic obstructive pulmonary disease (COPD) in combination with essential arterial hypertension (AH) in order to personalize the therapy of these patients. Materials and methods. The indicators of cardiohemodynamics by transthoracic echocardiography were studied in 89 male patients with stage II-IV COPD at the age of 34-74 years, mean age 62,0 [56,5-69,5] years. Of these, COPD in combination with essential hypertension of 1 degree 2 stage is 60 people, patients with COPD are not suffering from hypertension, 29 people. The control group consisted of 27 male patients with essential stage 1 hypertension of the 2nd stage at the age from 45-76 years, average age 60,0 [58,0-64,5] years. Processing of the obtained data was carried out in accordance with the rules of variation statistics using the programs “Statistica 6,0” and “Microsoft Excel 2010”. Results. In male patients with comorbidity of COPD and essential hypertension, remodeling of both the right and left parts of the heart was revealed. Changes were manifested by an increase in size, hypertrophy of the walls of the heart muscle, as well as an increase in total pulmonary resistance and total peripheral vascular resistance in conditions of pulmonary hypertension (p <0,05). In the group of COPD patients in combination with hypertension, a concentric type of remodeling unfavorable for prognosis was more often detected and more often “restrictive” diastolic dysfunction of the right ventricle was determined 76,7% (p = 0,03) and diastolic dysfunction of the right and left ventricle together 70%. Conclusion. Hemodynamic changes occurring in patients with comorbidity of COPD and hypertension significantly aggravate the course of both diseases. In this group of patients, remodeling of both ventricles of the heart was revealed in the form of an increase in their size, wall hypertrophy, an increase in total pulmonary resistance and total peripheral resistance, and a violation of the diastolic function of the heart. These changes require early diagnosis of diseases and determine the choice of therapy in patients with COPD in combination with hypertension