A comprehensive evaluation of respiratory status in patients with coronary artery disease undergoing coronary artery bypass surgery

The aim of the study was to analyze a potential role of lung function for a comprehensive evaluation of respiratory system in patients undergoing the coronary artery bypass surgery.

Methods. The study involved 662 patients. Spirometry, body plethysmography and the singlebreath diffusing capacity for carbon monoxide (DLCO) were measured in all patients. All patients were divided into three groups according to the results of pulmonary function tests: patients with a known history of respiratory disease (n = 74; 11.2%), patients with newly diagnosed respiratory disease (n = 222; 33.5%) and patients without any respiratory disorders (n = 366, 55.3%). An integral index was calculated which characterizes the comprehensive pulmonary function evaluation based on weight coefficients.

Results. Bronchial obstruction parameters, forced and slow vital capacities and diffusing capacity of alveolarcapillary membrane greatly contributed to the pulmonary function integral index. This index did not differed significantly between patients with newly and previously diagnosed respiratory diseases; however, it was significantly higher in patients without any respiratory disorders.

Conclusion. A correlation analysis of the pulmonary function integral index, clinical and demographic data confirmed an inverse relationship between the pulmonary function integral index and duration of coronary artery disease, hypertension, number of previous myocardial infarctions, functional class of angina pectoris and congestive heart failure along with generally accepted factors affecting pulmonary function such as age, body mass index, smoking, and industrial xenobiotics.

1. Mamarizaeva Kh.O., Isakov E.Z., Usmanov R.D. An impact of comprehensive factors on cardiovascular mortality. Aktual'nye problemy gumanitarnykh i estestvennykh nauk. 2014; 5 (2): 205–208 (in Russian).

2. Ivanova A.E., Golovenko S.E., Mikhaylov A.Yu. Results of politic measured for reduction cardiovascular mortality. Sotsial'nye aspekty zdorov'ya naseleniya. 2014; 37 (3): 1–28 (in Russian).

3. Evdokimov V.V., Evdokimova A.G., Tebloev K.I. et al. Optimal treatment for patients with chronic heart failure and respiratory comorbidity. Trudnyy patsient. 2014; 12 (4): 12–18 (in Russian).

4. Kutsenko M.A., Chuchalin A.G. Paradigma of comorbidity: syntropia of COPD and coronary artery disease. Rossiyskiy meditsinskiy zhurnal. 2014; 5: 389–392 (in Russian).

5. Girfanova E.O., Ushakov V.F., Petrova I.L. et al. Multifactorial analysis of preventive measures of functional impairment in patients with chronic obstructive pulmonary disease and comorbidity at the Northern territory. Byulleten' fiziologii i patologii dykhaniya. 2015; 55: 39–43 (in Russian).

6. Polikutina O.M., Slepynina Yu.S., Karetnikova V.N. et al. Survival analysis and hospital outcomes in patients with STelevation myocardial infarction and coexisting chronic obstructive pulmonary disease. Pul'monologiya. 2014; 2: 73–77 (in Russian).

7. Stefan M.S, Bannuru R.R., Lessard D. et al. The impact of COPD on management and outcomes of patients hospital ized with acute myocardial infarction: a 10yers retrospective observational study. Chest. 2012; 141 (6): 1441–1448.

8. Salisbury A., Reid K., Spertus J. Impact of chronic obstructive pulmonary disease on postmyocardial infarction out comes. Am. J. Cardiol. 2007; 99: 636–641.

9. Bursi F., Vassallo R., Weston S. et al. Chronic obstructive pulmonary disease after myocardial infarction in the community. Am. Heart J. 2010; 160: 95–101.

10. Hillis L.D., Smith P.K., Anderson J.L. et al. 2011 ACCF/AHA guideline for coronary artery bypass graft surgery: a report of the American College of Cardiology Foundation / American Heart Association Task Force on Practice Guidelines. J. Am. Coll. Cardiol. 2011; 58 (24): 123–210.

11. Global initiative for Chronic Obstructive Lung Diseases (GOLD). Global strategy for diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO workshop report. Last updated 2009. URL: www.goldcopd.org (date accessed: 24.04.2915).

12. Miller M.R., Crado R., Hakinson J. et al. Series ATS/ERS task force: standardization of function testing. Eur. Respir. J. 2005; 26: 319–338.

13. Aysanov Z.R., Kozlova L.I., Kalmanova E.N. et al. Chronic obstructive pulmonary disease and cardiovascular disease: an experience of treatment with formoterol. Pul'monologiya. 2006; 2: 68–71 (in Russian).

14. Van Weel C., Schellevis F.G. Comorbidity and guidelines: conflicting interests. Lancet. 2006; 367: 550–551.

15. Pelevina I.D., Shaporova N.L., Trofimov V.I. Ambulatory management of comorbid patients who quitted smoking. Atmosfera. Pul'monologiya i allergologiya. 2011; 4: 55–60 (in Russian).

16. Ballanova Yu.A., Kontsevaya A.V., Shal'nova S.A. et al. Prevalence of behavioral risk factors of cardiovascular diseases in Russian population according to results of the ECCERF study. Profilakticheskaya meditsina. 2014; 5: 42–52 (in Russian).

17. Bokeriya L.A., Golukhova E.Z., Merzlyakov V.Yu. et al. Risk factors and predicting postoperative complications in patients undergoing cardiac surgery. Kreativnaya kardiologiya. 2011; 2: 24–36 (in Russian).

18. Sode B.F., Dahl M., Nordestgaard B.G. Myocardial infarction and other comorbidities in patients with chronic obstructive pulmonary disease: a Danish nationwide study of 7.4 million individuals. Eur. Heart J. 2011; 32 (19): 2365–2375.

19. Conte J.V., Baumgartner W.A., Dorman T., Owens S.G. The Johns Hopkins manual of cardiac surgical care. 2nd ed. Mosby Elsevier; 2008.

20. Barbarash O.L., Rutkovskaya N.V., Smakotina S.A. et al. Lung injury in patients with hypertension. Kardiologiya. 2010; 3: 31–36 (in Russian).

21. Samoylenko V.V. Preoperative evaluation of patients with cardiovascular diseases before noncardiac surgery. Serdtse. 2008; 2: 98–107 (in Russian).

22. Bazdyrev E.D., Baiyrakova Yu.V., Polikutina O.M. et al. Relationships between respiratory function and myocardial structure and function in patients with type 2 diabetes mellitus and coronary artery disease. Kardiologiya. 2015; 1: 4–8 (in Russian).