Association between intracardiac hemodynamics and respiratory function in patients with coronary artery disease and respiratory comorbidity

The aim of this study was to investigate a relationship between the myocardial structure and function and respiratory parameters in patients with coronary artery disease (CAD) and respiratory disease.

Methods. We performed spirometry, body plethysmography, lung diffusing capacity test and measured the left ventricle (LV) systolic and diastolic function in patients with CAD with or without respiratory diseases and ventilation disorders.

Results. Patients with CAD (n = 662) participated in the study. The LV systolic dysfunction was found only in 60 patients (9.1%), while diastolic dysfunction was found in 387 patients with CAD (58.4%). Most patients with obstructive ventilation disorders had the systolic or diastolic LV dysfunction (40 patients (66.7%) and 197 patients (79.4%), respectively). Flow and volume lung function parameters and the lung diffusing capacity were associated with some echocardiographic and pulsed wave Doppler parameters.

Conclusion. Comorbidity of CAD and lung obstructive disease was associated with more frequent systolic and diastolic LV dysfunction. The relationship between respiratory and cardiac parameters could indicate the cross impact that could deteriorate the course of both the diseases.

1. Nazarov B.M., Zykov K.A., Ratova L.G.et al. Is spirometry needed in patients with cardiovascular diseases? Sistemnye gipertenzii. 2013; 2: 69–74 (in Russian).

2. Bazdyrev E.D., Bayrakova Yu.V., Kazachek Ya.V. et al. Respiratory diseases in patients with coronary artery disease. Sibirskiy meditsinskiy zhurnal. 2012; 112 (5): 46–50 (in Russian).

3. Kamenskaya O.V., Klinkova A.S., Lomivorotova V.V. et al. Complication risk in coronary artery bypass surgery in dependence of the lung ventilation. Patologiya krovoo# brashcheniya i kardiokhirurgiya. 2015; 19 (3): 68–73 (in Russian).

4. Kravchun P.G., Delevskaya V.Yu. A relationship between bronchial obstruction and the left heart diastolic dysfunction in patients with hypertension and chronic obstructive lung disease. Vestnik Vitebskogo gosudarstvennogo meditsinskogo universiteta. 2014; 13 (4): 48–53 (in Russian).

5. Mukhametzyanova N.A., Valeeva M.R. Possibilities of Doppler echography in early diagnosis of the myocardium diastolic dysfunction. Vestnik sovremennoy klinicheskoy meditsiny. 2015; 8 (6): 70–75 (in Russian).

6. Tarasov A.V., Miller O.N., Pozdnyakov Yu.M. et al. A choice of antiarrhythmic therapy in patients with the leftheart diastolic dysfunction complicated by the atrial fibrillation. Kardiovaskulyarnaya terapiya i profilaktika. 2011; 10 (8): 66–72 (in Russian).

7. Bazdyrev E.D., Gerasimova E.B., Polikutina O.M. et al. Cardiovascular risk factors in patients with chronic obstructive pulmonary disease. Klinitsist. 2014; 1: 22–27 (in Russian).

8. Ibragimova M.I., Masuev K.A., Alieva K.N., Shuaypova P.K. An assessment of the left and right heart diastolic dysfunction in elderly and senile patients with chronic obstructive pulmonary disease and bronchial asthma. Vestnik DGMA. 2013; 3: 25–28 (in Russian).

9. Grigor'eva N.Yu. Modern aspects of myocardium remodeling in patients with stable angina pectoris and comorbid chronic obstructive pulmonary disease . Klinicheskaya meditsina. 2010; 4: 77–82 (in Russian).

10. Lyamina N.P., Nosenko A.N., Razborova I.B. et al. Cardioprotective effect of physical rehabilitation in patients with ischaemic diastolic dysfunction underwent transcutaneous coronary interventions. Ratsional'naya farmakoterapiya v kardiologii. 2012; 8 (3): 415–419 (in Russian).

11. Casale P.N., Devereux R.B., Milner M. et al. Value of echocardiographic measurement of left ventricular mass in predicting cardiovascular morbid events in hypertensive men. Ann. Intern. Med. 1986; 105: 173–178.

12. Tkachenko S.B., Beresten' N.F. Tissue Doppler Examination of the Myocardium. Moscow: Real Taym; 2006 (in Russian).

13. Evdokimov V.V., Evdokimova A.G., Tebloev K.I. et al. The optimal therapy for patients with chronic heart failure and cardiorespiratory comorbidity. Trudnyy patsient. 2014; 12 (4): 12–18 (in Russian).

14. Akramova E.G. Clinical significance of heart examination in patients with COPD. Rossiyskiy kardiologicheskiy zhurnal. 2012; 1: 41–47 (in Russian).

15. Tamarchenko I.P., Pozdnyakova N.V., Sekerko S.A., Solov'eva K.V. The left heart diastolic dysfunction in patients with coronary artery disease: efficacy of telmisartan and enalapril. Rossiyskiy kardiologicheskiy zhurnal. 2010; 1: 47–53 (in Russian).

16. Shoykhet Ya.N., Klester E.B. Intracardiac and pulmonary hemodynamics in patients with chronic obstructive pulmonary disease and comorbidity according to echocardiography findings. Pul'monologiya. 2009; 3: 55–60 (in Russian).

17. Tuev A.V., Mishlanov V.Yu. Chronic obstructive lung diseases and the cardiovascular system. Perm': Presstaym; 2008 (in Russian).

18. Nekrasov A.A., Kuznetsov A.N., Mel'nichenko O.V., Kruglova I.S. Heart remodeling in patients with chronic obstructive pulmonary disease. Meditsinskiy al'manakh. 2011; 3: 112–115 (in Russian).

19. Belovol A.N., Knyaz'kova I.I., Gridasova L.N. Diagnosis of chronic heart failure in patients with chronic obstructive pulmonary disease. Nauchnye vedomosti. Seriya: Meditsina. Farmatsiya. 2014; 24 (28): 17–26 (in Russian).

20. Pavlenko V.I. Some features of the right heart and pulmonary hemodynamics in co"existing chronic obstructive pulmonary disease and coronary artery disease. Byulleten' fiziologii i patologii dykhaniya 2011; 42: 22–27 (in Russian).

21. Smith B.M., Kawut S.M., Bluemke D.A. et al. Pulmonary hyperinflation and left ventricular mass: the Multi"Ethnic Study of Atherosclerosis COPD Study. Circulation. 2013; 127 (14): 1503–1511.

22. Bhattacharyya P., Acharjee D., Ray S.N. et al. Left ventricular diastolic dysfunction in COPD may manifest myocardial ischemia. COPD. 2012; 9 (3): 305–309.