Chronic obstructive pulmonary disease as a predictor of poor outcome of surgery for chronic thromboembolic pulmonary hypertension
https://doi.org/10.18093/0869-0189-2016-26-6-694-700
Abstract
Aim. The aim of this study was to investigate an influence of pulmonary ventilation and diffusion disorders on outcome of pulmonary endarterectomy.
Methods. The study involved patients with chronic thromboembolic pulmonary hypertension (CTEPH) with (n = 43) or without (n = 88) chronic obstructive pulmonary disease (COPD). Body plethysmography and lung diffusing capacity measurement were performed in all patients before pulmonary endarterectomy. We analyzed perioperative clinical characteristics, complications and inhospital mortality.
Results. COPD was diagnosed twice more often in patients with CTEPH. Patients with CTEPH and COPD had more severe lung function disorders including more significant reduction in lung diffusing capacity. Comorbidity of COPD and CTEPH significantly increased a risk of respiratory failure in early postoperative period (OR = 2.1 (1.25 – 4.76), p = 0.020), length of hospitalization (p = 0.02), and a risk of inhospital mortality (OR = 4.4 (1.21 – 16.19), p = 0.023). Lung diffusion capacity had an independent predictive value to predict the development of the respiratory failure in early postoperative period (OR = 1.8 (1.08 – 3.57), p = 0.050).
Conclusion. Diagnosis of COPD in patients with CTEPH significantly increased risk of poor outcome of the pulmonary endarterectomy
About the Authors
I. Yu. Loginova
Academician E.N.Meshalkin Novosibirsk Federal Research Institute of Circulatory Pathology, Healthcare Ministry of Russian Federation
Russian Federation
Russian Federation
ul. Rechkunovskaya 15, Novosibirsk, 630055, Russia
Candidate of Biology, Senior Researcher at Group of Clinical Physiology, Center of Anesthesiology and Emergency Care, Academician E.N.Meshalkin Novosibirsk Federal Research Institute of Circulatory Pathology, Healthcare Ministry of Russian Federation; tel.: (383)3476066
O. V. Kamenskaya
Academician E.N.Meshalkin Novosibirsk Federal Research Institute of Circulatory Pathology, Healthcare Ministry of Russian Federation
Russian Federation
Russian Federation
ul. Rechkunovskaya 15, Novosibirsk, 630055, Russia
Doctor in Medicine, Leading Researcher at Group of Clinical Physiology, Center of Anesthesiology and Emergency Care, Academician E.N.Meshalkin Novosibirsk Federal Research Institute of Circulatory Pathology, Healthcare Ministry of Russian Federation; tel.: (383) 3476066
A. M. Chernyavskiy
Academician E.N.Meshalkin Novosibirsk Federal Research Institute of Circulatory Pathology, Healthcare Ministry of Russian Federation
Russian Federation
Russian Federation
ul. Rechkunovskaya 15, Novosibirsk, 630055, Russia
Doctor in Medicine, Professor, Head of Center of Surgery of Aorta, Coronary and Peripheral Arteries, Academician E.N.Meshalkin Novosibirsk Federal Research Institute of Circulatory Pathology, Healthcare Ministry of Russian Federation; tel.: (383) 3476066
V. V. Lomivorotov
Academician E.N.Meshalkin Novosibirsk Federal Research Institute of Circulatory Pathology, Healthcare Ministry of Russian Federation
Russian Federation
Russian Federation
ul. Rechkunovskaya 15, Novosibirsk, 630055, Russia
Doctor in Medicine; Corresponding Member, Russian Academy of Sciences; Head of Center of Anesthesiology and Emergency Care, Academician E.N.Meshalkin Novosibirsk Federal Research Institute of Circulatory Pathology, Healthcare Ministry of Russian Federation; tel.: (383) 3476066
References
1. Russian clinical guidelines on diagnosis, treatment and prevention of venous thromboembolic complications. Flebologiya. 2010; 2 (4): 1–37 (in Russian).
2. Lang I.M., Pesavento R., Bonderman D., Yuan J.X. Risk factors and basic mechanisms of chronic thromboembolic pulmonary hypertension: a current understanding. Eur. Respir. J. 2013; 41: 462–468. https://doi.org/10.1183/09031936.00049312
3. Delcroix M., Lang I., PepkeZaba J. et al. Longterm out come of patients with chronic thromboembolic pulmonary hypertension. Clin. Perspect. Circulat. 2016; 133 (9): 859–871. https://doi.org/10.1161/circulationaha.115.016522
4. Halbert R.J., Natoli J.L., Gano A. et al. Global burden of COPD: systematic review and metaanalysis. Eur. Respir. J. 2006; 28 (3): 523–532. https://doi.org/10.1183/09031936.06.00124605
5. Chuchalin A.G., Avdeev S.N., Aysanov Z.R. et al. Russian Respiratory Society. Federal Clinical Guidelines on Diagnosis and Management of Chronic Obstructive Pulmonary Disease. Pul'monologiya. 2014; 3: 15–54. http:// dx.doi.org/10.18093/086901892014031554 (in Russian).
6. Leavitt B.J., Ross C.S., Spence B. et al. Longterm survival of patients with chronic obstructive pulmonary disease undergoing coronary artery bypass surgery. Circulation. 2006; 114: 430–434. https://doi.org/10.1161/circulationaha.105.000943
7. O’Boyle F., Mediratta N., Chalmers J. et al. Longterm survival of patients with pulmonary disease undergoing coronary artery bypass surgery. Eur. J. Cardiothorac. Surg. 2013; 43 (4): 697–703. https://doi.org/10.1093/ejcts/ezs454
8. Ponomarev D.N., Kamenskaya O.V., Klinkova A.S. et al. An influence of bronchial obstruction on perioperative characteristics of patients underwent aortocoronary bypass: in terim results of a prospective cohort study. Patologiya krovoobrashcheniya i kardiokhirurgiya. 2015; 19 (4): 72–78. http://dx.doi.org/10.21688/16813472201547278 (in Russian).
9. Jenkins D.P., Madani M., Mayer E. et al. Surgical treatment of chronic thromboembolic pulmonary hypertension. Eur. Respir. J. 2012; 41 (3): 735–742. https://doi.org/10.1183/09031936.00058112
10. Miller M.R., Crapo R., Hankinson J. et al. General consid erations for lung function testing. Eur. Respir. J. 2005; 26: 153–161. https://doi.org/10.1183/09031936.05.00034505
11. Pellegrino R., Viegi G., Brusasco V. et al. Interpretative strategies for lung function tests. Eur. Respir. J. 2005; 26 (5): 948–968. https://doi.org/10.1183/09031936.05.00035205
12. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Global Initiative for Chronic Obstructive Lung Disease, 2015.
13. Iversen K.K., Kjaergaard J., Akkan D. et al. The prognostic importance of lung function in patients admitted with heart failure. Eur. J. Heart Fail. 2010; 12 (7): 685–691. https://doi.org/10.1093/eurjhf/hfq050
14. Karoli N.A., Borodkin A.V., Rebrov A.P. Chronic heart failure in patients with chronic obstructive pulmonary disease. Pul'monologiya. 2016; 26 (1): 38–45. http://dx.doi.org/10.18093/0869018920162613845 (in Russian).
15. Vatutin N.T., Smirnova A.S. Comorbidity of chronic obstructive pulmonary disease and cardiovascular diseases: therapeutic approach. Pul'monologiya. 2016; 26 (3): 364–371. http://dx.doi.org/10.18093/086901892016263364371 (in Russian).
16. Savushkina O.I., Chernyak A.V. A clinical role of body plethysmography. Atmosfera. Pul'monologiya i allergologiya. 2013; 2: 38–41 (in Russian).
17. Katsyuba M.V., Karetnikova V.N., Polikutina O.M. et al. An assessment of ventilation and diffusing capacity of the lungs in patients with cardiac infarction. Serdtse: zhurnal dlya praktikuyushchikh vrachey. 2014; 75 (1): 26–31 (in Russian).
18. Hoeper M.M., Meyer K., Rademacher J. et al. Diffusion capacity and mortality in patients with pulmonary hyper tension due to heart failure with preserved ejection fraction. JACC: Heart Failure. 2016; 4 (6): 441–449. https://doi.org/10.1016/j.jchf.2015.12.016
19. Shostak N.A., Klimenko A.A., and Demidova N.A. Chronic thromboembolic pulmonary hypertension and a problem of an orphan and multidisciplinary disease. Ratsional'naya farmakoterapiya v kardiologii. 2014; 10 (1): 73–78 (in Russian).
Review
For citations:
Loginova I.Yu., Kamenskaya O.V., Chernyavskiy A.M., Lomivorotov V.V. Chronic obstructive pulmonary disease as a predictor of poor outcome of surgery for chronic thromboembolic pulmonary hypertension. PULMONOLOGIYA. 2016;26(6):694-700. (In Russ.) https://doi.org/10.18093/0869-0189-2016-26-6-694-700
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