Priority Risk Factors of Developing Cor Pulmonale in Patients with Chronic Obstructive Pulmonary Disease According to Correlation Analysis Findings

The aim of the investigation was to determine priority risk factors of developing cor pulmonale in patients with chronic obstructive pulmonary disease (COPD) using correlation analysis.

Materials and Methods. 71 patients with moderate and severe COPD treated in the in-patient department of City Clinical Hospital No.10 (Nizhny Novgorod) have been examined. To characterize a nutritional status, body mass index, waist measurements, waist/height ratio have been determined. Dyspnea and CPOD severity according to mMRC scale, CAT test; oxygen saturation; external respiration function values have been evaluated; Doppler echocardiographic examination has been carried out.

Results. A severe COPD course with low values of spirographic parameters correlates with pathologic remodeling of the right parts of the heart and pulmonary hypertension. An essential risk factor of developing cor pulmonale is comorbid abdominal obesity. The role of the latter especially grows in the group with severe COPD. A thoroughly conducted correlation analysis was of great value in revealing "intimate" mechanisms of developing remodeling of the right parts of the heart in chronic obstructive pulmonary disease in comorbid conditions.

1. Global’naya strategiya diagnostiki, lecheniya i profilaktiki khronicheskoy obstruktivnoy bolezni legkikh (peresmotr 2014 g.) [Global strategy of diagnosis, treatment and prevention of chronic obstructive pulmonary disease (revised in 2014)]. Pod red. Belevskogo A.S. [Belevskiy A.S. (editor)]. Moscow: Rossiyskoe respiratornoe obshchestvo; 2014.
2. Vasil’kova T.N., Antipina A.N., Popova T.N., Sorokin D.V. Clinical features and pathogenetic mechanisms of chronic obstructive pulmonary disease progressing concurrently with obesity. Meditsinskaya nauka i obrazovanie Urala 2008; 9(4): 8–10.
3. Filatova Yu.I., Perfil’eva M.V., Chernov A.V. Specific features of clinical picture and therapy of chronic obstructive pulmonary disease accompanying by metabolic syndrome. Molodoy uchenyy 2014; 7: 220–222.
4. Couillard A., Veale D., Muir J.F. Comorbidities in COPD: a new challenge in clinical practice. Rev Pneumol Clin 2011; 67(3): 143–153, https ://doi.org/10.1016/j.pneumo.2010.05.003.
5. Karoli N.A., Rebrov A.P. Modern approaches to the treatment of chronic heart failure in patients with chronic obstructive pulmonary disease. Consilium medicum 2014; 16(3): 13–22.
6. Karoli N.A., Rebrov A.P. Chronic obstructive pulmonary disease and cardiovascular pathology. Klinitsist 2007; 1: 13–19.
7. Romashov B.B., Polyakova N.V. Characteristic features of the pathogenesis, clinical picture and treatment of chronic obstructive pulmonary disease combined with diabetes mellitus. Molodoy uchenyy 2015; 13: 310–314.
8. Ryazanov A.S., Kireev S.A., Eremenko N.N. Specific features of COPD clinical course in metabolic syndrome: the role of systemic inflammation. Ozhirenie i metabolizm 2010; 2: 49–51.
9. Ryazanov A.S., Kireev S.A., Eremenko N.N. Spirographic characteristics of patients with COPD and metabolic syndrome depending on a body mass. Ozhirenie i metabolizm 2010; 3: 28–30.
10. Ovcharenko S.I., Leshchenko I.V. Chronic obstructive pulmonary disease and concomitant cardiovascular pathology. Approaches to patient managing. Consilium medicum 2015; 1: 10–13.
11. Sin D.D., Anthonisen N.R., Soriano J.B., Agusti A.G. Mortality in COPD: role of comorbidities. Eur Respir J 2006; 28(6): 1245–1257, https://doi.org/10.1183/09031936.00133805.
12. Park S.K., Larson J.L. Metabolic syndrome and associated factors in people with chronic obstructive pulmonary disease. West J Nurs Res 2014; 36(5): 620–642, https://doi.org/10.1177/0193945913512423.
13. Donaldson G.C., Hurst J.R., Smith C.J., Hubbard R.B., Wedzicha J.A. Increased risk of myocardial infarction and stroke following exacerbation of COPD. Chest 2010; 137(5): 1091–1097, https://doi.org/10.1378/chest.09-2029.
14. Arutyunov G.P. Patient with chronic obstructive pulmonary disease: a cardiologist’s view. Pul’monologiya i allergologiya 2012; 4: 15–18.
15. Bugaenko V.V. Heart ischemic and chronic obstructive pulmonary diseases. Ratsional’naya farmakoterapiya 2012; 3: 63–69.
16. Alekhin M.N., Dukova N.A., Zateishchikova A.A., Kiselev D.G., Shavrin I.V., Privalov D.V., Vtorushin D.V., Sidorenko B.A., Zateishchikov D.A. Echocardiographical evaluation of mean pulmonary artery pressure in patients with chronic obstructive pulmonary disease. Kardiologiya 2010; 50(9): 41–46.
17. Bigaeva D.U., Daurova M.D., Gatagonova T.M., Bolieva L.Z. Features of structurally functional changes of cardiovascular system in patients with arterial hypertension and chronic obstructive pulmonary disease. Sovremennye problemy nauki i obrazovaniya 2014; 4. URL: http://www.science-education.ru/ru/article/view?id=14483.
18. Ryabova A.Yu. Osobennosti remodelirovaniya serdtsa u bol’nykh bronkhial’noy astmoy i khronicheskoy obstruktivnoy bolezn’yu legkikh. Avtoref. dis. … kand. med. nauk [Cardiac remodeling in patients with bronchial asthma and chronic obstructive pulmonary disease. PhD Thesis]. Saint Petersburg, 2008.
19. Kitabatake A., Inoue M., Asao M., Masuyama T., Tanouchi J., Morita T., Mishima M., Uematsu M., Shimazu T., Hori M., Abe H. Noninvasive evaluation of pulmonary hypertension by a pulsed Doppler technique. Circulation 1983; 68(2): 302–309, https://doi.org/10.1161/01.cir.68.2.302.
20. Reznik E.V., Gendlin G.E., Strozhakov G.I. Ekhokardiografiya v praktike kardiologa [Echocardiography in the practice of a cardiologist]. Moscow: Praktika; 2013; 212 p.
21. Nekrasov A.A., Kuznetsov A.N., Mel’nichenko O.V., Kruglova I.S. The cardiac remodeling of patients with chronic obstructive pulmonary disease. Meditsinskiy al’manakh 2011; 3(16): 112–115.

Vakhlamov D.A., Vakhlamov V.A. Priority Risk Factors of Developing Cor Pulmonale in Patients with Chronic Obstructive Pulmonary Disease According to Correlation Analysis Findings. Sovremennye tehnologii v medicine 2016; 8(4): 76, https://doi.org/10.17691/stm2016.8.4.10