Chronic Heart Failure in Patients with Hypersensitivity Pneumonitis and Ischemic Heart Disease (Clinical and Functional Parallels)

Aim. Study of clinical and functional parameters in patients with hypersensitive pneumonitis (GSP) associated with chronic heart failure (CHF) and identification of predictors of CHF development in patients with GSP. Design. Open-label comparative one-time study. Materials and methods. A total of 207 SHG patients were enrolled in the two parallel groups. The main group consisted of 109 people with SHP combined with coronary heart disease (CHD), the comparison group included 98 patients without CHD. Anamnestic data, radiation and functional parameters, echocardiography parameters for various clinical variants of CHF were analyzed. Results. CHF was statistically significantly more common in patients in the main group (in 40 (36.7%) patients) than in the comparison group (in 14 (21.4%) patients), p < 0.05%. The following predictors of CHF were established in both groups: age > 65 years, duration of GSP > 9.5 years, decrease in resting SaO2 < 85%, indicators of fibrosis on computed tomography > 2 points on the Kaseoroni scale, decrease in diffusion < 35.7 mmol/min/kPa, increase in systolic pressure in the pulmonary artery > 35 mm Hg. In patients of the main group, factors affecting the severity of CHF were identified: hypertrophy of the right and left chambers of the heart, increased stiffness of the vascular wall, the development of systolic and diastolic dysfunction of the left ventricle (LV). Conclusion. The frequency of CHF detection in patients with GSP was 36.7%. The appearance of CHF is associated with the progression of chronic pulmonary heart, comorbid cardiac diseases. The structure of CHF in patients with SHF is dominated by heart failure with preserved ejection fraction. A decrease in the LV ejection fraction is associated with the presence of coronary artery disease. The development of CHF in patients with a constant form of atrial fibrillation, arterial hypertension is due to diastolic dysfunction of the LV. Early detection of predictors of CHF in patients with GPS is necessary for the timely diagnosis of heart failure and the development of algorithms for the rational treatment of this category of patients. Keywords: hypersensitive pneumonitis, coronary heart disease, chronic heart failure.