Clinical markers of inflammation and myocardial remodeling in patients with chronic obstructive pulmonary diseases and chronic heart failure

The immunoinflammatory concept of the pathogenesis of occurrence and progression of chronic heart failure (CHF) has been studied in many researches. However, there is currently no unified concept of the role of inflammation in the development and progression of chronic obstructive pulmonary disease (COPD), and the issue of the impact of inflammation on cardiac remodeling remains a subject of study. Objective. To evaluate acute phase inflammation tests in different variants of cardiac remodeling in patients with chronic obstructive pulmonary disease and chronic heart failure. Materials and methods. The study included 52 patients admitted to clinic with pronounced dyspnea and clinical symptoms of bronchitic syndrome (cough, expectoration). After spirometry, echocardiography and determination of N-terminal Brain Natriuretic ProPeptide level, 2 groups were formed: the 1st group — patients with COPD, the 2nd group — patients with CHF. The study design included the investigation of relationships between the criteria of systemic inflammatory response with the signs of cardiac remodeling, pronouncement of structural changes in the pulmonary tissue — number of segments affected by intralobular emphysema (IE) with the formation of trapped air (TA), smoking intensity of patients and spirometry indicators. Results. The number of the pulmonary tissue segments with presence of IE and TA, smoking status predominated in patients with COPD. Inflammatory response and cardiac remodeling were more pronounced in patients with CHF in the absence of relationship with the smoking factor and presence of IE and TA present in patients with COPD. A relationship of systemic inflammatory response and cardiac remodeling both in patients with COPD and in patients with CHF has been established. In patients with COPD, a relationship between the number of the pulmonary tissue segments with presence of IE and TA with cardiac remodeling indicators has been revealed, as well as a correlation between the number of segments with the formation of TA and smoking history has been established. Conclusions. The study results indicate inflammatory and non-inflammatory mechanisms of cardiac remodeling in patients with chronic obstructive pulmonary disease and chronic heart failure.