Modern possibilities of correction of broncho-obstructive syndrome in chronic heart failure of ischemic origin in combination with chronic obstructive pulmonary disease: simple randomized parallel group study
AIM: To evaluate the efficacy and safety of complex basic therapy for chronic heart failure (CHF) of ischemic origin in combination with chronic obstructive pulmonary disease (COPD) with the inclusion of prolonged bronchodilators. MATERIALS AND METHODS: The study included 67 patients (50 men and...
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Concilium Medicum
2023-06-01
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| Series: | КардиоСоматика |
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| Online Access: | https://cardiosomatics.orscience.ru/2221-7185/article/viewFile/248417/pdf_1 |
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| author | Vladimir V. Evdokimov Anna G. Evdokimova Raisa I. Stryuk Elena N. Yushchuk Natalia O. Kuvyrdina Galina V. Voronina |
| author_facet | Vladimir V. Evdokimov Anna G. Evdokimova Raisa I. Stryuk Elena N. Yushchuk Natalia O. Kuvyrdina Galina V. Voronina |
| author_sort | Vladimir V. Evdokimov |
| collection | DOAJ |
| description | AIM: To evaluate the efficacy and safety of complex basic therapy for chronic heart failure (CHF) of ischemic origin in combination with chronic obstructive pulmonary disease (COPD) with the inclusion of prolonged bronchodilators.
MATERIALS AND METHODS: The study included 67 patients (50 men and 17 women) with CHF IIIII functional class (FC) with left ventricular ejection fraction (LVEF) of 45% in combination with moderate-to-severe COPD (GOLD). The patients were divided into three groups: group 1 (n=30) received formoterol as part of therapy, group 2 (n=19) received aclidinium, and group 3 (n=18) received a fixed combination of aclidinum and formoterol. The basic therapy for CHF included nebivolol, losartan, eplerenone, diuretics, low-dose glucocorticosteroids, nitrates, and cardiac glycosides (if necessary). The clinical condition of patients, intracardiac hemodynamics, was indicated using echocardiography, a 6-min walking test (6MWT), bifunctional 24-h monitoring of blood pressure and heart rate, and spirometry. Quality of life was assessed using the Minnesota Living with Heart Failure Questionnaire, St. Georges Respiratory Questionnaire, and Modified Medical Research Council dyspnea scale.
RESULTS: After 6 months of therapy, the clinical and instrumental parameters and quality of life improved in all groups. At the end of the observation period, the average FC of CHF and dyspnea severity decreased by 17.5, 18.2, 20.1 20.5, 24.2, and 28.1%, respectively. The increase in exercise tolerance was 22.1, 22.6, and 29.2%. An improvement in intracardiac hemodynamics was noted. The LVEF increased by 17.1, 20.5, and 24.6%, and the myocardial mass index decreased by 8.7, 14.2, and 17.4%. The total peripheral vascular resistance, degree of pulmonary hypertension, and duration and frequency of painless myocardial ischemia significantly decreased. The best results were obtained in group 3 using nebivolol, reninangiotensinaldosterone system antagonists, and a combination of long-acting bronchodilators. Therapy was well tolerated by all study groups, with no serious adverse side effects.
CONCLUSION: The inclusion of nebivolol and losartan in basic therapy, while taking long-acting bronchodilators, improves the clinical and functional states of patients and quality of life, and slows down disease progression. When used in a fixed combination, the use of aclidinium and formoterol improves spirometry to a greater extent. |
| first_indexed | 2024-03-13T05:22:46Z |
| format | Article |
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| issn | 2221-7185 2658-5707 |
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| last_indexed | 2024-03-13T05:22:46Z |
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| publisher | Concilium Medicum |
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| series | КардиоСоматика |
| spelling | doaj.art-ea00c4de37bf4daa81eb93a98a4f8b5e2023-06-15T12:41:16ZengConcilium MedicumКардиоСоматика2221-71852658-57072023-06-01141172610.17816/CS24841776532Modern possibilities of correction of broncho-obstructive syndrome in chronic heart failure of ischemic origin in combination with chronic obstructive pulmonary disease: simple randomized parallel group studyVladimir V. Evdokimov0Anna G. Evdokimova1https://orcid.org/0000-0003-3310-0959Raisa I. Stryuk2https://orcid.org/0000-0002-2848-046XElena N. Yushchuk3https://orcid.org/0000-0003-0065-5624Natalia O. Kuvyrdina4Galina V. Voronina5Yevdokimov Moscow State University of Medicine and DentistryYevdokimov Moscow State University of Medicine and DentistryYevdokimov Moscow State University of Medicine and DentistryYevdokimov Moscow State University of Medicine and DentistryCity Clinical Hospital No. 52Yevdokimov Moscow State University of Medicine and DentistryAIM: To evaluate the efficacy and safety of complex basic therapy for chronic heart failure (CHF) of ischemic origin in combination with chronic obstructive pulmonary disease (COPD) with the inclusion of prolonged bronchodilators. MATERIALS AND METHODS: The study included 67 patients (50 men and 17 women) with CHF IIIII functional class (FC) with left ventricular ejection fraction (LVEF) of 45% in combination with moderate-to-severe COPD (GOLD). The patients were divided into three groups: group 1 (n=30) received formoterol as part of therapy, group 2 (n=19) received aclidinium, and group 3 (n=18) received a fixed combination of aclidinum and formoterol. The basic therapy for CHF included nebivolol, losartan, eplerenone, diuretics, low-dose glucocorticosteroids, nitrates, and cardiac glycosides (if necessary). The clinical condition of patients, intracardiac hemodynamics, was indicated using echocardiography, a 6-min walking test (6MWT), bifunctional 24-h monitoring of blood pressure and heart rate, and spirometry. Quality of life was assessed using the Minnesota Living with Heart Failure Questionnaire, St. Georges Respiratory Questionnaire, and Modified Medical Research Council dyspnea scale. RESULTS: After 6 months of therapy, the clinical and instrumental parameters and quality of life improved in all groups. At the end of the observation period, the average FC of CHF and dyspnea severity decreased by 17.5, 18.2, 20.1 20.5, 24.2, and 28.1%, respectively. The increase in exercise tolerance was 22.1, 22.6, and 29.2%. An improvement in intracardiac hemodynamics was noted. The LVEF increased by 17.1, 20.5, and 24.6%, and the myocardial mass index decreased by 8.7, 14.2, and 17.4%. The total peripheral vascular resistance, degree of pulmonary hypertension, and duration and frequency of painless myocardial ischemia significantly decreased. The best results were obtained in group 3 using nebivolol, reninangiotensinaldosterone system antagonists, and a combination of long-acting bronchodilators. Therapy was well tolerated by all study groups, with no serious adverse side effects. CONCLUSION: The inclusion of nebivolol and losartan in basic therapy, while taking long-acting bronchodilators, improves the clinical and functional states of patients and quality of life, and slows down disease progression. When used in a fixed combination, the use of aclidinium and formoterol improves spirometry to a greater extent.https://cardiosomatics.orscience.ru/2221-7185/article/viewFile/248417/pdf_1aclidinium bromidechronic heart failurechronic obstructive pulmonary diseaseeplerenoneformoterolischemic heart diseaselosartannebivolol |
| spellingShingle | Vladimir V. Evdokimov Anna G. Evdokimova Raisa I. Stryuk Elena N. Yushchuk Natalia O. Kuvyrdina Galina V. Voronina Modern possibilities of correction of broncho-obstructive syndrome in chronic heart failure of ischemic origin in combination with chronic obstructive pulmonary disease: simple randomized parallel group study КардиоСоматика aclidinium bromide chronic heart failure chronic obstructive pulmonary disease eplerenone formoterol ischemic heart disease losartan nebivolol |
| title | Modern possibilities of correction of broncho-obstructive syndrome in chronic heart failure of ischemic origin in combination with chronic obstructive pulmonary disease: simple randomized parallel group study |
| title_full | Modern possibilities of correction of broncho-obstructive syndrome in chronic heart failure of ischemic origin in combination with chronic obstructive pulmonary disease: simple randomized parallel group study |
| title_fullStr | Modern possibilities of correction of broncho-obstructive syndrome in chronic heart failure of ischemic origin in combination with chronic obstructive pulmonary disease: simple randomized parallel group study |
| title_full_unstemmed | Modern possibilities of correction of broncho-obstructive syndrome in chronic heart failure of ischemic origin in combination with chronic obstructive pulmonary disease: simple randomized parallel group study |
| title_short | Modern possibilities of correction of broncho-obstructive syndrome in chronic heart failure of ischemic origin in combination with chronic obstructive pulmonary disease: simple randomized parallel group study |
| title_sort | modern possibilities of correction of broncho obstructive syndrome in chronic heart failure of ischemic origin in combination with chronic obstructive pulmonary disease simple randomized parallel group study |
| topic | aclidinium bromide chronic heart failure chronic obstructive pulmonary disease eplerenone formoterol ischemic heart disease losartan nebivolol |
| url | https://cardiosomatics.orscience.ru/2221-7185/article/viewFile/248417/pdf_1 |
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