FEATURES OF THE CLINIC AND DIAGNOSIS OF CHRONIC HEART FAILURE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Aim. To elucidate clinical and diagnostic features of chronic heart failure (CHF) in patients with chronic obstructive pulmonary disease (COPD). Materials and methods. The study included 239 patients with COPD and 42 patients with CHF without COPD. The first subgroup consisted of 60 patients with a history of myocardial infarction (MI) and the second subgroup consisted of 79 patients without a history of MI. A general clinical examination, EchoCG, measurements of N-terminal pro B-type natriuretic peptide (NT-proBNP), galectin 3, and high-sensitivity C -reactive protein (hsCRP) were performed for all patients. Results. The risk group for excluding HF as a cause of progressive dyspnea in COPD patients consisted of patients with the bronchitic phenotype who belonged to GOLD groups C and D with frequent exacerbations, increased hsCRP, reduced oxygen saturation, and impaired exercise tolerance. Patients with a history of MI constituted a special group of risk. Measuring specific biomarkers, primarily BNP or NT-proBNP, is recommended to confirm the presence/absence of CHF and to evaluate CHF severity in patients with these risk factors. Conclusion. A combination of COPD and CHF produces a number of clinical and, specifically, diagnostic problems, which have not been completely solved so far.