Кафедра внутрішніх та професійних хвороб
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Browsing Кафедра внутрішніх та професійних хвороб by Subject "chronic obstructive pulmonary disease"
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Item BODE index in patients with chronic obstructive pulmonary disease in combination with hypertensive heart disease(2020-12) Kapustnik, Valeriy; Kostyuk, Inna; Melenevych, Anastasiia; Tverezovskyi, VolodymyrThe prognostic potential of the BODE index in assessing future cardiovascular risk in patients with chronic obstructive pulmonary disease in combination with hypertensive heart disease based on left ventricular geometry has been established. Comparing the BODE index results depending on the type of left ventricular remodeling, a significant (p=0.032) increase in the index was determined in patients with prognostically unfavorable left ventricular remodeling compared to relatively favorable types – 1.73±0.45 scores vs. 1.45±0.63 scores. Patients with comorbid conditions showed a significant decrease in exercise tolerance and a tendency to desaturation. In order to increase the BODE index sensitivity in predicting the course of chronic obstructive pulmonary disease of the GOLD 2 grade, group B in combination with stage II hypertension, we propose to consider the presence of desaturation. That is, to consider a decrease in the saturation levels during a six-minute walk test from the initial value ≥4% as one of the prognostically unfavorable criteria.Item Clinical COPD Questionnaire results depending on the degree of the inflammatory response in patients with COPD combined with hypertension(2021-11-25) Melenevych, AnastasiiaLittle is known about the relationship between Clinical COPD Questionnaire (CCQ) score and degree of the inflammatory response in patients with COPD combined with hypertension (HT). We analyzed CCQ scores depending on the 6-min walk test (6MWT) and pulse oximetry data. An inverse correlation was found between the distance walked in 6MWT and the total CCQ score (r=-0,74; p<0,05); the functional state domain score (r=-0,75; p<0,05); the symptom domain score (r=-0,48; p<0,05) and the mental state domain score (r=-0,46; p<0,05). A direct correlation was found between desaturation and the total CCQ score (r=0,66; p<0,05); the functional state domain score (r=0,77; p<0,05) and the mental state domain score (r=0,41; p<0,05).We investigated serum IL-18 and IL-10 levels in 69 COPD (GOLD 2, group B) patients in remission in combination with HT stage II (57 males and 12 females; mean age 55,80±5,51 years). Patients were divided into three groups – tertiles, depending on the level of IL-18/IL-10 ratio. It was found that the growth of IL-18/IL-10 ratio significantly (p<0,001) associated with increasing the functional state domain score. The mean score of the functional state CCQ domain in patients of the 1st tertile was 2,38, 2nd - 2,50 and 3rd - 3,21.Thus, the functional state CCQ domain score significantly represented the imbalance between IL-18 and IL-10 in COPD with HT patients.Item Clinico-inflammatory issues of comorbid vibration disease and chronic obstructive pulmonary disease in workers from mechanical engineering(2012) Al-Hayki, Huda; Arkhipkina, Olga; Farid, F.; Fatima, M.Vibration disease (VD) takes one of the leading places in the structure of occupational diseases in the whole world. It often combines with chronic obstructive pulmonary disease (COPD), which also is an actual healthcare problem due to its prevalence, progressive course and mortality. Today one of the pressing problems of medicine is to study the role of cytokines in the pathogenesis of various diseases, because they have a wide spectrum of biological activity and they are regulators of intercellular interactions. Despite the number of studies published concerning VD and COPD, the cytokine profile of their combined course is not yet clear. The purpose of this study was to evaluate the content of cytokines TNF-α and IL-10 in patients with VD and VD, combined with COPD. Materials and Methods. The study involved 118 men who suffered from VD caused by local vibration. The average age of examined patients was 52,3 ± 0,81 years, working experience of contact with the local vibration was 19,13 ± 0,61 years. The main group included 66 patients with COPD and VD. 52 patients with isolated course of VD formed the group comparison. The control group consisted of 20 healthy men. The content of cytokines TNF-α and IL-10 in blood was determined by immunoassay analyzer for Stat Fax 2100 (USA) using reagent kits according to the instructions of the manufacturer "Vektor Best" (Novosibirsk, Russia). Statistical analysis of the results was performed with software Statistica 8.0 for Windows. Results. Determination of the inflammatory cytokine TNF-α showed increasing its concentration in the examined persons. Hereby, the content of TNF-α in patients with VD was significantly higher than in the control group (67,99 ± 4,53 pcg/106 against 42,59 ± 1,98 pcg/106; p<0.05). The level of inflammatory cytokine was more expressed in patients with combined pathology (86,27 ± 4,91 pcg/106) than in patients with isolated course of VD. Decreasing anti-inflammatory cytokine IL-10 occurred in both groups compared with the controls. Level of interleukin in the group comparison was 28,54 ± 2,23 pcg/106 that was lower than in the control group - 33,04 ± 2,51 pcg/106. The maximum decrease of IL-10 observed in the main group - 22,18 ± 1,65 pcg/106. Conclusions. Obtained data showed imbalance in cytokine profile in patients with VD, but more significant changes were found in the examined with accompanying COPD.Item Complement C3 and C-reactive protein in patients with moderate chronic obstructive pulmonary disease in remission in combination with hypertension(2024-07) Melenevych, AnastasiiaCardiovascular diseases remain the most common comorbid pathology among patients with chronic obstructive pulmonary disease (COPD). The prevalence of hypertension (HT) in COPD patients reaches 51,2%. Systemic inflammation, endothelial dysfunction, oxidative stress are common links in the pathogenesis of combined cardiopulmonary pathology that contribute to progression. Complement 3 (C3) is a key component of the complement system that plays an important role in the detection and elimination of pathogens. There is evidence for the protective role of C3 against oxidative stress, bronchial and myocardial apoptosis. The role of complement activation in relation to C-reactive protein (CRP) level in the pathogenesis of moderate COPD combined with HT has not been fully understood. We found that in moderate COPD patients combined with HT, C3 and CRP serum levels were significantly higher. C3 serum level predicted desaturation and emphysema in both groups, whereas CRP - in isolated COPD group only.Item Desaturation and IL-18/IL-10 ratio as prognostic predictors for adverse right ventricular remodeling(2021-09) Melenevych, Anastasiia; Melenevych, OlgaAdverse right ventricular (RV) remodeling leads to heart failure that represents an important determinant of outcome in patients with hypertension (HT) combined with chronic obstructive pulmonary disease (COPD). Chronic hypoxia and systemic inflammation contribute to tissue destruction and disruption normal repair and defense mechanisms, resulting in pulmonary vascular remodeling and pulmonary hypertension. We found that desaturation is associated with inflammatory activation and contributes to right heart chambers overload. The cut off level of IL-18/IL-10 ratio 26.64 is an independent prognostic predictor for RV pressure overload in patients with HT stage II in combination with moderate COPD.Item Diagnostic and prognostic role of markers of immune inflammation in chronic obstructive pulmonary disease in combination with hypertension(2016) Melenevych, AnastasiiaCurrently 210 million people have chronic obstructive pulmonary disease and it is predicted to become the third leading cause of death worldwide by 2030. In 2008, worldwide, approximately 40% of adults aged 25 and above had been diagnosed with hypertension. We have analyzed the most significant factors associated with increased cardiovascular risk in patients with COPD.Item Exercise-induced desaturation as an independent predictor of the occupational chronic obstructive pulmonary disease course in combination with hypertension(2023-05) Melenevych, Anastasiia; Kapustnik, Valeriy; Shelest, BorysWe found a significantly greater drop in the level of oxygen saturation (SpO2) during the 6-minute walk test (6MWT) in comorbid pathology compared to isolated COPD 62 (4,14±1,44 % vs. 3,39±1,31 %, p<0,05). Exercise-induced desaturation (EID), a 4 % drop in SpO2 during the 6MWT from the initial value, occurred significantly more often in comorbid pathology – in 56,5 % of patients, compared to 48,4 % in the isolated COPD group. In comorbid patients with EID, a significant (p<0,001) increase in pro-inflammatory interleukin (IL)-18 (3296,24 (2356,03; 3978,92) pg/ml vs. 2256,30 (1980,88; 2738,86) was found) pg/ml) and a decrease in anti-inflammatory IL-10 (61,12 (48,34; 79,63) pg/ml vs. 106,35 (89,45; 126,97) pg/ml) compared to patients without EID, which indicates a greater imbalance in the formation of the inflammatory response. EID in patients of the main group was associated with an increase in the right ventricular (RV) wall thickness (5,58±0,57 mm vs. 5,22±0,61, p<0,05), growth of the right atrium diameter (39,79±2,27 mm vs. 35,83±5,02 mm, p<0.05) and a decrease in the RV diameter (27,10±2,22 mm vs. 28,37±2,40 mm, p<0.05) in comparison with comorbid patients without EID. Patients with chronic obstructive pulmonary disease (COPD) and , hypertension (HT) with EID have more pronounced signs of RV pressure overload. Receiver-operating characteristic (ROC) analysis revealed the prognostic significance (p<0,001) of IL-18 level more than 3063,7 pg/ml (with a sensitivity of 61,5 % and a specificity of 90 %, area under the ROC curve (AUC) – 0,736) and the IL-18/IL-10 ratio value more than 39,9 (with a sensitivity of 76,9 % and a specificity of 83,3 %, AUC – 0,791) for EID in COPD patients combined with HT.Item Gender differences in exercise capacity and left ventricular geometry among patients with comorbid pathology – hypertension with chronic obstructive pulmonary disease(2023-09) Melenevych, AnastasiiaHypertension (HT) and chronic obstructive pulmonary disease (COPD) are one of the most common comorbid pathologies associated with the risk of cardiovascular events. As long as the ejection fraction (EF) remains preserved, it is quite challenging to establish signs of heart failure. Dyspnea and exercise intolerance in COPD can mask reduced heart function, especially in hypertensive patients. Our aim was to assess gender differences in exercise capacity using 6-min walk test (6MWT) and left ventricular (LV) geometry among patients with HT and COPD. We found that dyspnea level before and after the 6MWT, drop in SpO2 during the 6MWT as well as the distance walked in the 6MWT showed no significant (p > 0,05) gender differences. LV systolic function was preserved in all patients (EF > 55 %). LV diastolic function echocardiographic parameters didn’t show significant differences between men and women. At the same time, we found that all women had unfavorable types of LV geometry (concentric and eccentric hypertrophy), concentric hypertrophy was predominated. All four types of LV geometry were found among men. Thus, despite the lack of differences in clinical and functional data by gender, the predominance of LV concentric hypertrophy in women was reliably established among the patients with HT and COPD.Item Immunological issues of occupational chronic obstructive pulmonary disease in combination with arterial hypertension(2012) Костюк, Інна Федорівна; Костюк, Инна Федоровна; Kostyuk, Inna; Калмиков, Олексій Олексійович; Калмыков, Алексей Алексеевич; Kalmykov, OleksiyOne of actual practical and scientific problems in pulmonology and occupational medicine is often development of occupational bronchitis and its rapid transformation into chronic obstructive pulmonary disease (COPD). The study is dedicated to investigation of immune homeostasis and cytokine system in occupational COPD in combination with arterial hypertension (АH) and assessment of immune inflammation role in the development and progression of associated pathology. Peculiarities of clinical course of COPD in the relation to presence of combined AH and patients profession were revealed. The disease influence on life quality of dust professions workers from machinebuilding industry was established. It was proofed that one of mechanisms of COPD clinical manifestation is the disbalance in immune system. It included the moderate depression of non-specific (phagocytosis activity, nitro blue tetrazolium test, natural killers CD16) and cellular (decrease of Т-lymphocytes CD3, increase of lymphocyte migration inhibition reaction) components of immune system on the background of activation of humoral (increase of IgM, IgG), and in cytokine component – increase of TNFα, IL-4 with decrease of IFNγ levels. The presence of assosiated AH in patients with COPD is accompanied by the activation of immunoinflammatory process with boost of humoral answer at the background of cellular immunodepression and more espressed dysbalance in cytokine system. Immunoinflammatory changes are also connected with working conditions and define the peculiarities of clinical manifestation of COPD in different professional groups.Item Impact of right ventricular diastolic function on exercise tolerance in patients with chronic obstructive pulmonary disease and hypertension(2023-07) Melenevych, AnastasiiaWe evaluated the impact of right ventricular (RV) diastolic function on exercise tolerance in patients with chronic obstructive pulmonary disease (COPD) and hypertension (HT). Analysis of RV diastolic function showed reduced early RV filling (p<0.05) and the ratio between early RV filling (E-wave) and late RV filling (A-wave) (E/A ratio) (p=0.007), elevated E-wave deceleration time (p<0.05) and isovolumic relaxation time (p<0.05) in the COPD with HT compared to the isolated COPD patients. It indicates a more pronounced relaxation disturbances and increased RV stiffness in patients with COPD combined with HT. We found RV diastolic dysfunction in the majority of comorbid patients – 78,2%, impaired relaxation (Grade I) was the predominant grade (50.7%), pseudo-normalized (Grade II) diastolic function was determined in 27,5%. In the isolated COPD group, normal diastolic function predominated (58.1%), pseudo-normalized - was less common (12,9%). Restricted (Grade III) RV diastolic dysfunction was not registered in our patients. Among patients with COPD and hypertension significant differences (p<0.05) were found in exercise tolerance parameters between patients with normal RV diastolic function (n=15) and RV diastolic dysfunction (n=54): the 6-min walk distance - 393.2±14.61 m vs. 380.69±13.85 m; exercise-induced dyspnea (Borg scale) - 3.4±0.63 vs. 3.98±1.0; exercise-induced oxygen desaturation - 3.4±1.3 vs. 4.35±1.42%. In the isolated COPD group reliable distinctions (p<0.05) were found in exercise tolerance parameters between patients with normal RV diastolic function (n=18) and RV diastolic dysfunction (n=13): the 6-min walk distance - 402.06±17.75 m vs. 386.85±17.6 m; exercise-induced dyspnea (Borg scale) -3.22±0.65 vs. 3.92±0.95. There was no significant difference in exercise-induced oxygen desaturation between COPD patients with normal RV diastolic function and RV diastolic dysfunction. Thus, RV diastolic dysfunction contributes to exercise intolerance and exercise-induced oxygen desaturation in patients with COPD and HT.Item Item Interleukin-18/interleukin-10 ratio in predicting the further course of chronic obstructive pulmonary disease combined with hypertension(General medicine, 2019) Kapustnik, Valeriy; Kostyuk, Inna; Melenevych, AnastasiiaThe article presents the results of analysis of main prognostically significant criteria depending on the values of interleukin-18/interleukin-10 (IL-18/IL-10) ratio in patients with chronic obstructive pulmonary disease (COPD) combined with hypertension (HT). Growth of IL-18/IL-10 ratio was associated with emphysematous changes in chest X-ray, increase in the degree of dyspnea, decreased exercise tolerance, increased levels of desaturation, lower body mass index, waist and mid-arm circumferences. The results of echocardiography revealed that all patients with comorbid pathology had signs of myocardial overload. Patients of the first tertile (IL-18/IL-10 < 23) had more pronounced signs of an overload of the left heart. Instead, patients of the third tertile (IL-18/IL-10 ≥ 59) had more pronounced signs of an overload of the right heart by pressure. Prognostically unfavorable types of left ventricular geometry (concentric hypertrophy and eccentric hypertrophy) were more common in patients of the first tertile.Item Lung hyperinflation - a prognostically significant marker in geriatric patients(2024-04) Ananya DwivediLung hyperinflation is a common finding in patients with chronic obstructive pulmonary disease (COPD) observed via plain radiograph. Among people older than 65 years, the risk of developing COPD increases five times compared to 40 year olds (Easter M. et al., 2020). In addition, hyperinflation may be found in patients with the Tiffeneau index > 0,7. In most cases, this radiological finding is not given due attention, therefore further diagnosis and treatment is either delayed or insufficiently carried out.Item Practically significant innovations in GOLD 2011 guidelines for diagnosis, management and prevention of chronic obstructive pulmonary disease(2012) Melenevych, Anastasiia; Kalmykov, Oleksiy; Chernyakov, P.; Yasin, Abdul KarimOne of actual practical and scientific problems in general medicine and especially pulmonology is development of chronic obstructive pulmonary disease (COPD). Aim of the investigation was to reveal practically significant innovations in Global Initiative for chronic Obstructive Lung Disease (GOLD) 2011 guidelines for diagnosis, management and prevention of COPD. Material and methods: Comparation of two versions of GOLD guidelines published on official website www.goldcopd.org dated December, 2010 and February, 2012 (last one launched during a symposium hosted by the Asian Pacific Society of Respirology in November 2011) was performed. Only practically significant introductions are represented in this report. Results. The definition of COPD was reworded: 1) “common” - really, during last few years the incidence of COPD increased greatly all over the world; 2) “persistent” (about airflow limitation), while in all previous versions (starting from 2001) more cautious formulation “not fully reversible” was used. Additionally an assured formulation “exacerbations and comorbidities contribute to the overal severity of individual patients” is stated, while previously exacerbations were not included in COPD definition at all, and only presumptive “extrapulmonary effects may contribute” was used instead. Individualization of medical approach to patients with COPD remains in the limelight of COPD definition. Vitally important changes were conducted in diagnosis and assessment of COPD. It is still based on the patient's symptoms, the severity of the spirometric abnormality, identification of comorbidities, while evaluation of future risk of exacerbations was dramatically changed. Significance of lung ventilation function is specially highlighted: “Whereas spirometry was previously used to support a diagnosis of COPD, spirometry is now required to make a confident diagnosis of COPD”. Modernization of COPD management was performed using new diagnosis and assessment approaches to COPD. Strategy considering both disease impact (determined mainly by symptom burden and activity limitation) and future risk of disease progression (especially of the exacerbations) is recommended. Conclusion. New GOLD 2011 guidelines reflect a big step forward made in modern conception of COPD diagnosis, management and prevention. Further perspective from our point of view is to publish comprehensive monographs on the matter under the aegis of GOLD because of perfect analysis methodology provided by this international institution and highest qualification of experts (national leaders from different countries allover the world). This would greatly help medical practitioners and researchers.Item Right ventricular remodeling as an unfavorable feature in patients with chronic obstructive pulmonary disease combined with hypertension(2021-11) Melenevych, Anastasiia; Eshie, VictorWe investigated 69 patients with hypertension (HT) stage II in combination with chronic obstructive pulmonary disease (COPD) (GOLD 2, group B) in remission (57 males and 12 females ; mean age 55,80±5,51 years) who underwent 6-min walk test (6MWT), pulse oximetry, spirometry, chest X-ray, electrocardiography and echocardiography. IL-18 and IL-10 in the serum were determined by ELISA using a test system «Bender MedSystems, GmbH» (Austria). Worsening breathlessness, decreased tolerance to physical activity, reduction in oxygen saturation (SpO2) after 6MWT was associated with RV structural and functional impairment. Significant (p<0,05) differences in right heart chambers, indicating an increase in their overload, was found depending on the presence or absence of desaturation, i.e. decrease SpO2 during 6MWT more than 4% from baseline or below 90%: right atrial size - 39,79±2,27 mm vs. 35,83±5,02 mm; RV diameter - 27,10±2,22 mm vs. 28,37±2,40 mm; RV wall thickness - 5,58±0,57 mm vs. 5,22±0,61 mm; pulmonary artery to aorta ratio - 0,75±0,07 vs. 0,71±0,08. RV pressure overload (RV wall thickness > 5 mm and RV diameter < 30 mm) was associated with an imbalance of inflammatory response with increasing proinflammatory IL-18 and decreasing antiinflammatory IL-10. RV remodeling in response to pressure overload is often accompanied by maladaptive RV structural and functional impairment. Thus, RV remodeling with signs of overload by pressure was associated with increasing breathlessness, decreasing tolerance to physical activity, desaturation during 6MWT and imbalance of inflammatory response in patients with COPD combined with hypertension.Item Role of VEGF in development of chronic obstructive pulmonary disease in combination with hypertension(ХНМУ, 2015-05) Istomina, OlgaNowadays lot of attention is paid to issue of comorbid disease. On the basis of progressive humanity development, it is mentioned a decline of ecological situation, reduction of human motor activity, increasing of bad habits, poor nutrition and organism senilism. All these factors are lead to formation of several disease in humans at the same time. The prevalence of comorbid pathology averages 76,6%, 82% - for women, 72% - for men. One of the most common comorbid conditions is a chronic obstructive pulmonary disease (COPD) in combination with hypertension. According to the data WHO (newsletter #310, 2014) COPD and hypertension are included to the list of ten leading death causes in the world. Hypertension is found in COPD patients with varying frequency (from 6,8% to 76,3%) with average 34,3%. On this stage endothelial dysfunction can be considered as one of the most important independents risk factors for diabetes, atherosclerosis, COPD, hypertension, sepsis and growth of malignant neoplasms. One of the main endothelium functions is vascular growth regulations. One of the angiogenesis markers is vascular endothelial growth factor (VEGF). Among the angiogenic factors family, VEGF is considered to be a major one while neovascularization. Proteins which belong to the VEGF family group are glycoproteins that stimulate the formations of new blood and lymph vessels and also increase vascular permeability. One of the main factors for comobid pathology development is hypoxia and cells structure transformation under the mechanical factors influence that initiates VEGF production. By evaluation of GOLD 2014 revision COPD is characterized by a bronchial tubes affect (obstructive bronchiolitis) so as parenchymal distruction (emphysema). There are an extremely alveolar septa thinning and significantly reducing of their vascularization while progressive capillary endothelium loss and alveolar epithelium that leads to the substitution of lung tissue by the fibrous. Hypoxia promotes HIF-1a stabilization (hypoxia inducible factor-1a) which rapidly degraded at a sufficient oxygen concentration. HIF-1a and HIF-1βb is combined under hypoxia condition. Received complex is binded to a specific sensitive to the hypoxia region of the VEGF genes and increase its expression. Isolated mechanical stretching in a cell culture can contribute to VEGF realizing. Physical activity leading to the increasing of blood flow increasing shear stress and endothelial cells transformation followed by not only by increased VEGF level but also by increasing VEGFRs amount. A growth of shear stress and activation of the renin-angiotensin-aldosterone system while hypertension is also associated with increased VEGF content by mechanical influence on the vascular endothelial cells and angiotensin 2 interaction with angiotensin first type receptors which leads to the expression HIF-1a growth and increasing of VEGF synthesis. Thus VEGF and its receptors can be involved in many processes while COPD and hypertension, such as: airway walls remodeling, endothelial cell apoptosis and vascular remodeling.Item Surfactant protein C genetic polymorphism in patients with occupational COPD is associated with right ventricle changes(2014-02-03) Калмиков, Олексій Олексійович; Калмыков, Алексей Алексеевич; Kalmykov, OleksiyBackground: Chronic obstructive pulmonary disease (COPD) is characterized by steadily increasing morbidity and mortality, the last one is associated with mostly cardiovascular complications of COPD. The role of individual peculiarities of organism is taken into account in development of COPD. The role of surfactant, particularly surfactant protein C (SFTP С) genetic polymorphism is known in development of irreversible bronchial obstruction component as most typical feature of COPD. While relation of SFTP С to cardiological consequences of COPD was not studied enough. Aims and objectives: Investigation of relation of SFTP-С genetic polymorphism with development of chronic pulmonary hypertension, right heart hypertrophy with dysfunction and estimation of prophylactic potential of clinical-genetic investigation in workers exposed to dust. Methods: In 42 male Caucasian workers from machine-building industry 51,3±14,42 years old COPD of 2nd stage according to GOLD (2011) standards was diagnosed. Genotypes of SFTP С: А138С (АА, АС, СС) and А186G (AA, AG, GG) were investigated in polymerase chain reaction with following mass spectrometry analysis. Morphofunctional state of heart was defined using echocardiography. Results: It was stated that А138С and А186G polymorphisms of SFTP С gene are connected with more intensive changes of right heart. E.g., СС genotype is associated with right ventricle hypertrophy, GG genotype – with decrease of right ventricle pre-expulsion (р<0,01). This may be explained by determinant role of certain SFTP С phenotypes in formation of fibrosis, pulmonary emphysema, further disturbances of pulmonary circulation and increased right ventricle pre-load. Conclusions: Evaluation of surfactant protein C genetic polymorphism in workers of dust-related occupations has a perspective of introduction as a prognostic marker in prophylaxis of COPD cardiovascular complications by formation of risk groups.Item Surfactant protein C genetic polymorphism in patients with occupational COPD is associated with right ventricle changes(2012) Калмиков, Олексій Олексійович; Калмыков, Алексей Алексеевич; Kalmykov, OleksiyIndividual peculiarities are taken into account in development of chronic obstructive pulmonary disease (COPD). The role of surfactant protein C (SFTP-С) genetic polymorphism is known in development of irreversible bronchial obstruction component as most typical feature of COPD. However, relation of SFTP-С to cardiological consequences of COPD was not studied enough. Aims and objectives: Investigation of relation of SFTP-С genetic polymorphism with development of right heart hypertrophy and dysfunction, estimation of prophylactic potential of clinical-genetic investigation in workers exposed to dust. In 42 male Caucasian workers from machine-building industry 51,3±14,42 years old COPD of 2nd stage according to GOLD (2010) was diagnosed. Genotypes of SFTP-С: А138С and А186G were investigated in polymerase chain reaction with following mass spectrometry analysis. Morphofunctional state of heart was defined echocardiographically. It was stated that А138С and А186G polymorphisms of SFTP-С gene are connected with right heart changes. E.g., СС genotype is associated with right ventricle hypertrophy, GG genotype – with decrease of right ventricle pre-expulsion (p<0,01). This may be explained by determinant role of certain SFTP-С phenotypes in pulmonary fibrosis, emphysema, further disturbances of circulation and increased right ventricle pre-load. Evaluation of SFTP-С genetic polymorphism in workers of dust-related occupations has a perspective of introduction as a prognostic marker in prophylaxis of COPD cardiovascular complications.Item Which patient characteristics are associated with exerciseinduced desaturation in COPD combined with hypertension?(2023-10) Melenevych, AnastasiiaWe analyzed associations between various patient characteristics and exercise-induced desaturation in chronic obstructive pulmonary disease (COPD) combined with hypertension. We found that the male sex, dyspnea, fatigue, the distance walked in the 6-min walk test, BODE index, quality of life (assessed using a Clinical COPD Questionnaire) are associated with exercise-induced desaturation in patients with COPD combined with hypertension stage II.Item Клинико-функциональная характеристика хронической обструктивной болезни легких у рабочих машиностроения(2012-11-01) Калмиков, Олексій Олексійович; Калмыков, Алексей Алексеевич; Kalmykov, OleksiyОбследованы рабочие пылевых профессий в возрасте 52,3±4,71 лет, со стажем 20,7±2,05 лет, 77 из них были больны хронической обструктивной болезнью легких (ХОБЛ) I–II стадии и 25 — профессиональным бронхитом без бронхиальной обструкции. Установлено, что ХОБЛ у рабочих пылевых профессий характеризуется медленно прогрессирующим течением. Кашель нарастает постепенно, а одышка – боле интенсивно, что может быть связано с развитием перибронхиального фиброза, характерного для пылевой патологии. Для ранней диагностики бронхиальной обструкции большее значение имеет ОФВ1/ФЖЕЛ, в то время как снижение показателя ОФВ1 выявляется позже. Тест з 6-минутной ходьбой имеет значение для оценки выраженности патологического процесса. Потребность в бронхолитиках короткого действия определяется, в большей мере, выраженностью субъективной симптоматики (одышки, r=0,73, р<0,01), чем показателем ОФВ1 (r=-0,63, р<0,05). Возможно, это связано с особенностями восприятия больным дыхательного дискомфорта.