scholarly journals Dynamics of Inflammatory Markers in Patients with Pulmonary Hypertension on the Background of COPD combined with Hypertension under the Influence of Treatment

2020 ◽  
Vol 5 (6) ◽  
pp. 150-157
Author(s):  
K. L. Nikolaieva ◽  

Chronic obstructive pulmonary disease significantly affects the quality of life, considerably limiting the physical capabilities of patients and is one of the main causes of morbidity and mortality in modern society. Currently, the problem of the comorbidity for the patients with chronic obstructive pulmonary disease is very relevant. The most common in patients of this category is hypertension. Today, it has been established that disorders in the immune system are detected in a very large group of diseases, including both chronic obstructive pulmonary disease and hypertension. The purpose of the study was to evaluate the dynamics of inflammatory markers in the patients with pulmonary hypertension on the background of chronic obstructive pulmonary disease in combination with hypertension under the influence of treatment. Material and methods. The results of the study are based on data from a comprehensive survey of 170 patients aged 40 to 65 years with chronic obstructive pulmonary disease, of which 123 had pulmonary hypertension (of which 87 had stage II hypertension and 36 were without hypertension) and 47 people were without pulmonary hypertension. The patients were chosen in the period from 2015 to 2018 on the basis of the municipal institution "Zaporizhzhia regional clinical hospital" of the Zaporizhzhia regional council. Results and discussion. The results of this study indicate the role of inflammation, or rather the levels of hs-CRP and IL-6, in the pathogenesis of pulmonary hypertension in patients with chronic obstructive pulmonary disease. The level of hs-CRP among the patients with pulmonary hypertension on a background of chronic obstructive pulmonary disease made up 10.46 [6,24 ; 15,30] mg/l and was significantly higher as against the values in the group of patients with chronic obstructive pulmonary disease without pulmonary hypertension and compared with group of healthy persons. The increase in the level of IL-6 in the group of patients having pulmonary hypertension with chronic obstructive pulmonary disease is significantly higher by 57 % compared to the value in the group of chronic obstructive pulmonary disease without pulmonary hypertension and by 7.4 times the value in the group of healthy individuals (p <0.05). Comparing the subgroups of patients, and depending on the variant of exacerbation of chronic obstructive pulmonary disease, the level of hs-CRP and IL-6 was considerably higher in the subgroup with the infectious type of exacerbation compared with the subgroup of the non-infectious type of exacerbation of chronic obstructive pulmonary disease. Conclusion. After 12 months of treatment, when roflumilast was added to the basic therapy, we revealed a statistically significant difference in the levels of IL-6, hs-CRP and IL-10 in the plasma of patients with pulmonary hypertension on the background of chronic obstructive pulmonary disease combined with hypertension

Respiration ◽  
1985 ◽  
Vol 47 (3) ◽  
pp. 164-170 ◽  
Author(s):  
Marco Soroldoni ◽  
Fulvia Ferrarini ◽  
Enrico Biffi ◽  
Marzio Pozzi ◽  
Roberto Gatto ◽  
...  

2008 ◽  
Vol 51 (2) ◽  
pp. 106-113 ◽  
Author(s):  
Megumi Umehara ◽  
Akihiko Yamaguchi ◽  
Susumu Itakura ◽  
Mitsuhiro Suenaga ◽  
Yoshimune Sakaki ◽  
...  

Author(s):  
Elena Jurevičienė ◽  
Greta Burneikaitė ◽  
Laimis Dambrauskas ◽  
Vytautas Kasiulevičius ◽  
Edita Kazėnaitė ◽  
...  

Various comorbidities and multimorbidity frequently occur in chronic obstructive pulmonary disease (COPD), leading to the overload of health care systems and increased mortality. We aimed to assess the impact of COPD on the probability and clustering of comorbidities. The cross-sectional analysis of the nationwide Lithuanian database was performed based on the entries of the codes of chronic diseases. COPD was defined on the code J44.8 entry and six-month consumption of bronchodilators. Descriptive statistics and odds ratios (ORs) for associations and agglomerative hierarchical clustering were carried out. 321,297 patients aged 40–79 years were included; 4834 of them had COPD. A significantly higher prevalence of cardiovascular diseases (CVD), lung cancer, kidney diseases, and the association of COPD with six-fold higher odds of lung cancer (OR 6.66; p < 0.0001), a two-fold of heart failure (OR 2.61; p < 0.0001), and CVD (OR 1.83; p < 0.0001) was found. Six clusters in COPD males and five in females were pointed out, in patients without COPD—five and four clusters accordingly. The most prevalent cardiovascular cluster had no significant difference according to sex or COPD presence, but a different linkage of dyslipidemia was found. The study raises the need to elaborate adjusted multimorbidity case management and screening tools enabling better outcomes.


2021 ◽  
pp. 00348-2021
Author(s):  
Ragdah Arif ◽  
Arjun Pandey ◽  
Ying Zhao ◽  
Kyle Arsenault-Mehta ◽  
Danya Khoujah ◽  
...  

Chronic obstructive pulmonary disease-associated pulmonary hypertension (COPD-PH) is an increasingly recognised condition which contributes to worsening dyspnea and poor survival in COPD. It is uncertain whether specific treatment of COPD-PH, including use of medications approved for pulmonary arterial hypertension (PAH), improves clinical outcomes. This systematic review and meta-analysis assesses potential benefits and risks of therapeutic options COPD-PH.We searched Medline and Embase for relevant publications until Sep 2020. Articles were screened for studies on treatment of COPD-PH for at least 4 weeks in 10 or more patients. Screening, data extraction, and risk of bias assessment were performed independently in duplicate. When possible, relevant results were pooled using the random effects model.Supplemental long-term O2 therapy (LTOT) mildly reduced mean pulmonary artery pressure (PAP), slowed progression of PH, and reduced mortality, but other clinical or functional benefits were not assessed. Phosphodiesterase type-5 inhibitors significantly improved systolic PAP (pooled treatment effect −5.9 mmHg; 95%CI −10.3, −1.6), but had inconsistent clinical benefits. Calcium-channel blockers and endothelin receptor antagonists had limited hemodynamic, clinical, or survival benefits. Statins had limited clinical benefits despite significantly lowering systolic PAP (pooled treatment effect −4.6 mmHg; 95% CI: −6.3, −2.9).This review supports guideline recommendations for LTOT in hypoxemic COPD-PH patients as well as recommendations against treatment with PAH-targeted medications, Effective treatment of COPD-PH depends upon research into the pathobiology, and future high-quality studies comprehensively assessing clinically relevant outcomes are needed.


2021 ◽  
Vol 11 ◽  
Author(s):  
Chung-Yu Chen ◽  
Wen-Ting Wu ◽  
Ya-Ling Wang ◽  
Kuang-Ming Liao

Background: Patients with chronic obstructive pulmonary disease (COPD) are at risk for pulmonary hypertension (PH). The aim of our study was to investigate the benefit of statins for PH in patients with COPD.Methods: The study enrolled 23 million individuals from Taiwan’s population database from January 1, 2002, to December 31, 2017. COPD patients who met the inclusion criteria were enrolled, and patients with lung cancer, less than one year of observation, specific drug therapy for PH and lung transplantation were excluded.Results: A total of 643,131 COPD patients were included in the study, and only 12,308 patients developed PH during follow-up. Based on the inclusion and exclusion criteria, 8,577 PH patients were included in the cohort of patients with PH related to COPD for analysis. According to the definition of statin exposure, the final study population had 1,487 statin users and 7,090 statin non-users. The statin user group had a lower mortality related to PH than the non-user group (3.87 vs. 5.55 per 100 person-years, p &lt; 0.001). The mortality rate for PH in the multivariate analysis (aHR = 0.78, 95% CI = 0.62–0.98, p = 0.046) was significantly lower for statin users than for non-users.Conclusion: Statins seem to benefit patients with PH and COPD.


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