THE BEHAVIOR OF SILENT MYOCARDIAL ISCHEMIA AND ITS PREDICTIVE VALUE UNDER COMBINED CARDIOPULMONARY PATHOLOGY
Abstract
The aim of the research is to study in the comparative way the frequency of the occurrence, the features of manifestation and predictive value of silent myocardial ischemia in patients with chronic obstructive pulmonary disease (COPD) associated with ischemic heart disease (IHD) and in patients with isolated course of IHD. There are the results of comparative daily monitoring of Holter electrocardiograms of 136 patients with COPD of II stage combined with the stable angina of II functional class (group 1) and of 60 patients with isolated IHD who are compared by the age and angina duration (group 2). The period of observation was 12 months. As a result of the research it was found out that episodes of silent myocardial ischemia were oftener (р<0.01) registered in group 1 (in 56% of patients) than in group 2 (in 35%) and in the patients of group 1 the episodes during a day occurred oftener (р<0.05) and were more lengthy (р<0.01), there was more intensive dislocation of ST-segment below the isoline (р<0.01). The index of the absolute risk of silent myocardial ischemia development in group 2 was 0.345, in group 1 it was significantly higher (0.559), at the same time the relative risk of myocardial ischemia development in group 1 was 4.2 times higher than the same index in group 2 (р=0.01). The absolute risk of the development of acute cardiovascular cases in group 2 was 0.35; in group 1 it was 0.55. The relative risk of the development of acute cardiovascular cases in group 1was 3.3. times higher than in group 2 (p=0.001). Thus comorbide pathology (COPD and IHD association) is an important factor which increases the risk of the development of silent myocardial ischemia associated with the high risk of acute cardiovascular events development (in 64.5%) during the nearest 12 months. This dictates the necessity of active identification of silent myocardial ischemia and timely adequate correction which takes into account pathogenetic mechanisms of its formation.
About the Authors
Valentina I. Pavlenko
Amur State Medical Academy
Russian Federation
Russian Federation
Svetlana V. Naryshkina
Amur State Medical Academy
Russian Federation
Russian Federation
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Review
For citations:
Pavlenko V.I., Naryshkina S.V. THE BEHAVIOR OF SILENT MYOCARDIAL ISCHEMIA AND ITS PREDICTIVE VALUE UNDER COMBINED CARDIOPULMONARY PATHOLOGY. Bulletin Physiology and Pathology of Respiration. 2014;(51):44-47. (In Russ.)
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