Functional Status And Cytokine Profile Assessment In Patients With Chronic Obstructive Pulmonary Disease And Chronic Heart Failure

Objective — to evaluate the effect of chronic obstructive pulmonary disease (COPD) on the level of cytokines and the functional status of patients with chronic heart failure (CHF) with different categories of left ventricular ejection fraction. Methods — The study included 240 patients 40–70 years of age with CHF. All patients were divided into four groups: 69 CHF patients with preserved ejection fraction (CHFpEF), 91 CHF patients with reduced ejection fraction (CHFrEF), 36 COPD patients with CHFpEF and 44 COPD patients with CHFrEF. All participants underwent echocardiography, six-minute walk test (6MWT), the results of which were compared with the predicted six-minute walk distance: 6МWD (i). Additionally, we assessed the levels of NT-terminal fragment of pro-brain natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), IL-1β, IL-6, TNF-α, suppression of tumorigenicity 2 (ST2) in patient blood samples. Results — Patients with CHFpEF had higher levels of hs-CRP and proinflammatory cytokines as compared with patients with CHFrEF. The levels of NT-proBNP were higher in patients with COPD and CHF, compared with patients with CHF alone. A negative effect of COPD on the functional status of CHF patients with different EF values was established by the lower 6MWT values and 6MWD/6MWD ratio (i). An increase in the level of suppression of tumorigenicity 2 soluble forms (sST2) was noted in patients with COPD and CHF as compared with the isolated course of cardiac pathology patients. Conclusion — We established that unfavorable effect of COPD on patients with CHF was caused by disadvantageous values of NT-proBNP, ST2, 6MWT, and 6MWD/6MWD (i) ratio.