Features of endothelial dysfunction in patients with coronary heart disease occurring in comorbidity with chronic obstructive pulmonary disease

The objective was to conduct a comparative assessment of vasodilately with coronary heart disease (CHD) combined with chronic obstructive pulmonary disease (COPD) and isolated CHD.Material and research methods. A study of 226 patients with CHD. The main group comprised 68 patients with stable angina pectoris without acute coronary events in history and 54 patients after myocardial infarction with lifting segment T, with comorbid COPD. In the comparison group included 53 patients with stable angina and 51 patients who underwent myocardial infarction with lifting segment T, without comorbidity. Endothelium-dependent vasodilation was assessed by the classic test with reactive hyperemia according to D. Celermajer. To assess еndothelium-independent vasodilation of the brachial artery used the test with nitroglycerin.The results and conclusions. With the development of myocardial infarction in COPD patients observed a more pronounced decrease in the degree of increase in brachial artery diameter, violation of indicators of its tone and elasticity, than in patients with a combination of stable angina and COPD. Еndothelium- independent nitroglycerin-induced vasodilation with a combination of acute and chronic forms of ischemic heart disease with COPD impaired to a greater extent than in CHD without concomitant diseases. Technical simplicity, noninvasiveness, availability of ultrasound assessment of vasoreactivity allows you to determine the status of the regulation of endothelial function and to evaluate the efficacy of combined bronchodilator and antianginal therapy in patients with CHD and comorbid COPD. The disease in combination with COPD endothelial dysfunction more pronounced than in isolated CHD.