Ben A. Diagnosis of early hemodynamic disorders of patients with chronic obstructive lung disease: role of indicators of N-terminal-proBNP and markers of inflammatory process

Object of research: chronic obstructive pulmonary disease (COPD); purpose: to improve the effectiveness of early diagnosis of hemodynamic disorders on the basis of studying the brain natriuretic peptide (BNP) and markers of systemic inflammatory reactions among the patients with COPD; research methods: general and clinical, instrumental (respiratory function study with a bronchodilator test, echocardiography), laboratory, immunological, statistical; novelty: the frequency and nature of a myocardial dysfunction among the patients with COPD has been established for the first time, the dependence of development of hemodynamic disorders according to the severity of the disease, frequency of exacerbations, degree of shortness of breath have been proved; the main factors influencing the development of hemodynamic disorders have been defined; the role of a tumour-alfa necrosis factor (FNP-alfa) and interleukin-8 (ІL-8) as the predictors of unfavorable course of COPD has been proved; the dependence of the frequency of development of hemodynamic changes on the concentration of BNP have been scientifically confirmed; for the first time it has been proved that the raised concentration of BNP in blood is a reflection of the formation of a chronic pulmonary heart among the patients with COPD, it depends on the degree of manifestations of bronchial obstruction and the frequency of exacerbations of the disease during the year; for the first time has been developed and offered the mathematical formula (a polynomial of the fourth degree) to determine the intended concentration of BNP; it has been proved that the inclusion of a phosphodiesterase-4 inhibitor to the COPD therapy for the patients of groups "C" and "D" reduces the concentration of pro-inflammatory IL-8, increases the concentration of anti-inflammatory CNP-alfa, and also reduces the content of BNP, which contributes to the improvement of the course of the disease. The scope of application - medicine.