Didenko D. Ischemic heart disease and chronic obstructive pulmonary disease: diagnostics and features of clinical course in case of their combination.

The results of the study are based on data from a survey of 272 patients, including 98 patients with a combination of stable ischemic heart disease (IHD) and chronic obstructive pulmonary disease (COPD), 96 with stable IHD without concomitant COPD and 78 patients with isolated COPD. The frequency of undiagnosed COPD among patients on stable IHD, which denied the presence of chronic non-specific diseases of the respiratory organs, was established at 25.7 %. The use of a questionnaire for the diagnosis of COPD in patients with stable IHD has been developed and substantiated. After the complex clinical and functional examination, the negative effect of the combined pathology on the course of diseases was established: the growth of the signs of remodeling of the chambers of the heart, the significant increase in the number of supraventricular and ventricular rhythm disorders compared with patients with the isolated course of these pathologies. The possibility of rhythm disturbances in patients with IHD, COPD and their combined course during spirography with bronchodilator test was first discovered. The occurrence of high-grade ventricular extrasystoles (VE) was diagnosed in 11 (20.7 %) patients with a combination of IHD and COPD (p=0.008) and paroxysmal rhythm disturbances in 7.6 % of patients (p=0.023). Predictors of high-grade VE for patients with a combined pathology, which include indicators of echocardiography and daily monitoring of electrocardiogram, have been calculated. The results of work have been introduced into the practical medicine and educational process.