Nikolaieva K. Optimization of treatment of patients suffering from pulmonary hypertension with a background of chronic obstructive pulmonary disease combined with hypertensive disease

The dissertation is devoted to the improvement of treatment of patients suffering from pulmonary hypertension with a background of chronic obstructive pulmonary disease combined with hypertensive disease in the exacerbation phase of chronic obstructive pulmonary disease by determination of the clinical and pathogenetic role of inflammatory factors and endothelial function and optimizing their drug correction. The role of systemic inflammatory factors in the constellation with endothelial function markers in relation to the progression of pulmonary hypertension with a background of chronic obstructive pulmonary disease combined with hypertensive disease has been established in the work. It is proved that in the development of pulmonary hypertension with a background of chronic obstructive pulmonary disease combined with hypertensive disease, the average blood pressure in the pulmonary artery is significantly higher than in patients who did not have additional hypertensive disease. It was found that an increase in the degree of pulmonary hypertension leads to a violation of the filling of the left ventricle, which is characterized by a lower value of the stroke volume. The relationship between mean pulmonary artery blood pressure and markers of systemic inflammation and endothelial function has been elucidated. It has been shown that in patients with pulmonary hypertension with a background of chronic obstructive pulmonary disease combined with hypertensive disease, basic therapy with roflumilast had a positive effect on markers of systemic inflammation, improved endothelial function and reduced the relative risk of hospitalization by 3.5 times.