ACADEMIC AND RESEARCH PEER-REVIEWED MEDICAL JOURNALISSN 1727-2378 (Print)         ISSN 2713-2994 (Online)
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Interstitial Lung Disease and Ischemic Heart Disease Comorbidity: Clinical, X-ray, and Functional Features

DOI:10.31550/1727-2378-2018-152-8-50-56
Bibliography link: Abubikirov A.F., Zaitseva A.S., Leonova E.I., Mazaeva L.A., Medvedev A.V., Shmelyova N.M., Shmelyov E.I. Interstitial Lung Disease and Ischemic Heart Disease Comorbidity: Clinical, X-ray, and Functional Features. Doctor.Ru. 2018; 8(152): 50–56. DOI: 10.31550/1727-2378-2018-152-8-50-56
25 October 17:02

Study Objective: To investigate the clinical, X-ray, and functional parameters of patients with interstitial lung disease (ILD) accompanied by ischemic heart disease (IHD) and of those with ILD only.

Study Design: This was an open-label, comparative, cross-sectional, parallel-group study.

Materials and Methods: One hundred and eighty-six patients with ILD participated in the study, including ones with idiopathic pulmonary fibrosis (IPF), non-specific interstitial pneumonia (NSIP), and extrinsic allergic alveolitis (EAA). The patients were divided into two groups. The main group was made up of 59 patients with IHD (comorbidity group): 12 patients with IPF, 24 patients with NSIP, and 23 patients with chronic EAA. The comparison group comprised 127 patients without IHD: 22 patients with IPF, 46 patients with NSIP, and 59 patients with EAA. Clinical symptoms and imaging and functional assessments were analyzed.

Study Results: Patients with IPF or NSIP, in either case accompanied by IHD, had more significant respiratory symptoms than those without this comorbidity. Patients with ILD not accompanied by IHD had a longer history of lung disease. Cardiac symptoms force patients with ILD to seek prompt medical attention in an attempt to determine the nature of their dyspnea and understand their functional abnormalities in more detail. For that reason ILD is detected earlier in patients with coronary disorders than in those without them.

Plain chest X-rays of all patients showed a reticular pattern, which was more pronounced in patients with IPF or NSIP with or without IHD. Signs of hypervolemia were observed only in IHD patients, and significantly more often in patents with arrhythmia (р < 0.001). X-ray signs of pulmonary congestion were seen in patients with NSIP alone, or accompanied by IHD, while in patients with IPF or EAA these signs were present only in cases of IHD comorbidity. Multi-slice spiral computed tomography revealed hypervolemia accompanied by right heart hypertrophy. Ground-glass opacities were more often found in patients with NSIP and EAA. Honeycombing and traction bronchiectasis were more often detected in patients with IPF. In IHD patients lung consolidation occurred 1.5 times more often in people with NSIP than in those with IPF, and only in a handful of EAA cases.

Impaired gas exchange, obstructive and restrictive ventilatory patterns, and reduced lung elasticity were observed in all subgroups. Patients with IPF or NSIP had moderate pulmonary hypertension, right atrial dilation, and right ventricular hypertrophy, which were more significant in IHD patients. Left heart remodeling (left ventricular hypertrophy and/or dilation) was also seen more often in IHD patients.

Conclusion: Respiratory symptoms, restrictive ventilatory defects, reduction in lung diffusing capacity, and cardiac dilation are more pronounced in ILD patients with comorbid cardiovascular disease.

A.F. Abubikirov — Central Tuberculosis Research Institute, Moscow. City Clinical Hospital No. 24, Moscow City Department of Health. E-mail: аbubik_1@mail.ru

A.S. Zaitseva — Central Tuberculosis Research Institute, Moscow. E-mail: anyasyls@yandex.ru

E.I. Leonova — Central Tuberculosis Research Institute, Moscow. E-mail: zei86@mail.ru

L.A. Mazaeva — Central Tuberculosis Research Institute, Moscow. City Clinical Hospital No. 24, Moscow City Department of Health. E-mail: lara.mazaeva@yandex.ru

A.V. Medvedev — Central Tuberculosis Research Institute, Moscow. City Clinical Hospital No. 24, Moscow City Department of Health. E-mail: alexmedved_1@mail.ru

N.M. Shmelyova — Central Tuberculosis Research Institute, Moscow. E-mail: еishmelev@mail.ru

E.I. Shmelyov — Central Tuberculosis Research Institute, Moscow. E-mail: еishmelev@mail.ru

Доктор.ру
25 October 17:02
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