Optimization of pathogenetic therapy in patients with chronic obstructive pulmonary disease combined with ischemic heart disease

September 28, 2018

A comparative estimation of the influence of bronchodilators on the clinical symptoms of chronic obstructive pulmonary disease (COPD) and intracardiac hemodynamics in patients with COPD and coronary heart disease (CHD) has been conducted. The results of the study showed the advantage of the use of the long-acting M-cholinolytics (glycopyrronium bromide) against the long-acting β2-adrenergic agonist (formoterol fumarate) in reducing the number of exacerbations, preserving the contractile capacity of the myocardium and inotropic function of the heart, improving the diastolic function of the right ventricle, characterized by normalization (increasing) of the peak of the maximum speed of early diastolic filling and decreasing of the peak of the maximum speed of the atrial diastolic filling which led to the normalization of their relationship. The literature data and the results of our own research suggest that long-acting M-cholinolytics are the drug of choice in patients with COPD and CHD, and also mucolytics (acetylcysteine, ACC®, «Sandoz»), which contributes to lowering the frequency, severity and duration of exacerbations, should be included in the treatment scheme for such patients.

E.O. Krakhmalova, Yu.E. Kharchenko, A.Yu. Tokareva

Key words: chronic obstructive pulmonary disease, ischemic heart disease, long-acting M-cholinolytics, long-acting β2-adrenergic agonists, mucolytics, acetylcysteine, ACC®.

Published: 23.10.2018


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