Features of the Functional Status and Cytokine Profile of Patients with Chronic Heart Failure in Combination with Chronic Obstructive Pulmonary Disease

Abstract

The purpose of this research was to study the effect of COPD on the functional status and cytokine profile of patients with chronic heart failure (CHF) with different ejection fraction (EF). Methods and Results: The study involved 240 patients diagnosed with CHF (mean age of 72.4±8.7 years). Among them, 80 patients were diagnosed with CHF and COPD. Depending on the presence of COPD, the patients were divided into two groups: Group 1 included 160 patients with CHF without COPD; Group 2 included CHF 80 patients with COPD. According to the value of LVEF, each of the two groups was divided into two more subgroups: In Group 1, CHFpEF (EF≥50%) was recorded in 69 patients (Subgroup 1) and CHFrFV (EF<50%) in 91 patients (Subgroup 2). In Group 2, CHFpEF was observed in 36 patients (Subgroup 3) and CHFrEF in 44 patients (Subgroup 4). The 6-minute walk distance (6MWD) was measured in meters and compared with the proper 6MWD(i). All patients included in the study underwent the Borg test to assess dyspnea after 6MWT. The serum levels of NT-proBNP, hs-CRP, IL-1β, IL-6, and TNF-α were determined using an automatic analyzer IMMULITE 2000 (Siemens Diagnostics, USA) and quantitative ELISA kits. The patients with CHFpEF had higher levels of hs-CRP, pro-inflammatory cytokines than patients with CHFrEF. The combination of COPD and CHF amplifies systemic inflammation (hs-CRP, proinflammatory cytokines) and myocardial remodeling processes (NT-proBNP) in comparison with the isolated course of CHF. COPD negatively affects the functional status of patients with CHF with different EF by lower values of 6MWD, 6MWD/6MWD(i) ratio, and higher results on the Borg dyspnea test.