Terapevticheskii arkhivTerapevticheskii arkhiv0040-36602309-5342LLC Obyedinennaya Redaktsiya31438Research ArticleCardiac comorbidity in patients with chronic obstructive pulmonary disease: Diagnosis and economicsAkramovaÉ Gakendge@rambler.ruKhamitovaR Ia-15032014863242710042020Copyright © 2014, Consilium Medicum2014AIM: To provide a clinical and economic rationale for the comprehensive examination of patients with chronic obstructive pulmonary disease (COPD), by using functional and ultrasound methods for the early detection of cardiac comorbidity/MATERIAL AND METHODS: Three hundred and sixteen patients (33 with COPD, 44 with COPD + hypertension, 73 with COPD + coronary heart disease (CHD), 36 with hypertension, 50 with CHD, 19 with asthma, and 28 with asthma + hypertension) and 33 apparently healthy individuals were examined using 611 indicators obtained directly or by calculation during echocardiography, carotid artery duplex scanning, and 24-hour electrocardiographic (ECG) and blood pressure (BP) monitoring/RESULTS: Cardiovascular diseases develop in patients with COPD in its early stages. In cardiac comorbidity, the length of hospital stay increases by 1-1.5 days in patients with COPD; the number of people admitted to hospital more than once every 3 years rises from 14 to 28%; the cost of a pharmacotherapy cycle is 1.35- and 2.95-fold higher when COPD is concurrent with hypertension and CHD, respectively/CONCLUSION: In addition to ECG and spirometry, the management standard for patients with COPD should include echocardiography, 24-hour ECG and BP monitoring, and, according to thei/RESULTS: carotid artery duplex scanning.chronic obstructive pulmonary diseasecardiac comorbidityultrasound and functional examinationsclinical and economic analysisхроническая обструктивная болезнь легкихсопутствующая кардиальная патологияультразвуковое и функциональное обследованияклинико-экономический анализ[Авдеев С.Н., Баймаканова Г.Е. ХОБЛ и сердечно-сосудистые заболевания: механизмы ассоциации. Пульмонология 2008; 1: 5-13.][Huiart L., Ernst P., Suissa S. Cardiovascular morbidity and mortality in COPD. Chest 2005; 128 (4): 2640-2646.][Ansari K.A. A critical evaluation of prognostic indicators of the natural history of chronic obstructive pulmonary disease (COPD). British Library EThoS 2012: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.551118][Almagro P., Cabrera F.J., Diez J. et al. Comorbidities and short-term prognosis in patients hospitalized for acute exacerbation of COPD. The ESMI study. Chest 2012; 142 (5): 1126-1133.][Finkelstein J., Cha E., Scharf S.M. Chronic obstructive pulmonary disease as an independent risk factor for cardiovascular morbidity. Intern J Chron Obstruct Pulmon Dis 2009; 4 (3): 337-349.][Rasche K., Orth M., Kutscha A., Duchna H.W. Pulmonary diseases and heart function. Internist (Berlin) 2007; 48 (3): 276-282.][Vicente L.San, Galofre N., Oriol J. et al. Prevalence of heart disease in patients hospitalized for an acute exacerbation of COPD: impact on clinical outcome. A 6-month follow-up study. Eur J Heart Fail 2011; 10 (S1): S152.][Лещенко И.В., Лифшиц В.Р., Романовских А.Г. и др. Вопросы фармокоэкономики при лечении хронического обструктивного бронхита. Тер арх 2002; 3: 38-40.]