Shoĭkhet Ia N, Klester E B, Golovin V A
Klin Med (Mosk). 2008;86(3):21-6.
The purpose of the research was to study kinds, frequencies and features of heart rhythm disturbances (HRD) in patients with chronic obstructive pulmonary disease (COPD) subject to degree of severity, including presence of coronary heart disease (CHD). 1189 of patients with registered HRD were examined. 315 of them had COPD (group 1), 531--combination of COPD and CHD (group 2), 343 were CHD patients (group 3). The extent of examinations included electrocardiogram (ECG), Halter monitoring (HM), bicycle ergometry (BEM), external respiration function estimation. Supraventricular HRD were registered statistically more frequently in group 1: according to ECG data in rest - in 37.2% patients, by BEM results--in 18.8%, by HM--in 50%. Combined (supraventricular and ventricular) HRD were registered most frequently in group 2: 41.2 24.4, and 45.5% respectively. Ventricular HRD dominated in group 3: 47.6, 29.3 and 48.6% respectively. The results of the study indicate that supraventricular HRDprevaile in patients with COPD, combined HRD - in patients with COPD and CHD. Ventricular HRD, which most informatively reflect changes in intracardiac geometry and left ventricle hemodynamics, dominate in CHD patients. The optimization of therapy correction consists in early diagnostics of HRD subject to features of cardiorespiratory system functional state.
该研究的目的是根据严重程度，包括是否存在冠心病（CHD），研究慢性阻塞性肺疾病（COPD）患者心律失常（HRD）的类型、频率和特征。对1189例已确诊HRD的患者进行了检查。其中315例患有COPD（第1组），531例患有COPD和CHD的组合（第2组），343例为CHD患者（第3组）。检查范围包括心电图（ECG）、动态心电图监测（HM）、自行车运动试验（BEM）、肺通气功能评估。第1组中，室上性HRD的统计发生率更高：根据静息心电图数据，发生率为37.2%的患者；根据BEM结果，发生率为18.8%；根据HM结果，发生率为50%。第2组中，合并（室上性和室性）HRD的发生率最高，分别为41.2%、24.4%和45.5%。第3组中，室性HRD占主导，分别为47.6%、29.3%和48.6%。研究结果表明，COPD患者中室上性HRD占优势，COPD和CHD患者中合并HRD占优势。最能反映心脏内几何形状和左心室血流动力学变化的室性HRD在CHD患者中占主导。治疗调整的优化在于根据心肺系统功能状态的特征对HRD进行早期诊断。
