Молодежный инновационный вестникМолодежный инновационный вестник2415-7805Федеральное государственное бюджетное образовательное учреждение высшего образования "Воронежский государственный медицинский университет имени Н.Н. Бурденко" Министерства здравоохранения Российской Федерации7398Conference ProceedingsEVALUATION OF THE EFFECTIVENESS OF PHYSICAL ACTIVITY IN PATIENTS WITH COMORBID CURRENT OF THE CHRONIC HEART FAILURE AND CHRONIC OBSTRUCTIVE PULMONARY DISEASEGlavatskikhYuliyaYuliyag36@gmail.comhttps://orcid.org/0000-0002-2398-5987DrobyshevaValeria Romanovnadrobyshevavr@gmail.comhttps://orcid.org/0000-0001-6636-6644БудневскаяСофияYuliyag36@gmail.comhttps://orcid.org/0000-0003-3649-5642TokmachevRoman Evgenyevichr-tokmachev@mail.ruhttps://orcid.org/0000-0001-6379-463530062022111151192702202201042022Copyright © 2022, Glavatskikh Y., Drobysheva V.R., Будневская ., Tokmachev R.E.2022<p>Topicality. One of the most frequent combinations of pathologies is chronic obstructive pulmonary disease (COPD) associated with chronic heart failure (CHF). The comorbidity of these diseases often results in a pronounced deterioration in the well-being of such patients as well as a deterioration in the long-term prognosis, which requires further study of the progression mechanisms of CHF, Improving the diagnosis and treatment of this category of patients.<br />Target. Evaluate the influence of physical training on clinical flow, laboratory and instrumental indicators in patients with comorbid current of chronic heart failure and chronic obstructive pulmonary disease with different emission fraction. Study the clinical pathogenic relationship between comorbid diseases COPD and CHF.<br />Materials and Methods. The study included a group of patients (n=80) with comorbid currents CHF and COPD (48 men (60%) and 32 women (40%), with an average age of 67.55.9 years.) By LV EF, patients were divided into two groups. Two subgroups were formed in each group, depending on whether physical training was included in the treatment programme. At the time of inclusion and 12 months later, they conducted a definition of tolerance to physical load, laboratory and instrumental examination. The statistical analysis was carried out with the help of the Statistica 10 software package.<br />Results. A follow-up survey 12 months later in subgroups undergoing physical rehabilitation revealed a statistically significant (p0.05) decrease in the N-terminal fragment of the natriuretic peptide (NT-proBNP), the highly sensitive C-reactive protein (Hs-CRP), interleukin-1 (IL1)interleukin-6 (IL6), tumor necrosis factor alpha (TNF-alpha). There has been an increase in the tolerance of physical exertion, which is assessed with the help of 6MWT.</p>
<p>Conclusion. The combination of COPD and CHF amplifies systemic inflammation and myocardial remodeling processes determined by the level of the highly sensitive C-reactive protein, pro-inflammatory cytokines and NT-proBNP. The negative influence of the 6MWT on the functional status of CHF patients with different emission fraction has been established, which is manifested by the lower values of 6MWT and the ratio of 6MWD/6MWD(i). Physical rehabilitation of patients with comorbid COPD and CHF is accompanied by significant improvement of hemodynamic performance during load tests (6MWT), decrease of pro-inflammatory cytokines, high sensitive C-reactive protein, NT-proBNP.</p>CHFCOPDCytokine profileFunctional statusХроническая сердечная недостаточностьхроническая обструктивная болезнь легкихцитокиновый профильфункциональный статус[Tokmachev R.E., Kravchenko A.Ya., Budnevsky A.V., et al. Features of the functional status and cytokine profile of patients with chronic heart failure in combination with chronic obstructive pulmonary disease. International Journal of Biomedicine. 2021; 11(1): 9-13.][Дробышева Е.С., Токмачев Р.Е., Будневский А.В., Кравченко А.Я. Прогностическое значение биомаркеров сердечной кахексии при хронической сердечной недостаточности. Кардиоваскулярная терапия и профилактика. 2016; 15(4): 80-83.][Драпкина О.М., Концевая А.В., Кравченко А.Я., и др.// Биомаркеры st2 и интерлейкин 33 в оценке кардиального воспаления, фиброза и прогноза пациентов с хронической сердечной недостаточностью // Российский кардиологический журнал. 2021. Т. 26. № S3. С. 79-85.]