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

Roman E. Tokmachev, Andrey Ya. Kravchenko, Andrey V. Budnevsky, Evgeniy S. Ovsyannikov, Evgeniy V. Tokmachev, Tatiana A. Chernik

International Journal of Biomedicine. 2021;11(1):9-13.
DOI: 10.21103/Article11(1)_OA1
Originally published March 5, 2021


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.

chronic heart failure • ejection fraction • COPD • cytokine
  1. Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, et al.; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Executive summary: heart disease and stroke statistics--2012 update: a report from the American Heart Association. Circulation. 2012 Jan 3;125(1):188-97. doi: 10.1161/CIR.0b013e3182456d46. Erratum in: Circulation. 2012 Jun 5;125(22):e1001.
  2. Maggioni AP, Dahlström U, Filippatos G, Chioncel O, Crespo Leiro M, Drozdz J, et al.; Heart Failure Association of the European Society of Cardiology (HFA). EURObservational Research Programme: regional differences and 1-year follow-up results of the Heart Failure Pilot Survey (ESC-HF Pilot). Eur J Heart Fail. 2013 Jul;15(7):808-17. doi: 10.1093/eurjhf/hft050.3.         
  3. Budnevsky AV, Malysh EY. [Clinico-Pathogenetic Relationship of Cardiovascular Diseases and Chronic Obstructive Pulmonary Disease]. Kardiologiia. 2017 Apr;57(4):89-93. [Article in Russian].
  4. Drobysheva ES, Tokmachev RE, Budnevsky AV, Kravchenko AYa. [Predictive value of biomarkers of heart cachexia in chronic heart failure]. Kardiovaskulyarnaya Terapiya i Profilaktika. 2016; 15(4):80-83. [Article in Russian].
  5. Flu WJ, van Gestel YR, van Kuijk JP, Hoeks SE, Kuiper R, Verhagen HJ, Bax JJ, Sin DD, Poldermans D. Co-existence of COPD and left ventricular dysfunction in vascular surgery patients. Respir Med. 2010 May;104(5):690-6. doi: 10.1016/j.rmed.2009.11.013. 
  6. Cazzola M, Bettoncelli G, Sessa E, Cricelli C, Biscione G. Prevalence of comorbidities in patients with chronic obstructive pulmonary disease. Respiration. 2010;80(2):112-9. doi: 10.1159/000281880. 
  7. Hawkins NM, Wang D, Petrie MC, Pfeffer MA, Swedberg K, Granger CB, Yusuf S, Solomon SD, Ostergren J, Michelson EL, Pocock SJ, Maggioni AP, McMurray JJ; CHARM Investigators and Committees. Baseline characteristics and outcomes of patients with heart failure receiving bronchodilators in the CHARM programme. Eur J Heart Fail. 2010 Jun;12(6):557-65. doi: 10.1093/eurjhf/hfq040.
  8. Sin DD, Man SF. Chronic obstructive pulmonary disease as a risk factor for cardiovascular morbidity and mortality. Proc Am Thorac Soc. 2005;2(1):8-11. doi: 10.1513/pats.200404-032MS. 
  9. McGarvey LP, John M, Anderson JA, Zvarich M, Wise RA; TORCH Clinical Endpoint Committee. Ascertainment of cause-specific mortality in COPD: operations of the TORCH Clinical Endpoint Committee. Thorax. 2007 May;62(5):411-5. doi: 10.1136/thx.2006.072348. 
  10. Budnevsky AV, Ovsyannikov ES, Labzhania NB. [Chronic obstructive pulmonary disease concurrent with metabolic syndrome: Pathophysiological and clinical features]. Ter Arkh. 2017;89(1):123-127. doi: 10.17116/terarkh2017891123-127. [Article in Russian].
  11. Tokmachev RE, Kravchenko AYa, Budnevsky AV, et al. Activation of pro-inflammatory cytokines in patients with chronic heart failure comorbid with metabolic syndrome. Kardiovaskulyarnaya Terapiya i Profilaktika. 2015;14(2):116-117. [Article in Russian].
  12. Budnevsky AV, Shurupova AD, Kravchenko AY, Tokmachev RE. Clinical efficacy of acute respiratory viral infections prevention in patients with chronic heart failure. Ter Arkh. 2019 Mar 30;91(3):36-41. doi: 10.26442/00403660.2019.03.000111.  [Article in Russian].
  13. Tokmachev RE, Maksimov AV, Budnevsky AV. Device for cardiorespiratory analysis and method for assessing cardiorespiratory state. Invention patent RU 2637917 C, 07.12.2017. Application No. 2016148274. [In Russian].
  14. Budnevsky AV, Pronin SS, Kontsevaya AV. Register of patients with chronic heart failure. Certificate of registration of the computer program RU 2019667733, 26.12.2019. Application No.2019666660. [In Russian].

Download Article
Received October 14, 2020.
Accepted November 18, 2020.
©2021 International Medical Research and Development Corporation.