Effectiveness and safety of bronchodilator use in chronic cardiac insufficiency of ischemic genesis comorbid with chronic obstructive pulmonary disease

The article presents a brief literature review on the problem of cardiopulmonary comorbidity, namely, chronic heart failure (CHF) against ischemic heart disease (CHD) in combination with chronic obstructive pulmonary disease (COPD). The issues of epidemiology, the relationship of pathogenetic mechanisms in the development and progression of heart failure and COPD are considered. The questions of optimization of CHF and COPD treatment in the light of modern recommendations, controversial issues of safety and effectiveness of correction of bronchial obstructive syndrome are discussed. The results of our own study are presented in which 110 patients with chronic heart failure II–III FC with postinfarction cardiosclerosis (LVEF≤45%) and COPD 2–3 st. severity. It was shown that the inclusion of tiotropium and indacaterol both in mono and in combination in the complex therapy of CHF II–III FC ischemic genesis with COPD after 6 months of observation is safe and effective: the clinical state of patients improved, the quality of life improved significantly CHF, the degree of dyspnea, the frequency and duration of episodes of ischemia decreased. Improvement of parameters of intracardiac hemodynamics, a decrease in pulmonary hypertension, a positive effect on the bronchopulmonary system were noted