Keywords
Abstract
Aim: to determine the impact of long-term oxygen treatment on hemodynamics, diaphragmatic dysfunction and activity of systemic inflammation in COPD patients with hypoxemia. We studied 60 patients with COPD GOLD III and IV in remission at the age 66.2±5.7 years (group D, mixed phenotype). The patients were divided into three groups: 1 group - 20 patients with hypoxemia who received long-term oxygen treatment, group 2 - 20 patients with hypoxemia who did not received long-term oxygen treatment, group 3 - 20 patients without hypo-xemia. We assessed severity of systemic inflammation (fibrinogen, C-reactive protein), concentration of natriuretic peptide. Echocardiography and the sonographic measurements of the diaphragm were performed. The examination was carried out twice with an interval of 1 year. COPD patients with hypoxemia had an increased activity of systemic inflammation, increased concentration of natriuretic peptide, a violation of the functional state of the diaphragm. Changes of echocardiographic characteristics in patients with hypoxemia revealed hypertrophy and dilatation of the right heart, increased systolic blood pressure in the pulmonary artery, diastolic dysfunction of the left and right ventricles. On the background of the use of long-term oxygen treatment in COPD patients with hypoxemia showed a reduction in concentrations of Creactive protein and natriuretic peptide, systolic pressure in the pulmonary artery, improving diastolic function of the left and right ventricles, increased speeds of contraction and relaxation of the muscular part of the diaphragm during quiet breathing. Long-term oxygen treatment contributes to the stabilization of systolic pressure in the pulmonary artery and functional state of the right heart, reduced activity of systemic inflammation and improve function of the diaphragm.