PATHOGENETIC FEATURES OF STABLE ISCHEMIC HEART DISEASE WITH CHRONIC OBSTRUCTIVE LUNG DISEASES AND OBESITY

Nemish I. L., Stupnitskaya G. Y., Fediv O. I.

LITERATURE REVIEWS

Scentific article

The literature review describes the important pathogenetic mechanisms of stable ischemic heart disease (IHD), chronic obstructive pulmonary disease (COPD) and obesity. This problem is very actual nowadays because the number of patients with these comorbid pathologies is rising. One of the main factors in such patients is hypoxia. It plays an important role in disease impairment in comorbid patients. Hypoxia increases in patients with a high level of abdominal fat, airflow obstruction and insufficient myocardial oxygen supply due to coronary vessels atherosclerosis. As to the literature review, we suppose that some of the important pathogenetic mechanisms of IHD, COPD, and obesity are: endothelial dysfunction, chronic systemic inflammation, and oxidative stress. “Obesity paradox” is also one of the discussible questions in overweight COPD patients and patients with cardiovascular diseases. Also, many scientists focus their attention on the eosinophils participation in the pathogenesis in COPD, cardiovascular diseases and obesity. There are some researches about eosinophils and its mediators (interleukin-5 and eotaxin) participation in pulmonary emphysema formation in COPD patients, atherosclerotic plaque formation and participation in the energy metabolism in obesity patients. Also, there are some findings of antiinterleukin-5 treatment. Research is being conducted in order to receive the results of mepolizumab, reslizumab (humanized monoclonal antibodies to IL-5), and benralizumab (antibodies to the alpha subunit of the IL-5 receptor) treatment in COPD patients with eosinophilia in sputum and blood. These data are quite controversial and need further studies. Comorbid patients are difficult in treatment. That’s why it will be useful to find the drug with an impact on the clinical course without unsuspected side effects. We suppose that it may be an antianginal drug ranolazine. Today it is used in coronary artery disease treatment, especially in patients with stable angina pectoris. This drug increases tolerance to exercise intensity, reduces chest pain intensity and nitroglycerin intake. Also, there are some results in losing body weight after three months of treatment. The results of ranolazine influence on airflow obstruction are unknown. That’s why we suppose that ranolazine will be effective in IHD, COPD, and obesity patients. But this drug needs further investigations.

stable ischemic heart disease, chronic obstructive pulmonary disease, obesity, eosinophils, ranolazine.

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«Bulletin of problems biology and medicine» Issue 3 (152), 2019 year, 31-35 pages, index UDK 616.12-005.4-06:616.24-007.272]-036.1-071-092-08:613.24

10.29254/2077-4214-2019-3-152-31-35