The safety of spirography in patients with stable ischemic heart disease and chronic obstructive pulmonary disease based on the results of the daily monitoring of the electrocardiogram
Ischemic heart disease (IHD) and chronic obstructive pulmonary disease (COPD) are common among patients older than 40 years, and combination of these pathologies is associated with difficulties in diagnostics and the risk of complications. An important factor of the diagnostics of COPD is the study of the respiratory function, but the safety of this method for patients with IHD has not been studied sufficiently. The aim of the study was to determine features of heart rhythm disorders and ischemic signs during spirography in the patients with combination of stable IHD and COPD by the results of daily ECG- monitoring. 53 patients, mean age 65.4±0.9 years (group І), with stable IHD combined with COPD were studied. Comparison groups included: 53 patients with stable IHD without associated COPD, average age 58.1±1.2 years (group ІІ), and 42 patients with COPD but no IHD, average age 57.5±1.0 years (group ІІІ). All the patients underwent 24-hour ECG monitoring and assessed the presence of rhythm disturbances and signs of myocardial ischemia for 1 hour prior to performing spirography with a bronchodilator test and 1 hour after its conducting inclusively with the time of the forced expiration tests. It was found that among patients with combination of stable IHD and COPD during spirography increases the number of persons with supraventricular premature beats (SVPB) by 11.4% and ventricular premature beats (VPB) by 5.6%. High degree VPB appear after the forced expiration tests in 11 (20.7%) patients with combined pathology, paroxysmal rhythm disturbances - in 4 (7.6%). The number of SVPB in this group of patients increases by 12.6±6.8 per 1 hour after spirography, the number of VPB and paired VPB increases significantly by 27.8±12.6 and 1.85±1.0 per 1 hour, respectively. Therefore, for patients with combined pathology is necessary to introduce of selection criteria for safe performance of the respiration function.