Klinicheskaia Meditsina[JOURNAL]
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200 papers
[Modern approaches to the problem of hypertrophic cardiomyopathy].
Kaplunova VY, Shakar'yants GA, Kozhevnikova MV … +3 more , Khabarova NV, Privalova EV, Belenkov YN
Klin Med (Mosk) · 2016 · PMID 30299019
This review presents modern data about a hereditary disease of myocardium - hypertrophic cardiomyopathy. The main features of its epidemiology, pathophysiological changes in intracardiac hemodynamics, formation of main c...
This review presents modern data about a hereditary disease of myocardium - hypertrophic cardiomyopathy. The main features of its epidemiology, pathophysiological changes in intracardiac hemodynamics, formation of main clinical symptoms of the disease and variants of its clinical course are considered in terms of modern concepts. Much attention is given to characteristics of the variants of the disease and understanding of the formation of its clinical picture of each of them for the choice of the strategy for the management of these patients.
[Comorbidity in rheumatoid arthritis: A focus on cardiovascular diseases].
Gasparyan AA, Men'shikova IV, Kanevskaya MZ
Klin Med (Mosk) · 2016 · PMID 30299018
Cardiovascular diseases (CVD) in patients with rheumatoid arthritis (RA) are ranked first in the structure of comorbidity and mortality. This review includes recent data on common pathogenic mechanisms of inflammation an...
Cardiovascular diseases (CVD) in patients with rheumatoid arthritis (RA) are ranked first in the structure of comorbidity and mortality. This review includes recent data on common pathogenic mechanisms of inflammation and atherosclerosis, the impact of traditional and specific risk factors, biomarkers of CVD in RA patients. Variants of CVD in RA, the possible pathogenic mechanisms of their development and methods of diagnosis and prevention are described.
[Microvascular angina. Modern aspects of pathogenesis, diagnostics and treatment].
Yusupova AO, Shendrygina AA, Privalova EV … +1 more , Belenkov YN
Klin Med (Mosk) · 2016 · PMID 30299017
Microvascular angina was included in the European guidelines on the management of patients with stable coronary artery disease in 2013. Topical aspects of etiology, pathogenesis, clinical course, diagnosis, and treatment...
Microvascular angina was included in the European guidelines on the management of patients with stable coronary artery disease in 2013. Topical aspects of etiology, pathogenesis, clinical course, diagnosis, and treatment of microvascular angina are discussed in this review.
[Antiplatelet therapy in cardiology].
Popova LV, Aksenova MB, Khlevchuk TV
Klin Med (Mosk) · 2016 · PMID 30299016
Platelets are important components of hemostasis and play a key role in the formation of atherothrombosis. Rupture or erosion of atherosclerotic plaque gives rise to a thrombus with the involvement of platelets. Antiplat...
Platelets are important components of hemostasis and play a key role in the formation of atherothrombosis. Rupture or erosion of atherosclerotic plaque gives rise to a thrombus with the involvement of platelets. Antiplatelet agents are instrumental in preventing the development of atherothrombosis of different localization, including coronary arteries.
[RISK FACTORS OF DEATH IN DIABETES MELLITUS].
Asfandiyarova NS
Klin Med (Mosk) · 2016 · PMID 30296369
OBJECTIVE: To study risk factors of death in diabetes mellitus (DM). MATERIALS AND METHODS: This prospective cohort study included 337 patients with compromised carbohydrate metabolism (36 with impaired fasting glycemia...
OBJECTIVE: To study risk factors of death in diabetes mellitus (DM). MATERIALS AND METHODS: This prospective cohort study included 337 patients with compromised carbohydrate metabolism (36 with impaired fasting glycemia or impaired glucose tolerance, 80 with type 1 diabetes, 194 with type 2 diabetes, 27 with diabetes due to chronic pancreatitis). Mean follow-up was 11.2±4.8 years (from 1 January 1995 through 31 December 2014). We investigated causes and risk factors of death in patients with impaired carbohydrate metabolism. RESULTS: 115 patients died during the study period. The most common causes of death of patients with type 1 and 2 diabetes are cardiovascular diseases and cancer. Risk factors of death in type 1 DM include cardiovascular disease, diabetic nephropathy and retinopathy. Patients die at a younger age due to early onset of the disease. In type 2 diabetes risk factors of death are cardiovascular and oncologic diseases, nephropathy, the use of insulin. Patients die in elderly and senile age due to the late onset of diabetes. Gender differences in mortality associated with type 1 and 2 diabetes mellitus were not observed. CONCLUSION: Main causes of death in patients with type 1 and 2 DM are cardiovascular diseases and cancer. Risk factors of death include macro - and microvascular complications.
[VENOUS ECTASIA OF GASTRIC ANTRUM].
Olevskaya ER, Tarasov AN
Klin Med (Mosk) · 2016 · PMID 30296368
Gastric antral vascular ectasia (GAVE) is an uncommon but often severe cause of upper gastrointestinal bleeding. GAVE may be asymptomatic or accompanied by clinical anemia or overt gastrointestinal bleeding. The diagnosi...
Gastric antral vascular ectasia (GAVE) is an uncommon but often severe cause of upper gastrointestinal bleeding. GAVE may be asymptomatic or accompanied by clinical anemia or overt gastrointestinal bleeding. The diagnosis is mainly based on pathognomonic endoscopic pattern, defined as «watermelon stomach», located in antrum. Autoimmune disorders aye co-existing in about 60% of patients with GAVE, chirrosis in about 30%, and cardiac or renal failure in 10%.The "golden standarden" treatment of GAVE is endoscopic argon plasma coagulation (APC). There is poor information about diagnostics and treatment of GAVE in the domestic literature. The analysis of the presented materials shows that correct diagnostics takes much time and the choice of the optimum optimal treatment strategy encounters difficulty. Our experience with diagnostics and therapy of GAVE is based on the treatment of 4 patients. The diagnosis of GAVE was established within the period from 5 months to 1.5 years after onset of the disease. In two cases, GAVE was asymptomatic. Two patients with severe anemia completed endoscopic treatment; in one case, APC was supplemented by laser coagulation and bipolar coagulation. The implementation of laser coagulation caused some technical difficulties. Treatment of both patients was successful. Endoscopy pivotal for diagnosis of GAVE is the main method of its treatment. Due to the large number of diagnostic errors and the importance of correct diagnosis of GAVE, it is necessary to pay attention to this issue in training programs for endoscopists.
[ADHERENCE TO THE TREATMENT IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AND WAYS TO ITS OPTIMIZATION].
Yarkova NA, Borovkov NN
Klin Med (Mosk) · 2016 · PMID 30296367
A total of 148 patients (50 men and 98 women) with type 2 diabetes who were hospitalized in the endocrinology department «Nizhny Novgorod Regional Hospital N.A. Semashko». It was shown based on the Morisky-Green scale th...
A total of 148 patients (50 men and 98 women) with type 2 diabetes who were hospitalized in the endocrinology department «Nizhny Novgorod Regional Hospital N.A. Semashko». It was shown based on the Morisky-Green scale that 91 patients (61.4%) did not comply with the doctor's recommendation. 57 (38.6%) patients adhered to the treatment. The patients showing poor compliance with the treatment were divided randomly into two groups. One was comprised of patients with type 2 diabetes (n = 45) who had been trained in the school of diabetic patients, provided with a special literature and kept a diary of self-monitoring blood glucose. The second group consisted of patients with type 2 diabetes (n = 46) also trained at the school of diabetes and provided with the relevant literature but were under active control (telephone calls, visits to the center). The year-long prospective study demonstrated that adherence to treatment increased in the entire cohort. However, statistically significant positive dynamics of clinical and biochemical parameters was achieved only in the group of patients actively monitored by medical personnel.
[C-REACTIVE PROTEIN AS AN INDICATOR OF RISK OF CARDIOVASCULAR COMPLICATIONS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AND ITS CORRECTION].
Stryuk RI, Sviridova MI, Mkrtumyan AM … +1 more , Golikova AA
Klin Med (Mosk) · 2016 · PMID 30296044
The study included 74patients (22 men and 52 women) aged 48-75yr with type 2 diabetes mellitus (DM2). 62 (88,6%) of them had grade II hypertensive disease (grade II-III by the WHO/ISH-2010 classification), 46 (67%) prese...
The study included 74patients (22 men and 52 women) aged 48-75yr with type 2 diabetes mellitus (DM2). 62 (88,6%) of them had grade II hypertensive disease (grade II-III by the WHO/ISH-2010 classification), 46 (67%) presented with II- III class functional stable angina of effort, 7 patients survived myocardial infarction, two ones underwent coronary artery stenting. Patients of the main group (n=50) received oral hypoglycemic agents in combination with 1-exenatide (mimetic of glucagon-like peptide) in the form of two daily subcutaneous injections of 5 mcg for 1 month and 10 mcg during the next 5 months. Control patients (n=20) were given standard hypoglycemic therapy. Analysis of highly sensitive CRP demonstrated its increase to 3 mg/l and more in 72.8% of the patients that was responsible for the high risk of cardiovascular disorders. 22,8% of the patients had a CRP level 1,0-2,9 mg/l (moderate risk) and only in 4,2% it was lower than 1 mg/l (low risk). Six months of exenatide therapy resulted in normalization of glycemia, glycated hemoglobin and significant decrease of CRP level which suggested the improvement of the functional state of vascular endothelium due to reduction of chronic inflammation objectively reflected in the highly sensitive CRP level.
[CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ANEMIA: CLINICAL MANIFESTATIONS AND THERAPEUTIC STRATEGY].
Budnevsky AV, Provotorov VM, Ul'yanova MI
Klin Med (Mosk) · 2016 · PMID 30296043
UNLABELLED: Anemia refers to manifestations of systemic inflammation in chronic obstructive pulmonary disease (COPD) and a factor aggravating the disease. OBJECTIVE: To study gender characteristics of anemia in patients...
UNLABELLED: Anemia refers to manifestations of systemic inflammation in chronic obstructive pulmonary disease (COPD) and a factor aggravating the disease. OBJECTIVE: To study gender characteristics of anemia in patients with COPD, to increase the effectiveness of treatment through the use of pharmacological agents erythropoietin and enteral iron. MATERIALS AND METHODS: The paper presents clinical data on 74 patients with stage II/III COPD and anemia along with results of the treatment of 49 patients who received standard therapy in addition to epoetin and Sorbiferdurules. RESULTS: Patients with COPD much more frequently presented with iron deficiency anemia (IDA): 63 patients (85.1%) dominated by women (39 or 61.9% ) with men accounting only for 24 or 38.1% of the total. 11 patients (14.9%) had normochromic normocytic anemia with the parameters of anemia of chronic disease. The incidence of IDA in both groups correlated with age; it was largely a moderately severe condition that much more frequently occurred in women (24 out of 39 patients - 61,5%) than in men in whom the mild form of iron deficiency prevailed (14 of 24 patients - 58,3%). CONCLUSION: The overall prevalence of anemia concomitant with COPD was estimated at 26.5%. It was documented in44 women (33.7%), i.e. in each third patient. It occurred less frequently in men (30 or 20,7%). The presence of anemia deteriorates conditions of the patients, especially female ones, who more often suffer from shortness of breath, impaired general health status , fatigue, and depression; moreover, they more frequently need hospitalization. Correction of anemia with erythropoietin and iron preparations for the internal use can improve physical endurance of the patients, reduce cough intensity and shortness of breath, promote positive dynamics of physical tolerance for a prolonged period after the completion of antianemic therapy.
[CHARACTERISTIC OF APOPTOSIS OF CORONARY ARTERY CELLS WITH ATHEROSCLEROTIC LESIONS].
Vladimirskaya TE, Shved IA
Klin Med (Mosk) · 2016 · PMID 30296042
AIM: To study apoptosis of endothelial cells (EC), macrophages (MF) and smooth muscle cells (SMC) in the early atherosclerotic process (prior to plaque formation), elucidate mechanisms of its realization and evaluate eff...
AIM: To study apoptosis of endothelial cells (EC), macrophages (MF) and smooth muscle cells (SMC) in the early atherosclerotic process (prior to plaque formation), elucidate mechanisms of its realization and evaluate effect on progression of atherosclerosis. MATERIALS AND METHODS: Histopathological studies were performed on coronary arteries affected by atherosclerosis taken at autopsy of patients with coronary heart disease (n = 63). To detect apoptosis, the TUNEL method was used for calculating the apoptotic index (AI) in paraffin sections. Phenotyping the cells and test for expression of active caspase 3 (AC-3) and apoptosis-inducing factor (AIF) were performed using sections of coronary arteries stained by immunohistochemistry. RESULTS: The study of apoptosis showed a significant (p <0.0001) increase in AI of SMC, EC, MF coronary arteries affected by atherosclerosis compared with unaffected vessels. Progression of the atherosclerotic process led to a decrease of AI of SMC and EC. Statistical analysis revealed moderate feedback between AI of SMC and neointimal thickness in the development of atherosclerotic lesions (r = -0,44, p <0.0001). The amount of the AC-positive SMC and EC at the stage of lipoidosis significantly (p <0.0001) exceeded the number of AC -positive SMC at the liposclerosis stage. Expression of AIF was observed in the nuclei of EC in the newly formed vessels of hyperplastic intima. CONCLUSIONS: Early atherosclerotic lesions of the coronary arteries are accompanied by intense apoptosis of SMC, EC and MF. The intensity of apoptosis of SMC and EC decreases with the development of atherosclerosis. Progression of intimal hyperplasia at the early stages of atherosclerosis is associated with reduced apoptosis of smooth muscle cells and enhanced macrophage apoptosis. Apoptosis of SMC and MF is caspase-dependent. Apoptosis of endothelial cells can occur both with the participation of caspases and independently of them (with AIF).
[REGRESSION OF ATHEROSCLECROTIC LESIONS: MEDICAMENTAL AND ALIMENTARY FACTORS].
Magaeva SV, Kubatiev AA, Shirokov EA … +1 more , Simonenko VB
Klin Med (Mosk) · 2016 · PMID 30296041
The article reports results of clinical studies aimed to elucidate the influence of medicines on the size and density of atherosclerotic plaques in the walls of coronary and cerebral arteries. The phenomenon of regressio...
The article reports results of clinical studies aimed to elucidate the influence of medicines on the size and density of atherosclerotic plaques in the walls of coronary and cerebral arteries. The phenomenon of regression of atherosclerotic lesions in the survivors of Leningrad siege during a long period of starvation is analyzed. The influence of inhibitors of angiotensin-converting enzyme on apoptosis of smooth muscle and foam cells of atherosclerotic plaques in the sanological mechanisms of atherosclerosis is discussed. The concept of natural regression of atherosclerosis is formulated and the necessity of development of the methods for is pharmacological activation are formulated.
[[ANTIBACTERIAL THERAPY AT DIFFERENT STAGES OF TREATMENT OF INFECTIOUS ENDOCARDITIS. DO WE ACT CORRECTLY]?].
Ponomareva EY
Klin Med (Mosk) · 2016 · PMID 30296040
OBJECTIVE: To study characteristics of antibacterial therapy (ABT) at different stages of treatment of patients with infective endocarditis (IE) in clinical practice. MATERIALS AND METHODS: In retrospective (2001 to 2008...
OBJECTIVE: To study characteristics of antibacterial therapy (ABT) at different stages of treatment of patients with infective endocarditis (IE) in clinical practice. MATERIALS AND METHODS: In retrospective (2001 to 2008) and prospective (2008 to 2014) studies lasting 14-years, 302 hospitalized patients with confirmed native valve IE were given antibiotic therapy at outpatient and inpatient stages of treatment. The choice of antibacterial drugs, duration and side effects of prolonged use of antibiotics (AB) were analyzed in comparison with the results of hospital treatment of patients with IE. RESULTS: It was shown that outpatients with IE due to fever without a specific diagnosis, were frequently prescribed short courses of antibiotics with the prevalence of ceftriaxone monotherapy and its combination with aminoglycosides as the starting treatment under hospital conditions. The cases of incompliance with the recommended duration of antimicrobial therapy were documented. The most common side effects of AB included diarrheal disorders, but the most serious problem was nephrotoxicity resulting in total or partial withdrawal of ABT. CONCLUSIONS: The potential of antibiotic treatment of IE is employed but incompletely, the main obstacles to the implementation of adequate antibiotic therapy of IE being the low rate of early diagnosis of the disease including etiological one and the unacceptable level of long-term safety of ABT for the patients.
[THE RELATIONSHIP BETWEEN SERUM AND LIQUOR IL-1β, IL-6, TNFα, IL-10 LEVELS AND CLINICAL, COGNITIVE AND FUNCTIONAL CHARACTERISTICS IN ACUTE ISCHEMIC STROKE].
Kulesh AA, Kuklina EM, Shestakov VV
Klin Med (Mosk) · 2016 · PMID 30296039
INTRODUCTION: Inflammation is probably the main process that links cardiovascular risk factors with damage to blood vessels and neurons. Elucidation of mechanisms of this relationship is an important issue. MATERIALS AND...
INTRODUCTION: Inflammation is probably the main process that links cardiovascular risk factors with damage to blood vessels and neurons. Elucidation of mechanisms of this relationship is an important issue. MATERIALS AND METHODS: 70 acute stroke patients were studied to assess their neuropsychological (MMSE, MoCA, FAB, Clock Drawing Test, Shulte Tables and Verbal Fluency) and functional status (mRS, Rivermead Mobility Index). The serum and liquor IL-1β, IL-6, TNFa and IL-10 levels were analyzed. Control group included subjects without cerebrovascular diseases. RESULTS: Stroke patients had higher IL-10 serum concentration than controls. No difference was found for other cytokines. There was correlation between serum and liquor cytokines levels. We found positive correlation between IL-1β, IL-6 and IL-10 levels. High IL-1β concentration was associated with vascular risk factors, cardio embolic stroke, enhanced severity of cerebral stroke, low processing speed, impaired executive and visual-spatial functions and higher grade of mRS on discharge. The same pattern was revealed for IL-6 and IL-10. IL-6 level was related to mRS without relation to NIHSS on admission. High TNFa concentration was linked with vascular risk factors, low MMSE score and processing speed. DISCUSSION: Despite the antagonistic effects of IL-1β, IL-6 and IL-10 on inflammation, associations of these cytokines with anamnestic, clinical, neuropsychological and functional characteristics were similar in acute ischemic stroke. Probably, this fact indicates that during the acute ischemic brain damage process the immune response develops at the same time in pro- and anti-inflammatory directions. Its magnitude correlates with the damage severity and is associated with the effects of vascular risk factors before stroke.
[CARDIOPROTRECTIVE EFFECT OF REMOTE POSTCONDITIONING: MECHANISMS AND POSSIBILITIES OF CLINICAL APPLICATION].
Maslov LN, Tsibul'nikobv SY, Tsepokina AV … +5 more , Khutornaya MV, Kutikhin AG, Gurin AV, Basalai MV, Mrochek AG
Klin Med (Mosk) · 2016 · PMID 30296037
Experimental data indicate that postconditioning at a distance is an effective method for cardiac protection against reperfusion injury. Remote postconditioning prevents reperfusion necrosis and apoptosis of cardiomyocyt...
Experimental data indicate that postconditioning at a distance is an effective method for cardiac protection against reperfusion injury. Remote postconditioning prevents reperfusion necrosis and apoptosis of cardiomyocytes, decreases a probability of postinfarction remodeling of the heart. Cardioprotective effect of remote postconditioning depends on the release of tissue factor(s) increasing cardiac tolerance to long-term ischemia-reperfusion after transient ischemia. Clinical investigations show that postconditioning at a distance is an effective method for the prevention of reperfusion injury of the heart during coronary artery bypass surgery.
[UNRESOLVED PROBLEMS OF THE EVALUATION OF MYOCARDIAL BLOOD SUPPLY].
Milyukov VE, Zharikova TS
Klin Med (Mosk) · 2016 · PMID 30296035
Over the past few decades, a steady rise in the incidence, morbidity and mortality from cardiovascular diseases has been observed throughout the world. The most common pathology is coronary heart disease (CHD) which, in...
Over the past few decades, a steady rise in the incidence, morbidity and mortality from cardiovascular diseases has been observed throughout the world. The most common pathology is coronary heart disease (CHD) which, in addition, is responsible for chronic heart failure in more than one third of the cases. Patients with coronary heart disease are in need of early diagnosis and timely treatment. This article provides an overview of current scientific literature concerning anatomy of coronary vessels, their age-related changes, and modern radiological diagnostic methods of the lesions associated with coronary artery disease.
[Physician’s anticredo from the standpoint of errologia medica: between theory and practice].
Dimov AS
Klin Med (Mosk) · 2016 · PMID 30290105
The author presents the clinical and methodological analysis of the problem of medical errors based on the empirical data obtained in the 20 century. Relevant theoretical premises having applied implications are substant...
The author presents the clinical and methodological analysis of the problem of medical errors based on the empirical data obtained in the 20 century. Relevant theoretical premises having applied implications are substantiated.
[A case of mucoviscidosis in practical work of a pulmonologist].
Demko IV, Gordeeva NV, Mamaeva MG … +3 more , Kraposhina AY, Zeleny SV, Guseva IS
Klin Med (Mosk) · 2016 · PMID 30290104
A case of late manifestation ofmucoviscidosis is reported. In the past, this pathology was dealt with by pediatricians, but to-day the management of this problem involves a number of different specialists. The progress i...
A case of late manifestation ofmucoviscidosis is reported. In the past, this pathology was dealt with by pediatricians, but to-day the management of this problem involves a number of different specialists. The progress in clinical practice makes it possible to significantly prolong the life span of patients with this condition. The present case shows that its clinical manifestations may appear at any age.
[The problem of classification and organization of medical care for diabetic patients with different forms of ulcerative-necrotic lesions of lower extremities].
Udovichenko OV
Klin Med (Mosk) · 2016 · PMID 30290103
Patients with diabetes mellitus (DM) are at risk of development of both diabetic foot syndrome and ulcers on the lower legs due to chronic venous insufficiency and other factors. The main group in this study was comprise...
Patients with diabetes mellitus (DM) are at risk of development of both diabetic foot syndrome and ulcers on the lower legs due to chronic venous insufficiency and other factors. The main group in this study was comprised of diabetic patients with ulcers of different etiology (venous, post-traumatic, mixed) treated at the Diabetic Foot Cabinet during 5 years (n=101). The group of comparison included simultaneously treated patients with diabetic foot syndrome (n=721). Patients of the main group was dominated by women (71%) and patients with type 2 DM. Ulcer healing due to the treatment, persistent non-healing ulcers, and high-level amputations occurred equally often in the two groups: 60 and 58%, 18 and 15%, 4 and 5% respectively (р>0,05). Lower leg ulcers in DM are very persistent and constitute a serious medico-social problem to be addresses based at Diabetic Foot cabinets. The frequency of such ulcers and related amputations must be taken into consideration in epidemiological surveys.
[Peculiarities of progression of chronic glomerulonephritis associated with anemia].
Murkamilov IT, Aitbaev KA, Kaliev R
Klin Med (Mosk) · 2016 · PMID 30290102
AIM: To study the influence of renal anemia on the clinical course of chronic kidney disease in patients with chronic glomerulonephritis (CGN) at the early stage of the disease. MATERIALS AND METHODS: This prospective 12...
AIM: To study the influence of renal anemia on the clinical course of chronic kidney disease in patients with chronic glomerulonephritis (CGN) at the early stage of the disease. MATERIALS AND METHODS: This prospective 12 month study included evaluation of clinical and laboratory characteristics of 149 patients aged 17-66 (mean 37,6±12,6) years at the pre-dialysis stage of CGN (92 men (37,04±13,4 yr) and 57 women (38,2±11,2 yr). RESULTS: By the end of prospective observation, patients of group 1 (CGN without anemia) showed a decrease of the hemoglobin level accompanied by the impairment of nitrogen releasing function with the glomerular filtration rate of 70,1 (43,1-111) ml/min compared with 87 (61,3-115,3) at the onset of observations (p<0,05). In group 2 (CGN with anemia), dynamics of the nitrogen-releasing function was similar but even more pronounced with the glomerular filtration rate reduced to 47,4 (32,2-91,8) ml/min compared with 80,7 (39,8-107,9) at the onset of observations (p<0,05) and the serum creatinine level increased to157 (92-242) mcmol/l compared with 123 (86-171) (p<0,05). CONCLUSION: Reduction of hemoglobin level in patients with CGN is apparent at the early stages of the disease in association with impairment of glomerular filtration. The data obtained indicate that anemia can be a laboratory predictor of deteriorated nitrogen-releasing function.
[Clinico-functional phenotypes of chronic obstructive pulmonary disease, their influence on the severity of the disease, and prognostic value for risk evaluation].
Karnaushkina MA, Fedosenko SV, Sazonov AE … +4 more , Petrov VA, Arutyunova AB, Shukhnin SE, Ogorodova LM
Klin Med (Mosk) · 2016 · PMID 30290100
Attempts at optimizing classification of chronic obstructive pulmonary disease (COPD) reflect clinical heterogeneity of this pathology and provide a basis for the search of new phenotypic markers (especially at the early...
Attempts at optimizing classification of chronic obstructive pulmonary disease (COPD) reflect clinical heterogeneity of this pathology and provide a basis for the search of new phenotypic markers (especially at the early stages of the disease) that could be useful for prognostication of its severity in individual patients. One of the potential makers is phenotyping of COPD with distinguishing bronchitic, emphysemic, and mixed phenotypes. This paper presents results of analysis of functional characteristics of the patients with these phenotypes. They are shown to reflect clinical and functional features of the disease that may be of value for diagnostic purposes, the choice of the treatment strategy and prognosis of the outcome in individual patients.
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