[Cardiac remodeling in the light of immune status changes in patients with chronic obstructive pulmonary disease].

The degree of structural and functional heart changes was evaluated by means of Doppler echocardiography in 120 patients with chronic obstructive pulmonary disease (COPD) of different degrees of severity. Conventional immunological laboratory techniques were used in all the patients to evaluate the condition of cell-mediated, humoral, and cytokine-mediated immunity; inflammatory process activity and the degree of endotoxicosis were evaluated by measuring blood levels of acute phase proteins and medium mass molecules. The study showed that the character of heart remodeling depended on COPD severity. Only severe COPD was associated with a significant right atrial enlargement, as well as structural and functional changes in the left heart. The results demonstrated a distinct correlation between the variables of structural and functional condition of the heart and immunity parameters in COPD patients. The variables of right and left ventricular function moderately correlated with inflammatory and endotoxicosis indices. Decompensation of patients with severe COPD and cor pulmonale is accompanied by a pronounced immunodeficiency. An increase in blood levels of cytokines, tumor necrosis factor alpha in particular, may serve as a marker of early stages of chronic heart failure, while an increase in blood levels of interleukin-6 may be a marker of its severity.