Povezanost kronične opstruktivne bolesti pluća i kardiovaskularne bolesti

master's thesis

• Title (english): Association between chronic obstructive pulmonary disease and cardiovascular disease
• Author: Justina Mihaljević
• Mentor: Marija Gomerčić Palčić (mentor)
• Committee member: Sanja Popović-Grle (predsjednik povjerenstva)
• Committee member: Marko Jakopović (član povjerenstva)
• Committee member: Marija Gomerčić Palčić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Kronična opstruktivna plućna bolest (KOPB) je progresivna i kronična plućna bolest
karakterizirana opstruktivnim smetnjama prolaska zraka, smanjenjem respiracijske
površine i sistemskom upalom s izraženom plućnom komponentom. U populaciji
oboljelih od KOPB-a često su prisutne i kardiovaskularne bolesti (KVB). KVB su
najznačajniji komorbiditet u osoba oboljelih od KOPB-a, zbog svoje učestalosti, ali i
zbog povezanosti s lošijim ishodom. Bolesnici s KOPB-om i KVB imaju veći rizik za
hospitalizaciju, dugotrajnije bolničko liječenje te u konačnici i veći mortalitet. Najčešće
KVB koje se javljaju uz KOPB su arterijska hipertenzija, ishemijska bolest srca, srčano
zatajenje, plućna hipertenzija (PAH), periferna arterijska bolest i aritmije među kojima je
najčešća fibrilacija atrija. Njihova istovremena prisutnost dijelom se objašnjava zajedničkim rizičnim faktorima, prvenstveno pušenjem, no postoje mnogi patofiziološki
mehanizmi koji u oboljelih od KOPB-a utječu na razvoj KVB. Povezanost se još uvijek
istražuje, a glavni cilj je osmisliti ciljanu terapiju kako bi se spriječio razvoj oba stanja.
Osim što predstavljaju velik utjecaj na zdravstveno stanje oboljelih, ujedno je i veliko
financijsko opterećenje za zdravstveni sustav. Shodno navedenom, ovaj rad stavlja
naglasak na važnost aktivnog traženja i pravovremenog liječenja KVB u osoba oboljelih
od KOPB-a. Alati u svrhu ranog otkrivanja KVB u bolesnika s KOPB-om još uvijek nisu
zadovoljavajući, a uzrok tome je posljedica nepostojanja jasnih protokola za
dijagnosticiranje KVB u oboljelih od KOPB-a, ali isto tako i nepostojanju terapijskih
smjernica za njihovo liječenje. Edukacija je izrazito važna, a dokaz tomu je činjenica da
liječnici propisuju znatno manje lijekova za KVB u oboljelih od KOPB-a nego što je to
slučaj u bolesnika koji boluju isključivo od KVB. Glavni uzrok je strah od pogoršanja
osnovne bolesti u vidu poticanja bronhospazma. Neliječenje KVB u oboljelih od KOPBa
direktno utječe na njihovu kvalitetu života i stopu mortaliteta.

Abstract (english)

Chronic obstructive pulmonary disease (COPD) is a progressive and chronic lung
disease characterized by obstructive airway disorders, decreased respiratory area, and
systemic inflammation with a pronounced pulmonary component. Cardiovascular
disease (CVD) is often present in the COPD population. CVDs are the most significant
comorbidity in people with COPD, due to their frequency but also due to the association
with a poorer outcome. People who suffer from COPD with COPD have a higher risk of
hospitalization, longer hospital stays and, ultimately, higher mortality. The most common
CVDs that occur with COPD are hypertension, ischemic heart disease, heart failure,
pulmonary hypertension, peripheral arterial disease, and arrhythmias, among which
atrial fibrillation is the most common. Their simultaneous occurrence is partly explained
by common risk factors, primarily smoking, but there are many pathophysiological
mechanisms that affect the development of CVD in patients with COPD. The
association is still being investigated, and the main goal is to devise targeted therapy to
prevent the development of both diseases. In addition to being a major health problem
for sufferers, it is also a major financial burden on the health care system. That is why
this paper emphasizes the importance of active search and timely treatment of CVD in
people with COPD. Levels of early detection and appropriate treatment of CVD as a
comorbidity of COPD are still not satisfactory. The reason for this can be found in the
lack of clear protocols for access to CVD in COPD patients, but also in the absence of
therapeutic guidelines for the treatment of CVD in patients with COPD. Education is
extremely important, it has been proven that doctors prescribe significantly fewer drugs
for CVD in COPD patients than is the case in patients suffering exclusively from CVD.
The main cause is the fear of worsening the underlying disease, primarily the onset of
bronchospasm. This insufficient treatment of CVD in COPD patients directly affects the
deterioration of quality of life and increased mortality.

• Keywords: opstruktivna bolest pluća; kardiovaskularne bolesti
• Keywords (english): obstructive lung disease; cardiovascular diseases
• Language: croatian
• URN:NBN: urn:nbn:hr:105:128216
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-01-20 09:51:50