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Therapy of chronic heart failure in patients with hypersensitivity pneumonitis and coronary heart disease

https://doi.org/10.20340/vmi-rvz.2025.3.CLIN.6

Abstract

Objective: to study the effect of enalapril and valsartan + sacubitril on the reduction of CHF symptoms, on the change in functional and radiological parameters in patients with hypersensitivity pneumonitis (HP) combined with coronary heart disease.
Materials and methods. 183 patients with hypersensitivity pneumonitis were examined: 88 patients with coronary artery disease and 95 patients without it. CHF was diagnosed in 39 (44.3%)% of CHD patients and in 13 (13.68%) "isolated" SHG. General clinical, instrumental and functional study methods were performed in each group. When assessing the effectiveness of CHF treatment, patients are divided into two groups: еnalapril was prescribed to 20 patients in the main group: 21 patients in the comparison group received valsartan + sacubitril.
Results. 24-week therapy allowed to reduce the manifestations of diastolic dysfunction: a decrease in the indexed end-systolic volume of the left atrium by 5.13% in the main and 11.2% in the group, comparisons;, end-diastolic volume of the left ventricle by 4.13 and 11.4%, respectively; reduction of signs of left ventricular hypertrophy- reduction of its posterior wall thickness by 3.2% and 7.5%. The improvement in ECHOCG parameters was accompanied by a decrease in interstitial changes in CT, an improvement in the patency of small and medium bronchi and indicators of lung diffusion, a decrease in the severity of clinical manifestations of CHF, which justifies the use of sartans in the complex therapy of CHF in patients with hypersensitivity pneumonitis combined with coronary artery disease.

About the Authors

A. V. Medvedev
Central Research Institute of Tuberculosis
Russian Federation

Aleksandr V. Medvedev - Cand. Sci. (Med.), Senior Researcher, Department of Differential Diagnostics of Pulmonary Tuberculosis and Extracorporeal Treatment Methods 
Author's contribution: collection of clinical material, analysis and interpretation of examination results, statistical processing of data, writing the manuscript, review of publications on the topic of the article.

2, Yauzskaya alley str., Moscow, 107564
Competing Interests:

The authors declare no competing interests.



G. E. Alichubanova
Central Research Institute of Tuberculosis
Russian Federation

Gyulzhagan E. Alichubanova - Postgraduate student, Department of Differential Diagnostics of Pulmonary Tuberculosis and Extracorporeal Treatment Methods 
Author's contribution: selection, examination and treatment of patients, statistical analysis of the obtained data.

2, Yauzskaya alley str., Moscow, 107564
Competing Interests:

The authors declare no competing interests.



N. G. Dem'yanenko
Central Research Institute of Tuberculosis
Russian Federation

Natal'ya G. Dem'yanenko - Cand. Sci. (Med.), research fellow, head of the second therapeutic department of the department of differential diagnostics of pulmonary tuberculosis and extracorporeal treatment methods 
Author's contribution: selection, examination and treatment of patients, approval of the manuscript for publication.

2, Yauzskaya alley str., Moscow, 107564
Competing Interests:

The authors declare no competing interests.



S. A. Kasimtseva
Central Research Institute of Tuberculosis
Russian Federation

Svetlana A. Kasimtseva - Cand. Sci. (Med.), research fellow of the department for training highly qualified personnel for postgraduate education and telemedicine 
Author's contribution: collection of clinical material, analysis and interpretation of examination results, statistical data processing.

2, Yauzskaya alley str., Moscow, 107564
Competing Interests:

The authors declare no competing interests.



M. N. Kovalevskaya
Central Research Institute of Tuberculosis
Russian Federation

Marina N. Kovalevskaya - Cand. Sci. (Med.), Chief Physician 
Author contributions: study design development, review of critical content, approval of the manuscript for publication.

2, Yauzskaya alley str., Moscow, 107564
Competing Interests:

The authors declare no competing interests.



R. V. Tarasov
Central Research Institute of Tuberculosis; Moscow Medical University "Reaviz"; Russian Medical Academy of Continuous Professional Education
Russian Federation

Ruslan V. Tarasov - Cand. Sci. (Med.), research fellow, thoracic surgeon of the first surgical department; associate professor of the department of surgical diseases; assistant of the department of thoracic surgery named after Academician L.K. Bogush 
Author's contribution: review of publications on the topic of the article, analysis and interpretation of survey results, writing of the manuscript text.

2, Yauzskaya alley str., Moscow, 107564;
2, Krasnobogatyrskaya str., building 2, Moscow, 107564;
2/1, Barrikadnaya str., building 1, Moscow, 125993
Competing Interests:

The authors declare no competing interests.



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For citations:

Medvedev A.V., Alichubanova G.E., Dem'yanenko N.G., Kasimtseva S.A., Kovalevskaya M.N., Tarasov R.V. Therapy of chronic heart failure in patients with hypersensitivity pneumonitis and coronary heart disease. Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH). 2025;15(3):118-128. (In Russ.) https://doi.org/10.20340/vmi-rvz.2025.3.CLIN.6

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