Phenotype of bronchial asthma with obesity in combination with chronic coronary heart disease

Objective: to study the clinical characteristics of patients with the phenotype of obese brochial asthma in combination with chronic coronary heart disease. Material and methods: in an open-label  clinical trial, two groups of patients with chronic coronary heart disease (CHD) and bronchial asthma (BA) were formed. Patients of group I (n=43) had obesity as a concomitant disease. Group II (n=50) were non-obese patients. All patients underwent a general clinical examination. The results of Holter’s daily monitoring of the electrocardiogram (HMECG), duplex scanning of the brachiocephalic arteries (BCA DS), transthoracic echocardiography (EchoCG), coronaroangiography (CAG), and spirography  were evaluated. The results of biochemical blood testing were also evaluated. Results: for patients of group I, the main complaints were shortness of breath (84% vs 62%, p=0,036) and cough (65% vs 40%, p=0,027) compared with patients of the control group. According to the results of echo-CG in this group, signs of overload of the left heart were revealed. The LV EDV score was more significant than in the control group (p=0,034). The thickness of IVS is also more significant in patients of group I (p=0,022). Ultrasound of the common carotid and internal carotid arteries revealed atherosclerotic plaques in 53% of patients of group I vs 30% (p=0,037) of the control group. According to CAG, the prevalence of RCA stenosis was more significant in patients of group I (56% vs 24%, p=0,003). In patients of group I, spirometry showed a more pronounced decrease in OFV1 (64,1±6,7 vs 66,9±7,1, p=0,042). Conclusion: the adipose BA phenotype combined with CHD is characterized by more frequent cough complaints as the equivalent of choking  in bronchobstructive  syndrome. Also, patients are more likely to note shortness of breath as the equivalent of angina pain and, possibly, the manifestation of respiratory and heart failure. These clinical features of the phenotype are reflected in the results of instrumental examination methods: pronounced atherosclerotic vascular damage, signs of overload of the left heart, a more significant decrease in the FEV1 rate.

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