Possibilities of using a modified questionnaire in patients with broncho-obstructive pathology admitted to a specialized cardiology hospital

The aim of this study is to evaluate the effectiveness of the modified DCSI questionnaire (Dyspnea, Cough, Smoking, chronic recurrent respiratory Infections) developed by us to identify broncho-obstructive diseases (BOD) (COPD and bronchial asthma) in patients with cardiovascular diseases (CvD) and to compare the indicators of spirometric research in different groups of cardiac patients formed on its basis.
Materials and methods. The sample consisted of patients over 18 years of age with arterial hypertension (AH), including chronic heart failure (CHF), coronary heart disease (CHD), heart rhythm disturbances (HRD), admitted to the National Medical Research Center of Cardiology over a two-year period. The sample consisted of 1000 cardiology patients, including 137 patients with comorbid COPD and bronchial asthma diagnosed before participation in the study, 71 patients with comorbid COPD and bronchial asthma diagnosed for the first time during the study, 792 cardiology patients without comorbid COPD and bronchial asthma. All cardiac patients filled out the modified DCSI questionnaire in the emergency room. All cardiac patients underwent pulmonary examination, which included computer spirometry (including bronchodilator test) in accordance with the recommendations of the European Respiratory Society. The main spirometric parameters were recorded: Gaensler index (modified Tiffeneau index, FEv1/FvC) (normal >70%), FEv1% (normal >80%) and FvC% (normal >80%). Patients with deviations detected in spirometry data were consulted by a pulmonologist.
Results. All cardiac patients with COPD and bronchial asthma (137 patients with previously diagnosed comorbid COPD and bronchial asthma and 71 patients with newly diagnosed comorbid COPD and bronchial asthma during the study) had ≥2 points on the DCSI questionnaire. Cardiac patients without comorbid COPD and bronchial asthma had <2 points in 41% of cases and ≥2 points in 59% of cases on the DCSI questionnaire, which is due to concomitant cardiovascular pathology. Among patients with a score of 4 on the DCSI questionnaire, the proportion of cardiac patients with newly diagnosed comorbid COPD and bronchial asthma was significantly higher (62%) than with previously diagnosed comorbid COPD and bronchial asthma (p<0.001). Using the DCSI questionnaire and spirometric testing, it was found that cardiac patients with newly diagnosed comorbid COPD and asthma had more pronounced respiratory symptoms and a higher degree of airway obstruction than patients with previously diagnosed comorbid COPD and asthma (p<0.05). In cardiac patients with <2 points of DCSI questionnaire, spirometric indices of FEv1%, FvC%, Gaensler index (p<0.05) are significantly higher than in cardiac patients with ≥2 points on DCSI questionnaire.
Conclusions. The DCSI questionnaire developed by us for screening risk factors and symptoms of broncho-obstructive pathology in patients admitted to a cardiology hospital effectively excludes comorbid COPD and bronchial asthma at <2 points (0-1) and identifies previously undiagnosed comorbid COPD and bronchial asthma at 4 points. At 2 or 3 points, the diagnosis of COPD and bronchial asthma is potentially probable, and routine computer spirometry is recommended for a cardiac patient. Cardiology patients with newly diagnosed comorbid COPD and bronchial asthma have lower spirometric parameters (FEv1%, FvC%, Gaensler index) than patients with previously diagnosed comorbid COPD and bronchial asthma.

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