Changes in the indicators of stiffness and remodeling of magistral arteries in young patients at the early stage of essential hypertension under conditions of syntropy with obesity

OBJECTIVE

Aim: The study and analysis of indicators of remodeling and rigidity of magistral vessels in young essential hypertension patients with abdominal obesity and determination of the detected changes as a possible criterion for their remodeling..

PATIENTS AND METHODS

Materials and Methods: 98 young people with essential hypertension and obesity were included in the study. The structure of the carotid artery and its stiffness were assessed using the ultrasound method, and the level of abdominal fat was determined using dual-energy X-ray absorptiometry.

RESULTS

Results: Carotid Intima-Media Thickness in patients with essential hypertension reliably exceeded the corresponding indicator of the control group. We observed a significant increase in arterial stiffness indicators, which is explained by the increased stiffness of blood vessels in patients with obesity. During the correlation analysis, it was established that the relationship between the level of abdominal fat and the elasticity of the vascular wall was positive and strong, which indicated the dominant role of the abdominal type of obesity in the remodeling of the vascular wall in young patients with essential hypertension in combination with obesity.

CONCLUSION

Conclusions: In young patients at the early stage of the formation of essential hypertension, there are signs of a decrease in resilient-elastic properties and remodeling of magistral vessels, whose severity is significantly stronger in combination with abdominal obesity.

GENDER AND AGE ASPECTS IN THE PATHOGENESIS OF BONE MINERAL DENSITY DISORDERS

OBJECTIVE

The aim: To assess the structural and functional state of bone tissue in terms of gender and age.

PATIENTS AND METHODS

Materials and Methods: 108 people aged 54.7±14.8 years, who were divided into two groups according to gender, participated in the retrospective cohort study. All patients underwent ultrasound densitometry to assess bone mineral density (BMD) on the radial bone with an assessment of T-score, Z-score, and speed of ultrasonic wave propagation (SoS).

RESULTS

Results: The study found that T-score and Z-score values, which corresponded to osteoporosis, were recorded in the age group > 50 years, regardless of the gender of the subjects. All women older than 35 years had a decrease in BMD below -1.0 SD by T-score. It was determined that osteoporosis criteria clearly prevail in women of the > 50-year-old group. In osteoporosis, the SoS is significantly lower than in individuals with normal indicators of the T-criterion. According to the results of the T-score comparison, BMD disorders were determined in postmenopausal women which emphasize the importance of the level of female sex hormones in the formation of osteopenic syndrome, in contrast to men, in whom no changes in the state of bone tissue were recorded.

CONCLUSION

Conclusions: The results of the research prove the prevalence of osteopenic syndrome in terms of age and gender, with an emphasis on women aged 50 years and older. Screening for BMD disorders using ultrasound densitometry is appropriate and allows taking measures to prevent the progression of osteoporosis in the early stages.

Justification of Increasing the Blood Flow Velocity in the Arteries of the Thyroid Gland in Autoimmune Thyroiditis as a Reflection of Endothelial Changes Due to Inflammatory Status

OBJECTIVE

The aim of the research was to determine the dependence of the blood flow velocity in the thyroid arteries in patients with Autoimmune Thyroiditis (AIT) on the presence of atherosclerotic carotid disease and the level of systemic blood pressure.

METHODS

The research involved 20 patients with AIT in euthyroid state, 30 patients AIT in euthyroid state with stable Coronary Heart Disease (CHD), 30 patients with stable CHD and 30 healthy individuals. Participants of the research were examined using ultrasound of carotid arteries and inferior thyroid arteries. Parameters of blood flow velocity were compared with the level of systemic blood pressure.

RESULTS

In AIT peak systolic velocity and resistance index in the inferior thyroid arteries were significantly higher than in healthy individuals and patients with CHD (p<0.05). In patients with CHD velocity parameters in carotid arteries were high, unlike in the healthy individuals and patients with AIT (p<0.05). In patients with AIT without CHD the atherosclerotic changes of carotid arteries were not found. Increased systemic blood pressure was noticed in all patients with CHD without significant differences between groups.

CONCLUSION

The value of peak systolic velocity and resistance index of inferior thyroid arteries in autoimmune thyroiditis are noticed even with euthyroidism and do not depend on systemic blood pressure and atherosclerosis of carotid arteries. Increasing the thyroid arterial blood flow velocity parameters should be considered as sign of an active inflammatory period AIT, where advanced fibrosis is not present.

Condition of hemodynamics in the pulmonary circulation of patients with chronic obstructive pulmonary disease (copd) concurrent with metabolic syndrome with hypertrophy and atrophy of the myocardium

INTRODUCTION

In recent years, COPD is observed as not an isolated, but an associated pathology, in particular, concurrent with metabolic syndrome. The aim of the research is to identify the differences in changes of the rheopulmonography parameters (RPG) depending on the presence of hypertrophy or atrophy of the right ventricular myocardium in patients with COPD concurrent with metabolic syndrome.

MATERIAL AND METHODS

We studied changes in rheopulmonography (RPG) in 145 patients with chronic obstructive pulmonary disease (COPD) concurrent with metabolic syndrome.

RESULTS

We detected precapillary hypertension of the pulmonary circulation in patients with right ventricular myocardial hypertrophy: anacrotism serration; flattened peak of the systolic wave; decreased Vcp; high placement of incisura; horizontal course of catacrotism; decreased amplitude of the systolic wave (in this case, due to a greater increase in the resistance of the blood flow in the pulmonary vessels than the decreased impact volume of the right ventricle); prolonged Q-a (in this group of patients, it depends more on hypertension of the pulmonary circulation than on the reduction of contractile function of the myocardium). In atrophy of the right ventricular myocardium, the following changes in the RPG were revealed: decreased systolic wave at its dramatic rise; prolonged Q-a (in this case, due to the weakened heart contraction); Vmax reduction (it reflects the reduction of myocardial contractility); in hypertrophy of the myocardium, Vcp., unlike RPG, does not decrease, which is explained by the decrease in the pressure of the pulmonary circulation.

CONCLUSIONS

We believe that these changes in RPG allow differentiating hypertrophy and right ventricular myocardial atrophy along with established diagnostic criteria, and can be used as markers for the diagnosis and treatment of COPD concurrent with metabolic syndrome.

Evaluation of indicators of endothelial dysfunction and intracardiac hemodynamics of the left ventricle in patients with chronic pulmonary heart bronchopulmonary genesis of comorbidity with essential arterial hypertension

OBJECTIVE

Introduction: Chronic obstructive pulmonary disease (COPD) is the main cause of progression chronic pulmonary heart (CPH), it is a serious worldwide problem. The combination of COPD with essential arterial hypertension (EAH) ranges from 4 to 27.7% with increasing age. The aim: To evaluate endothelium function changes by the level of metabolites of nitric oxide, endothelin-1(ET-1), values of ultrasonic diagnosis of the humeral artery (HA), intracardial hemodynamics of the left ventricle in patients with CPH in combination with EAH.

PATIENTS AND METHODS

Materials and methods: The research is involved 175 patients. Indicators of endothelial function by the level of nitric oxide metabolites, ET - 1, ultrasound intracardiac hemodynamics of the left ventricle of the heart were studied.

RESULTS

Results: The patients with CPH in combination with EAH in compensation stage have reduced level of nitric oxide in comparison with patients with CPH without EAH and healthy. To a large extent, reducing of nitric oxide level in decompensation stage indicates about contribution of combined pathology and requires ED correction. On the contrary increased concentration of ET-1 in decompensation stage indicate about combined pathology and demands correction of endothelial cell function.

CONCLUSION

Conclusions: Thus, patients with CPH in combination with EAH are characterized by more pronounced changes in endothelial dysfunction toward an increase in the level of vasoconstrictor factors, a decreasing of vasodilators, which is confirmed by ultrasound diagnosis of HA and reflected in the peculiarities of the intracardiac hemodynamic state.

Effect of quercetin on parameters of central hemodynamics and myocardial ischemia in patients with stable coronary heart disease

THE AIM

The aim of our research was to study the effect of quercetin on parameters of central hemodynamics and myocardial ischemia in patients with stable coronary heart disease (CHD).

MATERIAL AND METHODS

The research involved 85 patients with CHD: stable angina pectoris, FC II, and 30 healthy individuals made up the control group. After 1.5 months of stabilizing therapy (ß-blockers, statins, aspirin) patients with CHD were randomized into 2 groups - the research group (30 people) and the comparison group (55 people). Quercetin at a dose of 120 mg per os daily was added to standard treatment of the patients of the research group (with CHD), patients of the comparison group continued receiving the same treatment. The day before randomization and 2 months after prescribing differentiation therapy to the patients, echocardiography (echo) and 24 hour Holter ECG monitoring were made.

RESULTS

Clinical evaluation of echocardiography revealed that diastolic dysfunction of the left ventricle (LV) had been found in 100% of patients studied: in 97.6% - in the form of violation of relaxation (type I), in 2.4% of patients - in the form of pseudonormalization (type II). The 24 hour Holter ECG monitoring revealed episodes of myocardial ischemia (10.7+2.7 episodes a day), premature atrial contractions (PACs) and premature ventricular contractions (PVCs) in patients with stable CHD. After a two-month term of therapy in patients of both research and comparison groups left ventricular systolic function in terms of ejection fraction (EF) of LV significantly improved (by 4.5% and 3.2% respectively). LV diastolic function improved in both groups in terms of the ratio of the phases of the transmitral flow E/A, also IVRT significance decreased (p<0.05). DT value dropped significantly influenced by quercetin, in the comparison group it didn`t change. According to the 24 hour Holter ECG monitoring, the total time and number of episodes of ST segment depression decreased with dominative results in quercetin group. PVC number was significantly reduced only by influence of therapy with quercetin (?=0.0022).

CONCLUSIONS

The data have shown cardioprotective properties of quercetin in conditions of CHD.