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.

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.

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.