Наукові праці. Кафедра внутрішньої медицини № 1
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Item Comparison of structural and functional vascular disorders in patiets with comorbidity of non-alcoholic fatty liver disease and two types of arterial hypertension(2023) Molodan, Volodymyr; Panchenko, Galyna; Prosolenko, Kostyantyn; Lapshyna, Kateryna; Shalimova, AnnaBackground: The aim was to conduct a comparative assessment of structural and functional vascular disorders in patiets with comorbidity of non-alcoholic fatty liver disease (NAFLD) and two types of arterial hypertension (HTN). Material and methods: The study included 329 patients 18–66 years old. All patients were divided into five groups: patients with comorbidity of NAFLD and primary HTN (121 subjects), patients with comorbidity of NAFLD and renal parenchymal HTN (88 subjects), patients with NAFLD (60 subjects), patients with primary HTN (30 subjects), patients with renal parenchymal HTN (30 people). The control group consisted of 20 healthy individuals of similar age and gender categories. Results: In the comparative analysis of the structural and functional ultrasonographic parameters of vessels, no significant differences between two comorbidity groups NAFLD + primary HTN and NAFLD + renal parenchymal HTN were found. The influence of AH and degree of liver steatosis on ultrasound indicators of arteries in examined patients with comorbidity was evaluated by MANOVA analysis. The influence of the HTN factor and the influence of the liver steatosis factor were evaluated separately, after which the influence of the comorbidity factor, i.e., the combined influence of these factors and one or another indicator, was evaluated. The additive effect of the factors of AH and liver steatosis was identified according to the parameters: intima media thickness, pulse wave velocity in the carotid artery, pulse wave velocity in the abdominal aorta and endothelial-related vasodilation, which indicates an important comorbid effect of NAFLD and primary/renal parenchymal HTN on the structural and functional state of arteries. Conclusions: There are no differences between the structural and functional indicators of arteries in patients with comorbidity of NAFLD + primary HTN and NAFLD + renal parenchymal HTN. The factor of the presence of HTN and the degree of liver steatosis significantly affect structural and functional indicators of the studied arteries.Item Features of the Severity of Cardiovascular Remodeling and Metabolic Disorders in Hypertensive Patients with Obesity in the Presence of Two Unfavorable Genotypes of the ADIPOQ and IRS-1 Genes(2020) Shalimova, Anna; Psarova, Valentyna; Kyrychenko, Nataliia; Kochuieva, MarynaThe results of a number of studies have shown that in ar- terial hypertension (AH), G/T and T/T genotypes of the adiponectin gene (ADIPOQ) and Gly/Arg and Arg/Arg genotypes of the insulin receptor substrate 1 gene (IRS-1) are associated with a greater severity of metabolic disorders and hemodynamic parameters compared with G/G and Gly/ Gly genotypes of these genes. The aim of the study: to evaluate the severity of cardiovas- cular remodeling and metabolic disorders in hypertensive obese patients in the simultaneous presence of two unfa- vorable genotypes of the ADIPOQ and IRS-1 genes.Item Effect of achieving blood pressure targets on the relative telomere length in hypertensive patients with and without type 2 diabetes mellitus(2019) Nemtsova, Valeriya; Bondar, Tetiana; Shalimova, AnnaBackground: The role of relative telomere length (RTL) as a marker of cardiovascular prognosis and quality control of the disease course remains to be found out. The aim of the study was to determine the relationship between the relative blood leukocyte telomere length (RLTL), relative buccal epithelium cell telomere length (RBTL) and achieving blood pressure targets (BPTs) in hypertensive (H) individuals with type 2 diabetes mellitus (T2DM) and without T2DM. Material and methods: In 156 patients with stage II hypertension (96 of them had T2DM), carbohydrate metabolism parameters and blood pressure levels were evaluated. RLTL and RBTL were determined by a real time quantitative PCR. Results: A combination of hypertension and T2DM was associated with significantly greater RLTL (р = 0.009) and RBTL (р = 0.001) compared with isolated hypertension. There was no convincing evidence of BPT influence on the change in the RLTL in isolated hypertension. Achieving BP targets was associated with a paradoxical shortening of RBTL. There was a significant shortening of RTL in hypertensive patients with T2DM when the BPTs were not reached. An analysis of variance revealed a significant influence of BPTs on the RBTL and RLTL. Conclusion: Patients with a comorbid course of hypertension and T2DM had more pronounced decrease in the RTL. Target levels of blood pressure have a more significant effect on the RLT than the glycemic control in patients with concomitant T2DM. An additional determination of the RBTL enhances the diagnostic and prognostic power when evaluating the effectiveness of correcting cardiovascular risk factors including blood pressure.Item Age-associated featurers of oxidative stress as marker of vascular aging in comorbid course of hypertension and type 2 diabetes mellitus(2018) Shalimova, Anna; Nemtsova, Valeriya; Bilovol, Olexandr; Ilchenko, IrynaA significant increase in the proportion of older people in the population of developed countries is accompanied by an increase in mortality from the main diseases of old age-diseases of the cardiovascular system, malignant neoplasms, neurodegenerative processes, reduced resistance to infection and diabetes mellitus.Item Heart rate variability, large vessel remodelling and metabolic parameters in stage 1 hypertension according to the ACC/AHA 2017 guidelines(2018) Shalimova, Anna; Graff, Beata; Szyndler, Anna; Wolf, Jacek; Blaszkowska, Magdalena; Orlowska-Kunikowska, Elzbieta; Wolnik, Bogumil; Narkiewicz, KrzysztofObjective: Controversial defi nition of arterial hypertension (AH) by the ACC/AHA 2017 Guidelines renewed interest in the earlier stages of blood pressure (BP) elevation. The aim: to investigate the features of the heart rate variability (HRV), large vessel remodelling (VR) and metabolic parameters in subjects with stage 1 AH according to the new American guidelines (130–139 / or 80–89 mmHg). Design and method: We investigated 148 untreated subjects with the following BP levels (mmHg): < 120 / and < 80 (group 1; n = 33), 120–129 / and < 80 (group 2; n = 27), 130–139 / or 80–89 (group 3; n = 60), > = 140 / or > = 90 mmHg (group 4; n = 28). HRV indices were assessed by 24-hour Holter monitoring data, large vessel remodelling parameters - on the basis of applanation tonometry (Sphygmocor) and carotid echo-tracking (Artlab) data. The results are presented as mean ± standard deviation. Results: In comparison to group 1, group 2 had lower levels the high-density lipoproteins levels (61.7 ± 15.6 and 51.7 ± 11.6 mg/dl, respectively, p = 0.009), increased diameter of carotid artery (6.8 ± 0.4 and 7.5 ± 0.5 mm, respectively, p = 0.034) and similar pattern of HRV parameters. Group 3, compared to groups 1 and 2, had signifi cantly higher glucose and uric acid levels (p = 0.045 and p = 0.017, respectively), and also increased carotid-femoral pulse wave velocity, compared to groups 1 (7.8 ± 1.2 and 7.2 ± 0.9 m/s, respectively, p = 0.025). These alterations were associated with an increase in the high-frequency component of HRV (HF, p = 0.013 and r-MSSD, p = 0.022) and greater distensibility of the carotid vascular wall (p = 0.004), which were not observed in the group 4. Conclusions: Subjects with blood pressure of 130–139 / or 80–89 mmHg are characterized by distinct metabolic abnormalities, initial signs of vascular remodelling and alterations of HRV, which might predispose to further progression of BP elevation and development of target organ damage.