Наукові роботи молодих вчених. Кафедра пропедевтики внутрішньої медицини № 1, основ біоетики та біобезпеки
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Item Mediators of cardiovascular continuum in patients with essential hypertension and left ventricular remodeling(2015-06-12) Demydenko, Ganna; Kovalyova, Olga; Ashcheulova, Tetyanainvestigation of apeline, vascular endothelial gowth factor, nitric oxide in patients with essential hypertension.Item Types of left ventricular remodeling and features lipid and cytokine profile in patients with essential hypertension(2015-06-12) Demydenko, Ganna; Kovalyova, Olga; Ashcheulova, TetyanaThe aim of the study was to investigate the influence cardiovascular risk factors.Item Modified cardiovascular risk factors in hypertensive postmenopausal women(2015) Mbabazi, Solomon; Pytetska, NataliaConclusions. It was established the III degree arterial hypertension prevalence among women with hypertension in postmenopausal period. The most important risk factors of arterial hypertension were obesity, emotional stresses, excessive use of salt.Item Hypertension as a factor of cardiometabolic risk(2015) Boateng, Isaac; Pytetska, N.Item Aldosteronism and hypertension: Conn’s syndrome(KhNMU, 2015-05) Кочубєй, Оксана Анатоліївна; Кочубей, Оксана Анатольевна; Kochubiei, Oksana; Shirgba Sonter, JacobMost hypertension is Essential Hypertension Proportion of Essential/Secondary depends on definition of “secondary” (eg if elevated BMI was a “secondary cause” 75% of patients would have it). Conn syndrome is an aldolsterone -producing adenoma. Conn's syndrome is named after Jerome W. Conn(1907–1994), the American endocrinologist who first described the condition at the University of Michigan in 1955. Aldosterone is a steroid hormone (mineralocorticoid family) produced by the outer section (zona glomerulosa) of the adrenal cortex in the adrenal glands It plays a central role in the regulation of blood pressure mainly by acting on the distal tubules and collecting of the nephrons, increasing reabsorption of ions and water in the kid, to cause the conservation of sodium, secretion of potassium, increase in water retention, and increase in blood pressure and blood volume. When dysregulated, aldosterone is pathogenic and contributes to the development and progression of cardiovascular and renal disease. Aldosterone has exactly the opposite function of atrial nutriuretic hormone secreted by the heart. Causes: Primary hyperaldosteronism has many causes, including adrenal hyperplasia and adrenal carcinoma. The syndrome is due to: 1. Solitary adrenal (conn) adenoma, 35% 2. Bilateral (micronodular) adrenal hyperplasia, 60% 3. Glucocorticoid remediable aldosteronism (dexamethansone-suppressible hyperaldosteronism) 1% 4. Rare forms, including disorders of the renin-angiotensin system 1% Complications list for Conn's syndrome: The list of complications that have been mentioned in various sources for Conn's syndrome includes: Enlarged heart (Heart symptoms) Loss of deep tendon reflexes Heart disease - due to high blood pressure Stroke- due to high blood pressure Congestive heart failure - due to high blood pressure Coronary artery disease - due to high blood pressure Abnormal heart rhythm - due to low blood potassium levels Death - due to low blood potassium levels Diagnosis measuring aldosterone alone is not considered adequate to diagnose primary hyperaldosteronism. The screening test of choice for diagnosis is the plasma aldosterone:plasma renin activity ratio. Renin activity, not simply plasma renin level, is assayed. Both aldosterone and renin are measured, and a ratio greater than 30 is indicative of primary hyperaldosteronism. Treatment - spironoloctone. Treatment of Conn's syndrome is usually successful. Many patients with a single adrenal adenoma will be able to stop drug treatment and will have normal blood pressures. Nevertheless, many specialist centres will follow a patient with Conn's syndrome for life. This is to monitor the rare possibility of growth of a second adenoma. Patients with bilateral hyperplasia should have life-long monitoring of effectiveness and side-effects of drug treatment. Again, quality of life is generally good, although some patients may not be able to tolerate spironolactone treatment.Item Interleukins 33 and 1β serum level is connected to left ventricular geometry and diastolic filling in patients with hypertension and obesity(2014-11-26) Kovalyova, Olga; Ashcheulova, Tetyana; Ambrosova, Tetyana; Honchar, Oleksii; Ivanchenko, Svitlana; Ковалева, Ольга Николаевна; Ащеулова, Татьяна Вадимовна; Амбросова, Татьяна Николаевна; Гончарь, Алексей Владимирович; Иванченко, Светлана Владимировна; Ковальова, Ольга Миколаївна; Ащеулова, Тетяна Вадимівна; Амбросова, Тетяна Миколаївна; Гончарь, Олексій Володимирович; Іванченко, Світлана ВолодимирівнаItem Role of interleukin 33 in left ventricular structural and functional remodeling in hypertensive patients with obesity(2014-05-15) Honchar, Oleksii; Гончарь, Олексій Володимирович; Гончарь, Алексей Владимирович; Ivanchenko, Svitlana; Іванченко, Світлана Володимирівна; Иванченко, Светлана ВладимировнаObjective. To investigate interrelations between interleukin 33 (IL-33) and 1β (IL-1β) serum levels, left ventricular (LV) remodeling and diastolic dysfunction (DD) in hypertensive patients with obesity. Method. 80 hypertensive patients (51 obese) underwent transthoracic echocardiography. IL-33 and IL-1β serum levels were estimated using ELISA. Results. IL-33 and IL-1β were higher in hypertensive patients (p<0,001), independently of BMI. Increase of IL-33>73 pg/ml, IL-1β>25 pg/ml was associated with highest LV myocardial mass index (MMI) (160,5 (142,8;185,8) g/m2, p<0,05), moderate decrease in E’ velocity (9,95 (8,32;10,60) cm/sec), relatively low PWP (9,23 (8,83;13,03) mm Hg) and 70,0% prevalence of LVDD. Increase of IL-1β>20 pg/ml with IL-33<71 pg/ml was characterized by relatively low LV MMI (116,9 (104,4;163,1) g/m2), lowest E’ (7,68 (6,50;9,67) cm/sec, p<0,01), highest PWP (12,26 (10,72;13,12) mm Hg, p<0,05) and highest rate of DD (85,0%). Increase of IL-33>71 pg/ml with IL-1β<25 pg/ml was associated with MMI of 121,4 (111,7;140,5) g/m2, highest E’ (11,04 (9,49;12,00) cm/sec), lowest PWP (9,07 (7,04;11,51) mm Hg) and lowest prevalence of LVDD (66,7%). IL-33<71 pg/ml with IL-1β<20 pg/ml had intermediate characteristics: LV MMI of 137,4 (121,3;157,8) g/m2, E’ of 9,95 (8,30;12,20) cm/sec, PWP of 11,20 (9,55;12,33) mm Hg, and 71,1% rate of DD. Conclusion. Significant increase in IL-33 and IL-1β levels in hypertensive patients independently of BMI was revealed. Increase in both cytokines’ levels was associated with highest rates of LVH and DD. Prevalent increase in IL-1β was connected to the worst state of diastolic function despite low rates of hypertrophy. Prevalent increase in IL-33 had the most favorable influence on the severity of LVH as well as diastolic filling.Item Интерлейкины 33 и 1β и ремоделирование общих сонных артерий у больных гипертонической болезнью с ожирением(2014-05-15) Гончарь, Алексей Владимирович; Гончарь, Олексій Володимирович; Honchar, Oleksii; Иванченко, Светлана Владимировна; Іванченко, Світлана Володимирівна; Ivanchenko, SvitlanaЦель. Изучить взаимосвязь между концентрацией интерлейкина 33 (ИЛ- 33) и 1β (ИЛ-1β) сыворотки крови и особенностями ремоделирования общих сонных артерий (ОСА) у больных гипертонической болезнью (ГБ) с ожирением. Материалы и методы. Обследовано 80 больных ГБ, включая 51 пациента с ожирением. Всем больным проведено УЗИ ОСА с оценкой ее геометрического типа по классификации А.В. Агафонова (2007) (граничным значением при выявлении гипертрофии сосудистой стенки была масса артериального сегмента (VM) > 0,275 г/см , концентрическое ремоделирование был диагностировано при относительной толщине стенок (ОТС) ОСА > 0,2). Сывороточные уровни ИЛ-33 и ИЛ-1B определялись иммуноферментным методом. Результаты. Уровни ИЛ-33 и ИЛ-1β сыворотки крови были выше у больных гипертонической болезнью (р<0,001), независимо от наличия и степени ожирения. Для выявления совместного влияния концентрации обоих цитокинов на особенности геометрии ОСА проведен кластерный анализ методом К-средних, получено 4 непересекающихся кластера. Уровни ИЛ-33 > 73 пг/мл, ИЛ-1β > 25 пг/мл ассоциировались с 80,0% распространенностью нормальной геометрии ОСА и 20,0% ее концентрической гипертрофии. ИЛ-1β > 20 пг/мл при ИЛ-33 < 71 пг/мл характеризовались 80,0% частотой нормальной геометрии, 10,0% негипертрофического концентрического ремоделирования ОСА, 5,0% концентрической и 5,0% эксцентрической гипертрофии. ИЛ-33 > 71 пг/мл при ИЛ-1β < 25 пг/мл были связаны с уменьшением доли нормальной геометрии ОСА до 50,0% и увеличением встречаемости концентрической гипертрофии до 41,7%; оставшиеся 8,3% пациентов имели эксцентрическую гипертрофию ОСА. При уровне ИЛ-33 < 71 пг/мл и ИЛ-1β < 20 пг/мл (р > 0,05 против контрольной группы) 57,9% пациентов имели нормальную геометрию, 15,8% концентрическое ремоделирование, 15,8% концентрическую и 10,5% – эксцентрическую гипертрофию ОСА. Выводы. Уровни ИЛ-33 и ИЛ-1β сыворотки крови были повышены у больных гипертонической болезнью независимо от наличия ожирения. Выраженное изолированноее увеличение концентрации ИЛ-33 ассоциировалось с резким увеличением частоты гипертрофии стенки ОСА, особенно ее концентрического варианта. Параллельное увеличение уровня ИЛ-1β сглаживало этот эффект.Item Obesity as a risk factor of hypertension(2014-04) Istomina, Olga; Kisilenko, KaterinaIstomina Olga, Kisilenko Katerina Obesity as a risk factor of hypertension Department of Fundamentals of Internal Medicine N1, Fundamentals of Bioethics and BiosafetyScientific Director: MD, professor O.N. Kovalyova Kharkiv National Medical University Kharkiv, Ukraine Obesity at the present time is the most known and recognized metabolic disease, become as common, as an epidemyc in developed countries, and in developing countries too. Average index by obesity in Ukraine in 2012 year is 1231 person per 100 thousand population. Obesity, is a risk factor for a lot of diseases, especially for arterial hypertension (AH).Characteristic changes in this combination will be: left ventricular hypertrophy (probability of occurrence of it in individuals with normal body weight is 5,5% and with obesity-29,9%), increased heart weight, myocardial remodeling of left ventricular and it's diastolic dysfunction, and in a result leads to reduced quality of life.It's known, that hypertension meets twice more in individuals with overweight, that why antihypertensive medication must be more aggressive and need more dosage of it.In the world-famous research Framingham Heart Study was noted that the risk of new cases of hypertension was highly associated with overweight, in comparison with people with normal body weight (BMI = 18,5 – 24,9) and it's for woman-1,75, for men-1,46. Also they notice, that obesity shortens lifespan by 6-7 years. In Tanno-Sobetus Study was determined that risk of development of AH increased by abdominal obesity type in 2,33 times. But, it should be remembered that obesity is modifiable.In accordance with Guidelines for the management of AH 2013 ESH/ESC doctor should focus on reducing body weight by 5 -15% over 6 months:patient should eat more vegetables,fruits; regular exercise; downgrading of body weight to a BMI of 25 kg/m2 and waist circumference to <102 cm for men and <88 cm for women and maintain blood pressure of <140/90 mmHg.Item The influence of the overweight and obesity on the degree of hypertension(2014-05-15) Sukchomlin, Nikolay; Balashova, Tatyana; Gerasimchuk, Nina: In Ukraine, as well as throughout the world, arterial hypertension remains one of the most important problems. This is due to the fact that hypertension is a major risk factor of coronary heart disease and cerebrovascular disease, which is determined at 88.1% death rate from diseases blood circulation system, characterized by the high prevalence. In our time it is generally accepted that the level of increase in the frequency of obesity among the population in developed countries is of the alarming rate, so this phenomenon is compared with the epidemic (WHO, 2000; Haffner S. et al., 2003; Eckel RH et al., 2005). The clinical significance of this fact consists in that overweight and obesity are potential factors of the risk for hypertension. Epidemiological studies have established a significant correlation between body mass index (BMI), waist circumference and blood pressure (Brown CD et al., 2000; Wilsgaard T. et al., 2000; Poirier P. et al., 2005) . The probability of developing hypertension in patients with overweight are 50% higher than in patients with normal body weight (Vasan RS et al., 2001).