Кафедра пропедевтики внутрішньої медицини № 1, основ біоетики та біобезпеки

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    Subclinical cardiac damage in cardiopulmonary polymorbidity. Part 2
    (KhNMU, 2019-10) Kochubiei, Oksana; Ambrosova, Tetyana; Ashcheulova, Tetyana; Honchar, Oleksii; Sytina, Iryna; Ащеулова, Тетяна; Амбросова, Тетяна; Кочубєй, Оксана; Гончарь, Олексій; Ситіна, Ірина
    Hypertension and chronic obstructive pulmonary disease are frequent comorbid conditions in the internal medicine and are subject to meaningful cooperation among physicians, cardiologists, and pulmonologists. A combination of chronic obstructive pulmonary disease and hypertension presents certain diagnostic and therapeutic challenges. These conditions share common risk factors, similar clinical presentations and some common parts of pathogenesis. A problem of association between chronic obstructive pulmonary disease and hypertension may be currently discusses both as a simple combination of various clinical entities, and as chronic obstructive pulmonary disease resulting in development of factors contributing to hypertension. One way or another, either a simple combination, or a mutually aggravating syndrome, but we state there is a cardiorespiratory continuum where chronic obstructive pulmonary disease acts as a valid component of hypertension development, and vice versa. Thus, it seems to be relevant to study peculiarities of the structural and functional status of the cardiovascular system and microcirculation, systemic remodeling mechanisms, endothelial dysfunction and inflammation in presence of chronic obstructive pulmonary disease-associated hypertension. Problems of additional cardiovascular risk marker development, treatment efficiency assessment remain topical. The use of electrocardiography and echocardiography with dopplerometry has been an important diagnostic principle of subclinical cardiovascular damage in presence of hypertension and chronic obstructive pulmonary disease comorbidity. Non-invasive imaging methods play a central part in diagnosis of subclinical target organ damage. Wide implementation thereof is based on high diagnostic accuracy, common availability, safety and relatively low price.
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    Subclinical cardiac damage in cardiopulmonary polymorbidity. Part 1
    (KhNMU, 2019-08-03) Ashcheulova, Tetyana; Ambrosova, Tetyana; Kochubiei, Oksana; Honchar, Oleksii; Sytina, Iryna; Ащеулова, Тетяна; Амбросова, Тетяна; Кочубєй, Оксана; Гончарь, Олексій; Ситіна, Ірина
    Hypertension and chronic obstructive pulmonary disease are one of the frequent comorbid conditions in internal medicine and are subject to meaningful cooperation among physicians, cardiologists, and pulmonologists. A combination of chronic obstructive pulmonary disease and hypertension presents certain diagnostic and therapeutic challenges. These conditions share common risk factors, similar clinical presentations and some common parts of pathogenesis. The problem of association between chronic obstructive pulmonary disease and hypertension may be currently discusses both as a simple combination of various clinical entities, and as chronic obstructive pulmonary disease resulting in development of factors contributing to hypertension. One way or another, either a simple combination, or a mutually aggravating syndrome, but we state there is a cardiorespiratory continuum where chronic obstructive pulmonary disease acts as a valid component of hypertension development, and vice versa. Thus, it seems to be relevant to study peculiarities of the structural and functional status of the cardiovascular system and microcirculation, systemic remodeling mechanisms, endothelial dysfunction and inflammation in presence of chronic obstructive pulmonary disease -associated hypertension. Problems of additional cardiovascular risk marker development, treatment efficiency assessment remain topical. Use of electrocardiography and echocardiography with dopplerometry has been an important diagnostic principle of subclinical cardiovascular damage in presence of hypertension and chronic obstructive pulmonary disease comorbidity. Non-invasive imaging methods play a central part in diagnostics of subclinical target organ damage. Wide implementation thereof is based on high diagnostic accuracy, common availability, safety and relatively low price.
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    Beneficial effects of combined therapy with lacidipine and candesartan in obese hypertensive patients
    (2018-11) Ashcheulova, Tetyana; Gerasimchuk, Nina; Kovalyova, Olga; Honchar, Oleksii
    Introduction Obesity is becoming one of the leading risk factors of coronary heart disease, hypertension, cerebrovascular disease. Despite the presence of a large number of antihypertensive agents and scientific substantiation of antihypertensive treatment principles it would be wrong to assume that the problem is completely solved. Development of endothelial dysfunction is one of the key pathogenic mechanisms in hypertension. This process is proven to be contributed by immune inflammation activation which is mediated by pro-inflammatory cytokines and oxidative stress. Aims: To investigate the additional benefits of the combined antihypertensive therapy with lacidipine and candesartan on the basis of studying their antioxidant properties, impact on endothelial function and pro-inflammatory cytokines activity in hypertensive patients with overweight and obesity. Methods A combination of a calcium channel blocker and angiotensin receptor blocker (lacidipine 2 mg, 4 mg, and candesartan 4mg, 8mg, 16mg) was prescribed to 30 patients with essential hypertension of grades 1-3, 30 to 65 years old (mean age – 54.7 ± 5.8 years), who previously have not been receiving regular antihypertensive therapy. Results During the course of combined antihypertensive therapy with lacidipine and candesartan, a significant reduction in i-NOS activity, TNF-α to its type I soluble receptor ratio (TNF-α/sTNF-αRI), and oxidative stress marker – 8-iso-PgF2α has been observed. Activity of e- NOS, levels of SOD and catalase, in contrast, have increased by the end of observation period. Conclusion The improvement of endothelial function due to lower level of oxidative stress and a significant decrease of immune activation has been observed in hypertensive patients with overweight and obesity under the influence of combined antihypertensive therapy with lacidipine and candesartan.
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    The relations between proinflammatory and atherogenic markers and vessels remodeling in patients with hypertensive disease
    (2018) Kysylenko, Kateryna; Kovalyova, Olga
    The article presents clinical data that shows the relationship between proinflammatory markers (IL-22) and atherogenic markers (indices of lipid spectrum) in the formation of structural and functional changes in the carotid arteries, which can be considered as early subclinical markers of atherosclerotic vascular damage in the cohort of patients with comorbidity of hypertension and obesity. Such a combined pathology can be considered a trigger of metabolic events adversely affecting the lipid profile and directing these patients to a high cardiometabolic risk group.
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    Carbohydrate and lipid disorders and adipokines levels in relation to body mass index in hypertensive patients
    (Revista Mexicana de Cardiología, 2018) Ashcheulova, Tetyana; Demydenko, Ganna; Ambrosova, Tetyana; Kysylenko, Kateryna; Gerasimchuk, Nina; Kochubiei, Oksana
    Obesity is considered as a valid risk factor for cardiovascular disease, due to the fact that the risk of morbidity and mortality from various causes in obese people is signifi cantly higher. Exact mechanisms of metabolic disorders in hypertension with obesity is still discussible. The aim of the study – to determine the peculiarities of carbohydrate, lipid metabolism changes and activity of adipokines and interleukin-22, in patients with hypertension according to nutritional status. Methods: 80 patients (37 males and 43 females) with essential hypertension (EH) of average age 60.17 years were examined. Carbohydrate, lipid profi les, apolipoprotein B (apo B), tumor necrosis factor-α (TNF-α), plasminogen activator inhibitor-1 (PAI-1), adiponectin, interleukin-22 (IL-22) were estimated. Results: In patients with EH and obesity was found carbohydrates metabolism abnormalities, that was manifested as hyperinsulinemia, glucose and HbA1c levels elevation and insulin resistance (according to HOMA index). Lipid metabolism disorders were observed as valid increasing of triglycerides and apo B. Body mass index elevation was associated with progressive increasing of TNF-α and PAI-1 concentration with reducing of adiponectin level in the patients with EH. Positive relationships between TNF- and HbA1c, apo B; PAI-1 with glucose levels: negative correlation adiponectin with body mass and waist to hip ratio were detected in the patients with obesity associated (BMI ≥ 30 kg/m2) EH. Positive signifi cant correlations between apo B and insulin levels, HOMA index, and TNF-α concentration were defi ned. IL-22 in overweigh and obese patients was signifi cantly higher, correlates negatively with HDL-C. Conclusion: In patients with EH and obesity the adipokine dysfunction was revealed, that correlates with carbohydrate and lipid parameters that indicate increased proinfl ammatory and prothrombogenic processes.
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    Hypertension and obesity as the risk factors of the cancer
    (2018) Pytetska, Natalia
    Summary. The problem of overweight and obesity and their role in cardiovascular risk is actual, especially in the elderly. It was found that the incidence of hypertension in patients obesity is 75% and is increasing in all age groups, which is largely due to the way of life, which is characterized by reduced physical activityand highly nutritious food. It is known that hypertension, overweight and obesity are associated with various types of cancer. The aim of our research is to determine the characteristics of obesity in hypertensive elderly men and hypertensive women in menopause with the analysis of modifiable risk factors. It was investigated 74 patients with hypertension from 60 to 74 years (62 women and 12 men). All patients had a complete clinical examination with determination of anthropometric indices and the main modifiable risk factors. It was established that 85.1% of patients with hypertension had overweight and obesity but women were associated with obesity, men – with overweight. In patientswas prevailed the android type of distribution of adiposal tissue, was dominated the low physical activity, abuse of common salt, low content in the diet of fresh fruits, vegetables, fish and a preference to eat fatty, meat and sweet confectionery and bakery products.
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    Chemerin Serum Level and Insulin Resistancein Hypertensive Patients with Obesity
    (2017-08-21) Kovalyova, Olga; Ashcheulova, Tetyana; Ivanchenko, Svitlana; Honchar, Oleksii
    The article presents data on serum chemerin levels and its relation to insulin resistance in hypertensive patients with obesity. The results show the increase in serum chemerin levels in patients with hypertension compared healthy subjects with the highest levels in early stages of obesity that may contribute to development of insulin resistance. Advanced grades of obesity that are characterized by already established hyperinsulinemia are characterized by lower serum chemerin levels compared to grade I obesity.
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    Role of nesfatin-1 in maintaining carbohydrate homeostasis in hypertensive patients
    (V. N. Karazin Kharkiv National University, 2016-11) Vizir, Maryna; Візір, Марина Олександрівна; Визир, Марина Александровна; Ковальова, Ольга Миколаївна; Ковалева, Ольга Николаевна; Kovalyova, Olga
    The aim of this study is to analyze changes in the nesfatin-1 level in hypertensive patients depending on the carbohydrate profile parameters. 83 hypertensive patients aged 33 to 77 years were examined. Nesfatin-1 levels were determined by enzyme immunoassay method. Hypertensive patients have significantly higher levels of adipocytokine than healthy people. Results of data analyses may indicate a possible antihyperglycemic and insulinotropic effect of nesfatin-1 in hypertensive patients with normoglycemia or prediabetes. Confirmation of these processes requires a special study.