Взаимосвязь структурно-функционального состояния миокарда с активностью сосудисто-эндотелиального фактора роста и воспалительной реакцией крови при туберкулезе легких

Abstract

Taking into account the conflicting literature data on the frequency of the clinical form of pulmonary tuberculosis and its impact on the structural and functional state of the heart, an echocardiographic assessment of heart parameters was carried out in patients with pulmonary tuberculosis and its relationship with the vascular endothelial growth factor VEGF-A. The purpose — to evaluate the relationship between the structural and functional state of the myocardium and the concentration of VEGF in the blood serum in patients with pulmonary tuberculosis. Material and methods. The study included 77 patients with newly diagnosed pulmonary tuberculosis. During the study, the patients were randomized into 3 groups: group 1 — patients with an infiltrative form (n = 42), group 2 — patients with a disseminated form (n = 20), group 3 — patients with fibrous-cavernous form of pulmonary tuberculosis (n = 15). The control group consisted of 10 volunteers. B-mode echocardiography was performed and VEGF concentration was assessed by ELISA. Results. Higher values of RV length, LA area and RA area, and mean LA pressure were found in patients with fibrous-cavernous form, which is due to hypertrophy of the right heart, as indicated by higher values of wall thickness RV — 4.12 mm vs 3.70 in patients of the control group. A high concentration of VEGF-A in the blood serum is associated with higher parameters of erythrocyte sedimentation rate and platelet count, which may indicate a more pronounced systemic inflammatory response in the infiltrative form of pulmonary tuberculosis. Conclusion. Pulmonary tuberculosis is accompanied by structural and functional remodeling of the right and left parts of the heart, the severity of which is associated with the clinical form of the disease. The infiltrative form of pulmonary tuberculosis is associated with significantly higher values of the pro-inflammatory angiogenic cytokine VEGF-A compared to other clinical forms of tuberculosis and the control group.