Manifestation Of Endothelial Dysfunction Research Articles

CLINICAL AND NEUROLOGICAL FEATURES OF DYSCIRCULATORY ENCEPHALOPATHY COURSE IN PATIENTS WITH HYPOTHYROIDISM ACCORDING TO THE PROSPECTIVE STUDY DATA

Introduction. Chronic insufficiency of cerebral blood circulation, dyscirculatory encephalopathy, takes a prominent place among cerebrovascular pathology. Currently, along with the growth of dyscirculatory encephalopathy, there is an increase in endocrine pathology, such as hypothyroidism. Neurological disorders in hypothyroidism are a severe and widespread condition of the nervous system. Cerebral pathology, which develops as a result of metabolic and vascular disorders in patients with hypothyroidism, is a manifestation of endothelial dysfunction, such as disruption of endothelial function compensation. Aim. The aim of our study was to reveal the clinical and neurological features of dyscirculatory encephalopathy in patients with hypothyroidism according to the prospective study data. Materials and methods. The 60 patients with hypertensive dyscirculatory encephalopathy and accompanying hypothyroidism, who were under supervision for 10 years, were examined with clinical, neurological, neuropsychological, instrumental and laboratory examination. Results. According to the study results, it was proved, that the patients of the second group, i.e. those who were examined at the present time, were more likely to complain of unsteadiness while walking and general weakness. When analyzing the objective neurological symptoms among the patients included in the study, a coordination disorders were established as dominating. At the same time, the II group of patients was characterized by more frequent detection of pathological plantar reflexes, unsteadiness in the Romberg posture and walking ataxia, compared to the I group. When analyzing the objective neurological symptoms, among the patients included in the study, coordination disorders were established as dominating. Conclusions. According to the results of a prospective study, it was proved that hypothyroidism is associated with a more severe course of vestibulo-ataxic syndrome in patients with chronic brain ischemia.

Genetic markers of endothelial dysfunction in chronic obstructive pulmonary disease

Objective. To analyze genetic markers of endothelial dysfunction in chronic obstructive pulmonary disease. Materials and methods. The study involved an examination of 285 patients with chronic obstructive pulmonary disease aged 67.12 ± 1.82, including males (73.68%) and females (26.32%). A control group consisted of 70 respondents, including 45 relatively healthy people, among whom males constituted 64.3% and females 35.7%. Polymorphisms of endothelial nitric oxide synthase NOS3 (C786T), endothelin-1 EDN1 Lys198Asn genes were examined by PCR method. Results. The cohort of COPD patients revealed a prevalence of pathological homozygous genotype 786SS NOS3 (χ2=12.84, df=1, p=0.0003). Carriage of heterozygous variant of LysAsn polymorphic marker Lys198Asn of EDN1 gene in COPD patients was detected in 32.5%. Conclusion. Manifestation of endothelial dysfunction in COPD patients is due to genotypic predisposition associated with carrying polymorphisms 786SS of NOS3 gene (OR 7.01, 95% CI 1.59-30.81) and Lys198Asn of EDN1 gene (OR 2.53, 95% CI 0.69-9.22)

THE ROLE OF INTRAUTERINE ANTIGEN EXPOSURE IN THE MORPHOGENESIS OF CEREBRAL BLOOD VESSELS

Introduction. The state of cerebral vessels in children of the first year of life with congenital toxoplasmosis, both active and without signs of activity (as models of antenatal antigenic exposure), was considered. The patients were born to mothers whose pregnancy proceeded with mild preeclampsia and perinatal damage to the nervous system. The features of the morphogenesis of the brain vessels of rats after exposure to antigens in the antenatal period were experimentally investigated. Materials and Methods. 119 children of the first year of life were examined. 43 patients with toxoplasmosis, 25 children from women whose pregnancy was complicated by mild preeclampsia, and 28 children with perinatal lesions of the nervous system of hypoxic-ischemic genesis due to antenatal hypoxia of the fetus. The comparison group consisted of 23 healthy children with an uncomplicated antenatal history. Experimental study of the morphogenesis of brain vessels of Wistar rats after intrauterine administration of antigens according to the method of M.A. Voloshin. Results. At 1–2 and 7–8 months of life, in children with antigenic antenatal exposure and perinatal lesions of the nervous system of hypoxic-ischemic genesis, blood flow disorders in the anterior cerebral arteries, vessels of the nail bed, manifestations of endothelial dysfunction and impaired function of the sympathoadrenal system were detected. In the experiment, after the intrauterine introduction of antigens of various nature, an increase in the proportion of the connective tissue component in blood vessels was established, and a significant decrease in the ratio of muscle and connective tissue components from the 1st to the 60th day of postnatal development. Changes in indicators of carbohydrate metabolism and a decrease in glycogen in the anterior cerebral artery of rats 1–60 days of life with antigenic antenatal exposure indicate long-term changes in metabolic disorders of carbohydrate metabolism in the anterior cerebral arteries. By extrapolating the results obtained in the experiment on rats, it is possible to predict metabolic disorders in the vessels of people of the appropriate age, which to a certain extent explains the ultrasound and biomicroscopic changes in vessels, endothelial dysfunction detected in children with antigenic antenatal stimulation at 1–2 and 7–8 months of life. Conclusions. The identified features indicate a change in the morphogenesis of brain vessels after antenatal antigenic exposure and are the background for the formation of central nervous system pathology in children

Endothelial dysfunction in patients after COVID-19

Relevance: Over the past two years, the COVID-19 infection has gained unprecedented relevance at the global level. All countries are spending significant resources in the fight against COVID-19 [1 2]. The purpose of the work is to clarify the issue of the state of the kidneys in the distant post-covid period (after 2-3 months), we conducted a study of the kidneys simultaneously with the desquamation of the endothelium, as one of the probable mechanisms of the nephrotic effect of the COVID-19 virus. Materials and methods: 29 people participated in the study. Patients with post-covid syndrome (n=10) were treated on an outpatient basis at the "KNP "Center of primary medical and sanitary (medical and sanitary) care No. 3, Odesa" of the Odesa City Council" in the period from 2020 to 2021. The control group consisted of patients without cardiovascular and endocrine disorders, comparable in terms of gender and age, who were examined in 2018 at the Odesa Regional Clinical Medical Center of the Odesa Regional Council. Endothelial dysfunction "ED" was determined by the intensity of desquamation of the endothelium according to the method of J. Hladovec as modified by M.M. Petryschev. and other. (2001). Statistical analysis was performed using Status software [https://status-please.herokuapp.com/]. Mean values ​​(M) and its standard deviation (SD) were used to describe quantitative data, and percentages were used for qualitative data. For comparison, data were presented as M and standard error of the mean (SEM). Analysis of normality was performed using the Shapiro-Wilk test. Levene's test was used to assess homogeneity of variances. Differences between groups were determined using Student's t-test and one-way analysis of variance (ANOVA). The relationship and presence of correlation between the studied parameters was determined using the Pearson correlation coefficient (r). The correlation coefficient in the range of 0.5≤|r|<1 indicated a strong correlation relationship, 0.3≤|r|<0.5 – a relationship of medium strength, 0<|r|<0.3 – on a weak correlation. Statistical significance was established only at the level of p < 0.05. Results: 17 men and 12 women aged from 32 to 80 years who suffered from a disease of moderate severity participated in the study. The average age of the group of patients with post-covid syndrome (n=9) is 55.9±14.47 years, the average age of the control group (n=20) is 55.95±14.47 years. There were no complaints from the urinary system in the examined patients. According to blood serum tests, it was established that the creatinine level among patients with post-covid syndrome was on average 113±11.91 μmol/l, the urea level was 8.11±1.2 mmol/l, the GFR level was 55.06±12, 19 ml/min/1.73. m2. In the control group, the numbers were as follows: creatinine level was 73.2±8.5 μmol/l, mean urea level was 4.61 mmol/l, GFR was 94.78±13.76 ml/min/1.73 m2. Conclusions: 2-3 months after the transfer of COVID-19, the examined patients show signs of chronic kidney disease. After a disease with COVID-19, an increase in CEC is detected, which is a manifestation of endothelial dysfunction.

Abstract 113: Impact of COVID-19 on arterial stiffness

Background: Arterial Stiffness is a manifestation of endothelial dysfunction and it can be used as a prediction parameter and a target for therapies aimed at ameliorating endothelial cell dysfunction which is raised after Covid 19 infection.Aims and Objectives: To evaluate arterial stiffness using carotid-femoral Pulse Wave Velocity (cfPWV) and to compare the difference in different groups among the study subjects.Methods and Results: Observational single centre study was done after randomly selecting 170 subjects from Telangana State Police Department after excluding subjects with chronic inflammatory diseases on chronic steroid therapy and pregnant/lactating subjects. Analysis after dividing them into 4 groups based on the presence or absence of past history of COVID-19 infection and the presence or absence of Comorbidities (Diabetes Mellitus, Systemic Hypertension, CAD, CVA or CKD) showed mean increase in cfPWV was 76.21 cm/s in Group-A (Covid-ve & Comorbidity-ve), 126.5 cm/s in Group-B (Covid+ve & Comorbidity-ve), 210.1 cm/s in Group-C (Covid-ve & Comorbidity+ve) and 263.9 cm/s in Group-D (Covid+ve & Comorbidity+ve). Significant p values were obtained for intergroup differences in cfPWV.Conclusions: The Arterial stiffness values of prior COVID-19 positive subjects were higher than the group of subjects without prior COVID-19 infection. Comorbidities also independently added to the risk. Pulse wave velocity can be considered as an easy non-invasive screening tool in post-COVID patients to identify possible high-risk candidates.

Evaluation of indicators of red blood and some indicators of the aggregate state of blood in students in different periods of study, taking into account gender differences

BACKGROUND: An examination session in students can be considered as a manifestation of a stress factor. As a result, during this period there are changes in the basic physiological parameters of students, which are due to the release of a large amount of cortisol. AIM: To evaluate the indicators of red blood and some indicators of the aggregate state of blood in students in different periods of study, taking into account gender differences. MATERIALS AND METHODS: The study design included 100 examined. Of the total number of examined relatively healthy (did not make complaints, were not on the dispensary register and did not have established diagnoses) 100 people (50 men and 50 women). The absence of diseases was confirmed by medical documentation, since all persons of this group underwent an annual preventive examination for admission to study. Included in the study were volunteers aged between 18 and 30 years who, based on medical records, had no acute or chronic illness and gave voluntary consent to participate in the study. The average age was 23 3 years. RESULTS: Based on the presented study, it was found that the stressful situation caused by the examination session leads to pronounced changes in the hemostasis system, which may be a manifestation of endothelial dysfunction, while there are differences between these changes in men and women, which are manifested by differences in indicators of red blood, rheological properties of blood, endothelin levels, von Willebrand factor, tPA-PAI-1 complexes, antithrombin III. In addition, when comparing these indicators by gender, the predominance of fibrinogen levels in female students over men was noted. However, despite the pronounced changes in the hemostasis system, they were not critical and did not lead to the development of pathological conditions, moreover, as further studies showed, these changes were quickly stopped when the stress factor was stopped. As our research shows, after the end of the session, in the period of 7-8 days, both men and women, all analyzed indicators returned to physiologically normal indicators. CONCLUSIONS: Thus, the conducted studies show that during the examination session, which can be regarded as a stressful situation, there is a significant activation of the hemostasis system, while there are certain differences related to gender. Thus, the predominance of fibrinogen levels in female students over men was established.

PECULIARITIES OF PREGNANCY COURSE IN WOMEN WITH CONCOMITANT OBESITY WHO TAKE THERAPEUTIC AND PROPHYLACTIC COMPLEX AIMED TO PREVENT PREECLAMPSIA

The rapid growth in the incidence of overweight and obesity among women of childbearing age is posing specific issues related to their pregnancy, thereupon choosing adequate and effective tactics for the prevention of preeclampsia in women with concomitant obesity who are at high risk group for this complication is of undoubted relevance. The aim of this study is to assess the occurrence and characteristic of obstetric and prenatal complications in women with concomitant obesity, who receive therapeutic and prophylactic complex designed to prevent the development of preeclampsia. We studied the course of pregnancy of 255 women, who were divided into 3 groups according to the class of obesity, and then, in turn, were subdivided into subgroups taking into account the presence of preeclampsia and the therapeutic and prophylactic complex course. The high efficiency of the therapeutic and prophylactic complex including L-arginine and diosmin for obese women enables to reduce the manifestations of endothelial dysfunction, the occurrence of preeclampsia and its severe forms; to lower down the occurrence of other complications during the pregnancy (risks of premature birth, placental insufficiency, distress and foetal growth retardation); to avoid perinatal mortality and improve the condition of the foetus. Applying this pathogenetically grounded therapeutic and prophylactic complex we elaborated (acetylsalicylic acid, L-arginine, calcium supplements and semisynthetic diosmin) to prevent the occurrence of preeclampsia in pregnant women with concomitant obesity, who are at high-risk group, promotes the reduction of occurrence and intensity of obstetric and prenatal complications resulted from endothelial dysfunction. We can suggest the therapeutic and prophylactic complex for pregnant women with concomitant obesity as effective therapy because no cases of severe and early preeclampsia have been registered.

The level of adhesion molecules in polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is characterized by dysfunction of the ovaries, hyperandrogenism and combination of metabolic disorders that increase the risk of developing cardiovascular diseases.The objective: of the investigation was to study the serum level of adhesion molecules (ICAM-1, VCAM-1 and E-selectin) in women with PCOS with different body weights as a marker of endothelial dysfunction, and their relationship with other factors of cardiovascular pathology.Materials and methods. 45 women with PCOS were examined, among whom a group of obese people – 23 women (age: 22,82±3,03 years, BMI 35,67±4,6) and a non-obese – 22 women (age: 22,81±2,03 years, BMI 22,35±2,16). The control group included 20 women aged 20,15±2,15 years, BMI 21,32±2,19. The serum level of ICAM-1, VCAM-1 and E-selectin was determined by the enzyme immunoassay. The significance of the differences of mean values was determined by the Student’s t-test. Correlation and multivariate regression analysis was used to assess the relationship between the studied factors,.Results. We revealed a significant increase of the serum level of adhesion molecules in obese and non-obese women with PCOS in comparison with women in the control group: ICAM-1 – +54,18%, +36,72%, respectively (p<0,0001), VCAM-1 – +50,76%, +36,33% respectively (p<0,0001), E-selectin – +40,24%, +29,56% respectively (p<0,0001). The concentration of these factors was higher in obese women with PCOS compared to non-obese women with PCOS: ICAM-I – +12,76% (p=0,04), VCAM-1 – +10,58% (p=0,009), E-selectin – +8,24% (p=0,03); p<0,05. The relationship was established between insulin content, HOMA and Caro index, lipid metabolism, hyperandrogenemia and an increase of serum level of adhesion molecules (p<0,01).Conclusions. As a result of our study, an increase of serum level of adhesion molecules in PCOS was revealed, both in combination with obesity and normal body weight, which may be a manifestation of endothelial dysfunction in this pathological condition. An increase in the content of ICAM-1, VCAM-1, E-selectin may be associated with insulin resistance, dyslipidemia and hyperandrogenism.

Estimation of efficiency of shock wave therapy in patients with chronic nonbacterial prostatitis / chronic pelvic pain syndrome

Estimation of efficiency of shock wave therapy in patients with chronic nonbacterial prostatitis / chronic pelvic pain syndrome

P1166DOES PERITONEAL PROTEIN LOSS AFFECT CARDIOVASCULAR MORTALITY OF PERITONEAL DIALYSIS PATIENTS ?

Abstract Background and Aims Peritoneal protein loss (PPL) through peritoneal effluent has been a well-recognized detrimental result of peritoneal dialysis (PD). The amount of protein lost will depend on dialysis time, protein size, its serum concentration and other factors including patients’ clinical status. Peritoneal protein loss may be a manifestation of endothelial dysfunction, as with another type of capillary protein leakage, microalbuminuria, a recognized endothelial dysfunction marker. The aim of this study was to retrospectively evaluate the influence of PPL on cardiovascular mortality of peritoneal dialysis patients Method This is a single center retrospective study of 84 PD patients (m=54, f=30) with mean age of 65.2±17 years, mean PD duration of 43.2±24.9 months conducted for the time period from 2006 to 2019 (13 years). The patients were divided into two groups according to the amount of protein excreted during the modified Peritoneal Equilibration Test (PET) procedure using PD solution of 3.86% DW, 2 Lt infusion volume for total time of 4 hours. The total amount of proteins excreted was calculate from PET by multiplying the concentration of proteins at the end of the test with the total volume of PD fluid at the same time. Group A excreted a total amount of proteins < 1.55 gr (median value) at the end of PET test and Group B > 1.55 gr. The cumulative all-cause and cardiovascular survival of the PD patients was calculated by Kaplan Meier while the possible effect of any parameter in survival rates was evaluated by using Cox Regression analysis Results There was not any statistically significant difference between the two groups according to PD duration, age, dialysis adequacy targets, Residual Renal Function(RRF), BMI, ultrafiltration volume during PET and their transport status. The cumulative all-cause survival using Kaplan-Meier analysis revealed no statistically significant deference between the two groups (Log Rank p=0.55) even though mortality risk was adjusted for several factors (Cox Regression). When cardiovascular survival, using Cox Regression analysis, was adjusted for age, sex, Diabetes, PD modality, dialysis Kt/V and RRF we found that Group A (with protein excretion < 1.55 gr) had statistically significant better cardiovascular survival (p=0.029) compared to Group B. We confirm these results while trying to find among the total of our patients the possible risk factors for cardiovascular mortality. Using Cox Regression analysis, the amount of protein excreted during PET procedure and the type of PD solutions (high or low in GDPs) used were statistically significant (p=0.019 and p=0.04 respectively) independent risk factors for cardiovascular survival in our patients. Conclusion These results indicate that protein loss during peritoneal dialysis procedure has negative impact on cardiovascular mortality and survival of PD patients. Additionally, the use of PD solutions with low Glucose Degradation Products (GDPs) and AGEs may improve PD patient’s cardiovascular survival. Randomized interventional studies are encouraged to address the pathological concern of PPL in the future, namely its effects on cardiovascular conditions or its role as marker and effort to reduce PPL using ACE inhibitors or vit D should be considered only if it diminishes cardiovascular morbidity or mortality.

Prevalence of Erectile Dysfunction among men of the Uzbek Population who were on the Inpatient Examination and Treatment

In order to study the prevalence of erectile dysfunction (ED) in men of the Uzbek population, an anonymous survey of men who were on a stationary examination and gave consent was conducted. 648 questionnaires were analyzed. It was found that ED symptoms were present in 587 (90.6%) men. Age-related symptoms (according to the AMS questionnaire) were detected in 259 (44.1%) patients, and most of them were aged 45-60 years. It is necessary to actively detect ED in men, since it can be one of the early manifestations of serious diseases. Erectile dysfunction (ED) - a continuing inability to achieve and/or maintain an erection sufficient for satisfactory sexual activity. ED is a symptom complex that is part of the clinical picture of a number of somatic diseases, which in its severity directly depends on them. Numerous risk factors are known that create favorable conditions for the development of ED: systemic diseases (atherosclerosis, cardiovascular diseases, renal and liver failure), nervous diseases (neurosis, multiple sclerosis, Alzheimer's disease), mental illness (depression, astheno-depressive and hypochondria) endocrine diseases (diabetes mellitus, hypo- and hyperthyroidism, androgen deficiency, hyperprolactinemia). The risk of developing ED increases with age due to the process of increased comorbidity. ED is a common disorder affecting men of all ages; it often does not lend itself to proper diagnosis and treatment. There are numerous well-reasoned evidences that ED is functionally reversible damage to the arteries - endothelial dysfunction (EnD). Currently, EnD is considered as a functional stage in the development of atherosclerosis [1-3]. EnD is a generalized process that occurs due to: oxidative stress, impaired metabolism of nitric oxide, processes of redox phosphorylation of blood vessels, in particular endothelium. A manifestation of EnD can be disturbances in the mechanisms of normal blood flow in the pelvis, which can manifest as erectile dysfunction, lower urinary tract syndrome (LUTS), interstitial cystitis, and overactive bladder (OAB) [4]. EnD as a manifestation of endothelial dysfunction can be a predictor of cardivascular diseases, which means that it can be used as a screening assessment of the cardiovascular system in men after 35-40 years. The social and psychological discomfort of the modern world, the prevalence and increased mortality from cardiovascular disease (CVD), the increase in ED have become one of the main health problems of men of the XXI century. Keywords: Erectile dysfunction; Andrology; Male health

Влияние этанола на развитие оксидативного стресса и эндотелиальной дисфункции

The review focuses on the pathogenetic mechanisms of ethanol influence on the development of oxidative stress (OS) and endothelial dysfunction (ED). It is shown that both in acute and chronic alcohol intoxication, the intake of ethanol in the body initiates the development of OS, the formation of reactive oxygen species, causes a decrease in the content of endothelium-derived relaxing factors (nitric oxide (NO), prostacyclin, endothelium-derived hyperpolarization factor (EDHF)), an increase in the concentration of endothelium-derived constricting factors (endothelin, angiotensin-II), thereby causing the development of ED. When alcohol is consumed in small doses by healthy non-drinkers, ethanol can act as an antioxidant, cause the neutralization of reactive oxygen species, promote the formation of NO, and prevent the formation of ED. Currently used methods for evaluating ED allow us to characterize the functional state of the endothelium. Structural changes in the blood vessel wall as a manifestation of ED in alcoholic disease are not sufficiently described, which indicates the need to study them using modern histological, histochemical, immunohistochemical and electron microscopic methods.

Дисфункция эндотелия как главный фактор кардиоваскулярного риска, лимитирующий работоспособность юных спортсменов: методы оценки и коррекция с помощью специализированных продуктов питания на основе апифитокомпонентов

Objective: to assess with exercise tests the endothelial dysfunction (ED) and performance before and after the treatment with specialized athlete’s nutrition product (SANP) with apian and herbal components. Materials and methods: 88 athletes aged 16-18 we tested. The main group included 58 athletes, who took SANP (candy bar «Gold F25 ApiSpeis Light») for 2 months. The control group-1 included 32 schoolchildren and students, non-athletes, with normal endothelium-dependent vasodilatation function of the brachial artery (EDVD BA) at the peak of the reactive hyperemia test (RHT). Control group-2, 30 athletes who did not take SANP, was formed for the comparison with the main group after taking SANP. For all individuals, we evaluated the level of EDVD, endothelium-dependent vasoconstriction (EDVC BA) at the peak of the hyperventilation test (HVT), the coefficients (C) of the endothelial sensitivity to shear stress and the blood flow velocity (Vps) of the BA at the peak of the RHT and HVT, the endothelial sensitivity index (ESI), and the maximum load (Wmax), the anaerobic threshold time (ATT). We also did general and biochemical blood tests. Results: the earliest manifestation of endothelial dysfunction is a decrease in sensitivity to shear stress during RHT and HVT resulting from endotheliocyte overstrain which can be assessed with ESI (sensitivity 80.9%, specificity 99.4 The EDVD diagnostic significance was 5.6 times lower than that of EIS, while 10.5% of athletes with over 10% EDVD actually had ED, with a predominant vasospasm and high cardiovascular risk. After the course of SANP in the main group, EDVD increased by 70%, EDVC decreased by 2.2 times, and the ESI increased by 2.3 times, against the background of improved performance. Total cholesterol decreased by 13%, triglycerides by 17%, cortisol by 14%, lactate by 25%. Red blood cell and mineral levels increased. A correlation was found between an increase in ATT a decrease in cortisol (r=-0.53; p<0.0001), an increase in red blood cells (r=0.62; p<0.0001), and an increase in Vps in BA during of hyperventilation with an increase in Wmax (r=0.52; p<0.0001). Conclusions: ED is the main factor of cardiovascular risk, limiting working capacity and forming a spastic type of regional hemodynamics of young athletes. The ESI criterion enables the detection of a decrease in the endothelial sensitivity to shear stress during a hyperventilation test, which causes the predominant vasospasm. Th e tested SANP can be used in the system of biomedical support for young athletes.

Functional Features of Vascular Endothelium with Developing Arterial Hypertension

At present, the initial stages of the development of vasopathy in various cardiac pathologies, especially in arterial hypertension, are of great interest to researchers. Its development negatively affects the state of the cardiovascular system, increasing the risk of thrombosis. Until now, changes in the hemostatic properties of blood vessels in a person with initial manifestations of arterial hypertension have not been adequately studied. To close the gaps in the scientific knowledge system, 65 men aged 35-45 years with arterial hypertension of the 1st degree were examined in the work. They were divided into two groups, depending on the duration of this pathology. The control group consisted of 30 healthy volunteers of the same age. In the blood of the examinees, the level of malonic dialdehyde, acyl hydroperoxides, catalase activity and biochemical markers of the functional state of the endothelium were determined. It was found out that, when there is an arterial hypertension of 1 degree to half a year, the violations of the measured parameters are not expressed strongly. In patients who have arterial hypertension for more than half a year, an increase in the level of tumor necrosis factor-α and a decrease in the content of nitric oxide with an increase in the manifestation of endothelial dysfunction have been noted in the blood. Apparently, these disorders progressed as a result of activation of free radical processes, which intensify as the duration of the patient's arterial hypertension increases. Strengthening of symptoms of vasopathy in patients with arterial hypertension, occurring as the duration of the disease increases, gradually increases the risk of thrombosis and thereby worsens the overall prognosis.

Maternal ascites an independent prognostic factor in severe preeclampsia: a matched cohort study.

Preeclampsia is a multi-systemic, multi-organ dysfunction associated with increased maternal and perinatal complications. The presence of maternal ascites, a manifestation of endothelial dysfunction and increased capillary permeability, is shown to be associated with adverse outcomes. We aim to investigate the impact of maternal ascites on pregnancy outcome in women with severe preeclampsia. A matched cohort study was conducted in a tertiary care teaching hospital in South India between March 2014 and March 2015. One hundred and twenty-one severe preeclamptic women with ascites formed the study cohort while age-, parity-, and gestational age-matched group of 121 severe preeclamptic women without ascites formed the control. Primary outcome was the composite maternal adverse outcome defined as the development of any of eclampsia, pulmonary edema, renal failure, or disseminated intravascular coagulation (DIC). Secondary outcome was the composite perinatal outcome defined as the occurrence of any of still birth, hypoxic ischemic encephalopathy or early neonatal death. Four maternal deaths occurred in the study group. The rates of pregnancies with composite maternal adverse outcome [42 vs 9% RR 4.6 (95% CI 2.5-8.4)] and composite perinatal adverse outcome [36 vs 17% RR 2.1, (95% CI 1.3-3.3)] were significantly more in ascites group than in control group. After adjusting for other confounding variables, ascites was independently associated with adverse maternal events [adjusted OR 16.40 (95% CI 2.88-93.31)] but not adverse perinatal outcome. In women with severe preeclampsia, maternal ascites is an independent risk factor for adverse maternal outcome.

The condition of lipid metabolism, hemostasis and general homocysteine level as a manifestation of endothelial dysfunction at progressing course of atherosclerosis obliterans of the lower extremities

The condition of lipid metabolism, hemostasis and general homocysteine level as a manifestation of endothelial dysfunction at progressing course of atherosclerosis obliterans of the lower extremities

FUNCTIONAL HETEROGENEITY OF THE ENDOTHELIUM (THE REVIEW)

The paper summarizes data about the structure and function of the endothelium of the brain vessels, heart, lungs, liver and kidneys. Endothelial cells have important functions, the implementation of which depends on the hemodynamic and cellular microenvironment of a particular organ or tissue. The manifestations of endothelial dysfunction, changes in the direction and intensity of the formation of individual endothelial factors due to the heterogeneity of the endothelium, and depend on the structure, organization and biochemical functions of the authority. Understanding the differences in morphology, ultrastructure, gene expression and function of various subpopulations of endothelial cells may be of therapeutic relevance for regenerative medicine, cell therapy of endothelial dysfunctions and ischemic revascularization.

Cardiovascular Risk in Patients Affected by Autoimmune Diseases Early Diagnosis and Treatment

The majority of deaths developing in autoimmune diseases are caused by cardiovascular reasons, with a close relationship to this disease group. Chronic inflammation in autoimmune diseases and the inflammatory process observed in atherosclerosis have similar characteristics, and the early premature formation of atherosclerosis is one of the most important results affecting mortality in this patient group. The observation of early atherosclerosis even before clinical signs of disease means that early diagnosis and treatment choices will be the cause of stopping or slowing the progression of disease. Thus manifestations of endothelial dysfunction, development of atherosclerosis, and development of acute coronary syndrome which affect mortality and morbidity will be reduced to a minimum. In this review we aim to evaluate some tests used for early diagnosis and treatment choices in terms of the effect on disease progression in this patient group. Keywords: Premature atherosclerosis, autoimmune disease, cardiovascular disease

INDICIES OF ENDOTHELIAL FUNCTION IN WOMEN WITH PYELONEPHRITIS

Due to the high level of gestational complications during pregnancy in women with pyelonephritis a study of the features of the mother-placenta-fetus is topical. It is detected that in chronic pyelonephritis of pregnant, which is not accompanied by an increase in pro-inflammatory interleukins and impaired membrane permeability of nefrocytes, there is no manifestation of endothelial dysfunction both in mother, and in neonates. In chronic pyelonephritis during pregnancy, in case of serum transamidinase and increasing levels of IL-1, endothelial dysfunction is present, there is a risk of polyhydramnios, fetal endothelium is damaged. In gestational pyelonephritis of pregnant there’s endothelial dysfunction, increased risk of intrauterine growth retardation, endothelial function in the newborn is impaired. Our results justify the need of prediction of state of the fetus and possible preventive measures, the conduction of research of transamidinase in serum of pregnant women with pyelonephritis.

Vasospastic Acute Coronary Syndromes as a Manifestation of Endothelial Dysfunction and the Role of Flow Mediated Dilatation Test

There are many evidences and randomized clinical trials on management and treatment of acute coronary syndromes (ACS’s) caused by atherotrombotic mechanisms, in opposition to those ACS’s that present no evidence of having been caused by a thrombotic event and/or atherosclerotic disease. We believe that endothelial dysfunction is the pathophysiological key behind most coronary spams, both epicardial and microvascular, after the ruling out evident secondary causes. In this article we describe four different clinical scenarios of vasospastic ACS’s, the potential role of flow mediated dilatation test and we generate an algorithm that will help guide clinical management.