The study of the dynamics of clinical and laboratory-instrumental parameters in hypertensive patients with obesity who underwent COVID-19-associated pneumonia

BACKGROUND: According  to the results of the ESSE-RF study, the frequency of obesity in the population  reached 29.7%. Obesity is one of the main risk factors for the development of cardiovascular diseases. Features of the course of COVID-19 in patients with obesity is a very urgent problem.AIM: The aim of the study was a comparative investigation of clinical and laboratory-instrumental parameters in AH patients with or without obesity who had COVID-19 associated pneumonia, to identify the role of obesity as a potential predictor of post-COVID cardiovascular complications 3 months after discharge from the hospital.MATERIALS AND METHODS: Materials and methods. The study included 174 patients with COVID-19-associated pneumonia. Group 1 included 78 patients with AH without obesity, group 2 — 96 patients with AH and obesity. All patients were tested with a blood sample at the time of admission and 3 months after discharge from the hospital. We assessed parameters of general blood test, biochemistry, hemostasis, inflammation biomarkers — concentration of C-reactive protein (CRP), highly sensitive CRP (hs-CRP), homocysteine, IL-6, etc. All patients initially underwent computed tomography  of the chest. In both groups, 24-hour blood pressure monitoring was performed using BPLaB device, according to the standard protocol; echocardiography using  an expert class ultrasound diagnostic  system Vivid S70. The study is registered with the Clinical Trials.gov database Identifier: NCT04501822.RESULTS: Results. The biomarker that significantly distinguished the both groups of patients, as well as subgroups according to the degree of obesity was the concentration of maxCRP and hs-CRP, which was significantly higher in group 2. In addition, the registered maximum values of MPO, NT-proBNP, IL-1,6, TNA-α and NRL parameters in group 2 of patients with 2–3 degrees of obesity, may indicate the highest probability of developing  delayed adverse cardiovascular complications  in this group of patients. Mean systolic blood pressure, variability of systolic and diastolic blood pressure, and heart rate at night were significantly  higher in AH patients with obesity. Numerous correlations of obesity with laboratory and instrumental parameters have been registered, which may indicate an increased likelihood of delayed unwanted cardiovascular complications in this particular group of patients. Multiple regression showed that obesity is an independent predictor of an increase in LDH, hs-CRP and right atrium.CONCLUSION: Dynamic control of the studied parameters in patients with AH and OB registered an increased concentration of CRP at the initial stage and 3 months after treatment, with a general trend towards a decrease in the increased initial structural parameters of ECHO CG. The logistic regression method showed that the presence of OB in patients with AH is an independent factor causing increased levels of immune inflammation (CRP), a marker of tissue destruction (LDH), and load on the right atrium

Peculiarities of parameters of lipid metabolism and concentration of C-reactive protein of patients with chronic coronary heart disease who were treated by transluminal balloon angioplasty with stenting

This article presents a comparative evaluation of the parameters of lipids metabolism and high-sensitive C-reactive protein in patients with chronic coronary heart disease, depending on the degree of stenosis of coronary arteries. The dynamics of the studied parameters before and after the year of transluminal balloon angioplasty with stenting. Significant excess of atherogenic lipid fractions in the group of patients with hemodynamically significant stenosis of the coronary arteries is identified. After the year of operative measure positive dynamics of lipids profile and increase of concentration of high-sensitive c-reactive protein are registered.В данной статье представлены данные сравнительной оценки параметров липидного обмена и высокочувствительного С-реактивного белка у пациентов с хронической формой ишемической болезни сердца в зависимости от степени стеноза коронарных артерий. Прослежена динамика изучаемых параметров до и через 1 год после проведения транслюминальной баллонной ангиопластики со стентированием. Выявлено достоверное превышение атерогенных фракций липидов в группе пациентов с гемодинамически значимым стенозом коронарных артерий. Отмечена положительная динамика параметров липидного спектра и повышение концентрации высокочувствительного С-реактивного белка через год после проведения оперативного вмешательства

Clinico3hemodynamic features of arterial hypertension in patients with metabolic syndrome

The trial included 56 patients (mean age 51.8 ± 0. 8) with metabolic syndome (MS): arterial hypertension - AH (mean stage of AH 11.45 ± 1.1 yrs), non-insuline-dependent diabetes mellitus (mean stage 6. 7+0. 7 yrs), abdominal adiposity, and dyslipidemia. The control group consisted of 22 patients (mean age 49.27 ± 1.78) without metabolic abnormalities. 24-hour BP monitoring was performed in both groups. AH patients with MS demonstrated abnormalities in daily profile of heart rate (HR) and double product (DP, BPx HR/100) during all temporal intervals (whole day, day- and nighttime). This enhanced hemodynamic load on the heart and facilitated progression of left ventricular myocardial hypertrophy (LVMH). Advanced stage of high BP made MS more severe: Stage III AH patients with MS demonstrated significantly greater increase in systolic BP (SBP) (whole day, day- and nighttime) and SBP variability (whole day, day- and nighttime). Therefore, AH is an important factor in MS pathogenesis and progression