THE ERYTHROCYTE MEMBRANE ENDURANCE AGAINST TISSUE ISCHEMIA IN PATIENTS WITH HYPERTENSIVE DISEASE AND ISCHEMIC HEART DISEASE AND ITS RELATIONSHIP WITH ENDOGENOUS FACTORS

Aim. To find out the type of erythrocyte membrane endurance to local ischemia in patients with AH and AP including its relationship with endogenous factors. Material and methods. Totally 60 men included with stable form of angina pectoris and 50 men with hypertension of the age 40-55 y.o. To compare the relationships that were found with normal values the parameters studied also were measured in healthy men (n=20) at the age 27±2,5 y.o. The prominence of changes in erythrocyte membrane was evaluated by their comparison before and after local ischemia. In every patient the endurance index (index(m)) was calculated for the erythrocyte membrane. Then we studied endogenous factors that modified the shifts of erythrocyte membrane endurance in the patients studied.Results. During the study it was shown that the erythrocyte membrane endurance to tissue ischemia in AH and AP patients was significantly lower comparing to healthy males. Also in patients there was relation between shifts of membrane endurance and baseline level of various endogenous factors activity. In AP patients the endurance of membrane could be modified by five predictors: blood viscosity in moderate diameter vessels, ACE and less von Willebrand factor. In both groups the increase of baseline ACE and blood viscosity was followed by the decrease of membrane endurance. But if the ischemia developed at the background of weak ACE activity or low blood viscosity, then erythrocyte membrane was more endurable to this pathogen factor.Conclusion. The relationships found for endogenous factors and membrane endurance, it seems, shows differences in genesis of angina pectoris and hypertension. The relations require confirmation in other patients selections with the same pathology and only then can be used for the development of further findings of the main pathogenetic chains in the patients with AH and AP, as for additional treatment strategies development

Dysfunction of vascular endothelium at arterial hypertension and coronary disease (literature review)

This review presents the observation of the role of endothelial dysfunction in development of atherosclerosis, coronary disease and. hypertension. Among other causes of endothelial dysfunction the most significant are hemodynamic factors (wall transverse strain, transmural pressure), dyslipoproteinemia, hyperhomocysteinemia, hyperglycemia, free radical damage of endothelium. It is supposed that in development and. progressing of coronary disease more significant role may belong to endothelial dysfunction rather than to morphological vascular changes, predetermined by atherosclerosis. However, there is still no clear view of development of endothelial dysfunction and. mechanisms of development and. progressing of both isolated forms of coronary disease and arterial hypertension and their combination

Ultrasound assessment of vasodilatory endothelial reactions in patients with Type 2 diabetes mellitus, associated with coronary heart disease and arterial hypertension

Aim. To assess heterogeneous vasodilatation mechanisms in coronary heart disease (CHD) patients with Type 2 diabetes mellitus (DM2) and arterial hypertension (AH). Material and methods. In total, 62 DM2 patients aged 41-60 years were examined. By DM2 compensation, all participants were divided into two groups: Group I (n=37) with compensated DM2, and Group 2 (n=25) with DM2 decompensation. Age- and gender-matched control group consisted of 30 relatively healthy volunteers. Endothelium-dependent vasodilatation (EDVD) of brachial artery (BA) was measured by ultrasound scanning and flow dopplerography, in reactive hyperemia test. Shear stress and endothelium sensitivity to shear stress were calculated. Endothelium-independent vasodilatation (EIVD) was assessed in sublingual nitroglycerin test. Results. In decompensated DM2 patients, even at rest, BA blood flow and elasticity were reduced. In Celermajer D.S. test, BA diameter increase was twice as low as in healthy individuals. Shear stress endothelial sensitivity was reduced in DM2 participants. In diabetic patients with carotid atherosclerosis, BA diameter increase in nitroglycerine test was significantly lower than in participants without peripheral artery atherosclerosis. Conclusion. In DM2 patients, atherogenic lipid metabolism disturbances resulted in reduced endothelial sensitivity to shear stress, and endothelial dysfunction in middle-size arteries. In inadequate hyperglycemia compensation, endothelial dysfunction was observed more often

THE SENSITIVITY OF VASCULAR ENDOTHELIUM AND ITS PREDICTORS IN PATIENTS WITH CARDIOVASCULAR PATHOLOGY

Aim. To estimate the role of endogenous metabolic factors in formation of vascular endothelium reactivity in patients with different genesis cardiovascular regulation disorders.Materials and methods. The research included 30 patients with ischemic heart disease (IHD) with stable form of exertional angina (EA) of II–III severity class, 30 patients with I–II stage and 1st–2nd degree essential hypertension (EH), and 15 clinically healthy volunteers. We researched the signs of functional state of vascular endothelium before and after occlusion test. The parameters investigated included: adhesion of thrombocytes, spontaneous aggregation, prostacyclin activity of blood plasma, levels of antithrombine-III, of von Willebrand factor, contents of malonic aldehyde, of nitrites, of endothelin-1, of membrane-connected haemoglobin, of methaemoglobin in erythrocytes, activity of angiotensineconverting enzyme, level of sorption on the membrane of erythrocytes of nucleotides. Research of hemorheology was performed by viscosimetry method.Results. In healthy volunteers high probability of endothelium sensitivity to transverse strain decrease (in 82%) was determined and 25% increase of activity of peroxide oxidation of lipids. In patients with exertional angina influence of dynamic changes of blood flow on endothelium occurred by 2% decrease of viscosity and more than 120% increase of production von Willebrand factor (in 87%). It was concluded that as higher the production of prostacyclin in response to mechanic stimuli (more than 50%) is, the higher is probability of blood flow dynamic changes influence on endothelium. In patients with essential hypertension 30% increase of level of antithrombine-III in 100% of cases caused increase of sensibility of vascular endothelium to transverse strain.Conclusion. The most significant factors linked with sensibility of endothelium of vascular wall to dynamic blood flow changes in examined groups of patients were determined. In patients with exertional angina vascular reaction was mostly linked with rheological qualities and adhesive-aggregation characteristics of blood. In patients with essential hypertension the sensitivity of vascular endothelium was implied to be concordant with anticoagulant activity of blood plasma