The ways of rehabilitation of petients with ishemic heart disrase

Застосування електрофорезу бішофіту Полтавського показано на амбулаторному так і стаціонарному етапах лікування, а також на санаторно-курортному етапах реабілітації пацієнтів з ішемічною хворобою серця з позитивним впливом на стан пацієнтів

The level of systemic inflammation and the state of central hemodynamics in patients with coronary heart disease with metabolic syndrome

Metabolic syndrome (MS) is one of the possible risk factors for coronary heart disease (CHD) [2,7]. Meanwhile, cardiovascular disease, and first and foremost, CHD, is one of the leading causes of death in developed countries of the world [1,8]. The prognosis for patients with coronary heart disease depends, predominantly, on the progression of coronary atherosclerosis (CA). Clinical significance of MS is determined by its important prognostic value in the development of cardiovascular diseases (CVD), and in particular, CHD, due to disturbance of the function of endothelial and smooth muscle cells of the vessels, local intravascular inflammation, increased platelets function and thrombosis [4,8]. The achievement of recent years is the concept as to the important role of chronic systemic inflammation (CSI) and insulin resistance (IR) in the pathogenesis of CA and CHD, which is especially relevant for MS patients [3, 8, 9]

Study gender and age characteristics metabolic syndrome

Поширеність метаболічного синдрому в Україні, відсутність потрібної та доступної інформації про фактори ризику потребує застосування нового системного підходу її вирішення, який може бути реалізований, на нашу думку, через розробку спеціальної програми профілактики метаболічного синдрому з урахуванням гендерних і вікових особливостей

Evaluation of indicators of endothelial dysfunction and intracardiac hemodynamics of the left ventricle in patients with chronic pulmonary heart bronchopulmonary genesis of comorbidity with essential arterial hypertension

Chronic obstructive pulmonary disease (COPD) is the main cause of progression chronic pulmonary heart (CPH), it is a serious worldwide problem. The combination of COPD with essential arterial hypertension (EAH) ranges from 4 to 27.7% with increasing age

The level of systemic inflammation and the state of central hemodynamics in patients with coronary heart disease

Materials and methods. An open clinical trial was conducted. 230 patients with CHD were examined: stable angina pectoris, II FC, CH 0-I (119 men and 111 women aged 57 + 8.3 years) and 30 healthy subjects (control group). The criteria for inclusion in the study were the age of men and women (40-75 years), the presence of CHD: exertional angina of II FC in the absence of destabilization of the course for at least two months, the informed consent of the patient to participate in the study. The exclusion criteria were the presence of chronic heart failure higher than stage I, high blood pressure, complications of cardiac rhythm and conduction disorders, rheumatism, cancer, anemia, diabetes mellitus, renal and hepatic insufficiency. To achieve the aim of the research, patients’ blood was tested for levels of IL-1β and TNFα by the immune enzyme method; fibrinogen (FG) plasma levels – by weight method and echocardiography (echo) [7]. The global contractile ability of LV was estimated by the stroke volume (SV), the ejection fraction (EF), and the velocity of the blood flow (v) in the external path (EP) of the LV. The diastolic function of LV was investigated by recording the transmitral blood flow rates by the ratio of the velocities of the early (E) and late (L) diastolic filling of the LV (E / A), the delay time of early diastolic filling of the LV (DT) and the time of isovolumic LV relaxation (IVRT) [7]

Justification of increasing the blood flow velocity in the arteries of the thyroid gland in autoimmune thyroiditis as a reflection of endothelial changes due to inflammatory status

Abstract: Objective: The aim of the research was to determine the dependence of the blood flow velocity in the thyroid arteries in patients with autoimmune thyroiditis (AIT) on the presence of atherosclerotic carotid disease and the level of systemic blood pressure. Method: The research involved 20 patients with AIT in euthyroid state, 30 patients AIT in euthyroid state with stable coronary heart disease (CHD), 30 patients with stable CHD and 30 healthy individuals. Participants of the research were examined using ultrasound of carotid arteries and inferior thyroid arteries. Parameters of blood flow velocity were compared with the level of systemic blood pressure. Results: In AIT peak systolic velocity and resistance index in the inferior thyroid arteries were sig- nificantly higher than in healthy individuals and patients with CHD (p<0.05). In patients with CHD velocity parameters in carotid arteries were high, unlike in the healthy individuals and patients with AIT (p<0.05). In patients with AIT without CHD the atherosclerotic changes of carotid arteries were not found. Increased systemic blood pressure was noticed in all patients with CHD without significant differences between groups

FEATURES OF HEART INVOLVEMENT IN METABOLIC SYNDROME IN YOUNG AND MIDDLE-AGED PATIENTS

In the prevention of cardiovascular disease (CVD), great importance is given to timely detection and correction of cardiovascular risk factors. One of the risk factors for heart disease is the metabolic syndrome (MS), which is a complex of pathogenetically interrelated metabolic disorders caused by insulin resistance, compensatory hyperinsulinemia, which contributes to the formation of arterial hypertension, abdominal and visceral obesity, dyslipidemia, hyperglycemia, chronic subclinical inflammation, and disruption of the hemostasis system. To date, the main pathogenetic mechanisms of MS have not yet been agreed upon. According to most publications, the syndrome is based on insulin resistance and central obesity. In addition, other mechanisms that may underlie the pathogenesis of MS have been described: chronic activation of the immune system, impaired functioning of the hypothalamic-pituitary-adrenal axis, changes in the action of glucocorticoid hormones, chronic stress, production of excessive amounts of cytokines, hormones and other biologically active substances by adipocytes. Metabolic syndrome often occurs at a young age; its complete symptom complex develops in adulthood when the patient suffers from arterial hypertension, ischemic heart disease, and diabetes mellitus with atherosclerotic vascular involvement. This significantly increases the risk of stroke or myocardial infarction. Therefore, an urgent task is early diagnosis of MS, heart involvement in MS, especially in young and middle-aged patients. The most pronounced effect of treatment and prophylactic measures to reduce mortality from CVD should be expected in this group. The aim of the researchis to promote early diagnosis and to study the features of CVD in MS in young and middle-aged patients. The object and methods of the research.The study is based on examination of 92 patients of young (35-44 years old) and middle age (44-60 years) according to the WHO classification. According to the results of Holter monitoring, 37 patients (40% of the total number of patients) were identified, of which 25 (67.6%) were men and the rest 12 (32.4%) women, with disrupted processes of repolarization with episodes of ST segment change, T wave. Changes were of the nature of depression or elevation. In particular, depression of the segment was observed in 60% of cases, elevation in 26.7% and in 13.3% of cases, there was a depression and segment elevation. Among them: the subjects, who presented three existing MS symptoms: 29.8% of the total; 72.7% with ischemic changes; patients with four or more MS manifestations accounted for 18% of the total and 100% had ischemic changes. In 40% of patients, we observed concentric remodeling of the left ventricle (LV), in 12% its hypertrophy (in 17% dilatation of LA, 5% dilatation of LV). Studying the correlation between echocardiographic parameters and signs of MS, it was established that with the increase in the abnormal obesity characteristic of MS, the walls of the LV thicken and its hypertrophy is increasing, the index of which is the mass index of LV. The growth is also associated with the expansion of the cavities of the heart and the decrease in the contractility of the lungs. Conclusions 1. Manifestations of MS are a common problem among young and middle-aged patients. 2. There is an observed relationship between the number of symptoms of MS and the presence of ischemic changes. 3. It is expedient to carry out daily monitoring of ECG, echocardiography in patients with MS for early detection of changes in the state of coronary circulatory syste

Comorbidity in patients with ischemic heart disease

За даними Державного комітету статистики України (від 23.01.2018 р.), смертність від серцевосудинних захворювань посідає перше місце і становить 66,6 %. У сучасній науковій літературі активно обговорюється проблема надання медичної допомоги пацієнтам із ішемічною хворобою серця (ІХС), які мають супутню та поєднану патологією, де потрібна інтегральна оцінка стану здоров’я людини, призначення лікування з урахуванням взаємодії медикаментозних препаратів, надання рекомендацій щодо режиму і тривалості їх прийому. Тому питання коморбідності є актульними і потребують широкого дослідження

The prevalence of components of metabolic syndrome of patients with thyroid dysfunction, their structural indicators and the functional activity of the thyroid gland

Протягом останніх десятирічь світова спільнота приділяє особливу увагу питанням метаболічного синдрому, який набув надзвичайно високої актуальності. У пацієнтів, які страждають метаболічним синдромом в поєднанні з тиреоїдною дисфункцією, частіше зустрічалися багатокомпонентні варіанти метаболічного синдрому, посилення тяжкості його клінічних проявів та проявом більшої частоти структурних та функціональних порушень ЩЗ, зниженням функціональної активності щитоподібної залози; В течение последних десятилетий мировое сообщество уделяет особое внимание вопросам метаболического синдрома, который приобрел чрезвычайно высокую актуальность. У пациентов, страдающих метаболическим синдромом в сочетании с тиреоидной дисфункцией, чаще встречались многокомпонентные варианты метаболического синдрома, усиление тяжести его клинических проявлений и проявлением большей частоты структурных и функциональных нарушений щитовидной железы, снижением ее функциональной активности; For the last decades the world community has paid special attention to the problem of metabolic syndrome (MS), which has become extremely urgent. Taking into account, that amount of people with symptoms of MS in 2030 year will have reached up to 360 million, the problem of prevention, diagnostic and treatment has gained a huge scientific and practical importance. This issue predetermines the need of more improved principle of MS detection, more advanced detection of their etiological factors, pathogenesis and opportunity of prevention of complications. Nowadays the problem of pathogenetic basis of interaction of a various components of MS and function of thyroid gland have not been solved yet, in spite of high attention to determining different aspects of progression MS. In Ukraine in structure of an endocrinopathy pathology of a thyroid gland is on the first place on its prevalence (44%) and in the western regions this indicator reaches to 70% owing to iodine deficiency. The aim of this work was to estimate the prevalence of MS components among patients with thyroid dysfunction (TD) and to reveal violations of structural indicators of the thyroid gland functional activity. The object and methods of research. The research is based on examination of 78 patients with MS and TD, who were treated in the therapeutic department of Poltava city clinical hospital №3 and in day hospital of Poltava clinical policlinic №3. There were 52% women and 48% men among patients. The results. The patients were divided into 3 groups on the results of the examination: the patients of the first group had TD without MS (26 participants), the second group of patients had MS without TD (18 participants) and the third group of patients had MS in a combination with TD (34 participants). The average age among participants in the firth group is 54,27 ± 3,01, the second – 54,27 ± 1,73, the third – 55,07 ± 2,93. There were such 5 components of the MS during the examination of patients in the groups: abdominal obesity (80%), arterial hypertension (82%), disorders of carbohydrate metabolism (49%), hypertriglyceridemia (19%) and dyslipoproteinemia (22%). On the results of ultrasound examination of thyroid gland we were discovered a high frequent prevalence of diffuse disorders of structure of thyroid gland among women and men with components of MS in combination with TD and in the group among patients with thyroid dysfunction without metabolic syndrome. The conclusion. The patients suffering from metabolic syndrome in combination with thyroid dysfunction had more often multicomponent variants of metabolic syndrome, worsening clinical manifestations and manifestations of a greater frequency of structural and functional disorders of the thyroid gland, reduction of functional activity of the thyroid gland. The prospects for further research. Further scientific research in these directions can prevent the progressive prevalence of metabolic syndrome, reduce the intensity of its consequences – cardiovascular and endocrine pathology, to reduce morbidity rate of metabolic syndrome and thyroid dysfunction among population

Features of cardiac rhythm variability in patients with arterial hypertension on the background of type 2 diabetes

Артеріальна гіпертензія (АГ) та цукровий діабет (ЦД) 2 типу, будучи одними з головних факторів ризику серцево-судинних захворювань, мають визначальне значення в структурі серцево-судинної і загальної смертності; їх поєднання активізує розвиток атеросклерозу і ураження органів-мішеней. Одним з індикаторів стану регулюючих систем організму є варіабельність ритму серця (ВРС). Прогностичне значення зниження ВРС пов'язують зі схильністю до розвитку життєво загрожуючих аритмій і раптової смерті. Питання практичного застосування аналізу ВРС у хворих АГ в поєднанні з ЦД типу 2 вивчений недостатньо