ОЦЕНКА ВЗАИМОСВЯЗИ УРОВНЕЙ АДИПОКИНОВ, ЦИТОКИНОВ, МАРКЕРОВ ДИСФУНКЦИИ ЭНДОТЕЛИЯ И ПОКАЗАТЕЛЕЙ ГЕМОСТАЗА С СОСТОЯНИЕМ ОРГАНОВ-МИШЕНЕЙ ПРИ СОЧЕТАНИИ АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИИ С АБДОМИНАЛЬНЫМ ОЖИРЕНИЕМ У ЛИЦ МОЛОДОГО ВОЗРАСТА

Background. To estimate the correlation of adipokines, cytokines, endothelial dysfunction markers and hemostasis with state of target organs in young patients with hypertension and abdominal obesity.Materials and methods. The blood content of adipokines, cytokines, endothelial dysfunction markers and hemostasis in patients with hypertension, abdominal obesity and their combination was determined. Standard 12-lead ECG, two-dimensional echocardiography and duplex scanning of the brachiocephalic arteries were performed in all patients.Results. In young patients with combination of hypertension and abdominal obesity were determined the increased levels of leptin, interleukin-6, monocyte chemoattractant protein type 1, endothelin, angiotensin II and prothrombotic changes in hemostasis. Among this patients were revealed hypertrophy of the left ventricle myocardium and increased intima-media complex thickness compared to those in groups with isolated hypertension, isolated abdominal obesity and the control group. The greatest diagnostic significance for predicting myocardial hypertrophy of the left ventricle according to the ROC-analysis were endothelin level >3,49 pg/ml and interleukin-6 level >5,67 pg/ml.Цель. провести оценку взаимосвязи уровней адипокинов, цитокинов, маркеров дисфункции эндотелия и показателей гемостаза с состоянием органов-мишеней у лиц молодого возраста с артериальной гипертензией в сочетании с абдоминальным ожирением.Материалы и методы. Пациентам с изолированной артериальной гипертензией и изолированным абдоминальным ожирением, а также с их сочетанием в крови определяли содержание адипокинов, цитокинов, маркеров дисфункции эндотелия и показателей гемостаза. Для диагностики поражений органов-мишеней проводились: стандартная ЭКГ в 12-ти отведениях, эхокардиография, дуплексное сканирование брахиоцефальных артерий.Результаты. Установлено повышение уровня лептина, интерлейкина-6 и моноцитарного хемоаттрактантного протеина 1 типа, эндотелина и ангиотензина II, а также протромботические изменения гемостаза у пациентов с сочетанием артериальной гипертензии и абдоминального ожирения. Среди исследуемых пациентов чаще выявлялись гипертрофия миокарда левого желудочка и увеличение толщины комплекса интима-медиа по сравнению с таковыми в группах с изолированными артериальной гипертензией и абдоминальным ожирением, а также контрольной группой. Наибольшей диагностической значимостью для прогнозирования развития гипертрофии миокарда левого желудочка по данным ROC-анализа оказались уровень эндотелина >3,49 пг/мл и уровень интерлейкина-6 >5,67 пг/мл

Association between Carotid Wall Shear Rate and Arterial Stiffness in Patients with Hypertension and Atherosclerosis of Peripheral Arteries

Aim. To evaluate carotid wall shear rate (WSR) in association with local and regional vascular stiffness in patients with hypertension (HTN) and atherosclerosis of peripheral arteries and to study the pattern of change of WSR in patients with HTN with increasing severity of peripheral artery atherosclerosis. Materials and Methods. Study involved 133 patients with HTN, 65 men and 48 women, aged in average 57.9±10.8 years. All patients were divided into four groups in accordance with ultrasound morphologic classification of vessel wall. Duplex scanning of carotid and lower limb arteries was performed. Carotid-femoral (cfPWV) and carotid-radial (crPWV) pulse wave velocity (PWV) were measured. Local carotid stiffness was evaluated by carotid ultrasound. Results. WSR of patients with plaques without and with hemodynamic disturbance was 416±128 s−1 and 405±117 s−1, respectively, which was significantly less than the WSR in patients with intact peripheral arteries – 546±112 s−1. Decreased carotid WSR was associated with increased crPVW, cfPWV, Peterson’s elastic modulus, decreased distensibility, and distensibility coefficient. Conclusion. In patients with HTN and atherosclerotic lesions of peripheral arteries, it is registered that the carotid WSR decreased with increasing severity of atherosclerosis. Decreased carotid WSR is associated with increased local carotid stiffness, regional vascular stiffness of muscular, and elastic vessels

Circulating Ageing Neutrophils as a Marker of Asymptomatic Polyvascular Atherosclerosis in Statin-Naïve Patients without Established Cardiovascular Disease

Background: Current data on the possible involvement of aging neutrophils in atherogenesis are limited. This study aimed to research the diagnostic value of aging neutrophils in their relation to subclinical atherosclerosis in statin-naïve patients without established atherosclerotic cardiovascular diseases (ASCVD). Methods: The study was carried out on 151 statin-naïve patients aged 40–64 years old without ASCVD. All patients underwent duplex scanning of the carotid arteries, lower limb arteries and abdominal aorta. Phenotyping and differentiation of neutrophil subpopulations were performed through flow cytometry (Navios 6/2, Beckman Coulter, USA). Results: The number of CD62LloCXCR4hi-neutrophils is known to be significantly higher in patients with subclinical atherosclerosis compared with patients without atherosclerosis (p = 0.006). An increase in the number of CD62LloCXCR4hi-neutrophils above cut-off values makes it possible to predict atherosclerosis in at least one vascular bed with sensitivity of 35.4–50.5% and specificity of 80.0–92.1%, in two vascular beds with sensitivity of 44.7–84.4% and specificity of 80.8–33.3%. Conclusion: In statin-naïve patients 40–64 years old without established ASCVD with subclinical atherosclerosis, there is an increase in circulating CD62LloCXCR4hi-neutrophils. It was also concluded that the increase in the number of circulating CD62LloCXCR4hi-neutrophils demonstrated moderate diagnostic efficiency (AUC 0.617–0.656) in relation to the detection of subclinical atherosclerosis, including polyvascular atherosclerosis

Evaluation of the hemostatic state, carbohydrate and lipid metabolism in young women with abdominal obesity and hypertension

Aim of this study was to determine the characteristics of the laboratory parameters of hemostasis, carbohydrate and lipid metabolism in women with metabolic syndrome, isolated abdominal obesity or with hypertension.Materials and methods. The study included 71 women aged 30 – 44 years and was conducted at laboratory study of hemostasis system, carbohydrate and lipid metabolism.Results. In women with abdominal obesity and arterial hypertension we found an increased levels of glucose, total cholesterol, LDL-C and triglycerides and a decrease in a concentration of HDL-C compared to healthy women. The study of hemostasis revealed prothrombotic changes in the form of activation of coagulation hemostasis and fibrinolysis system activity.Conclusions. The disorders of carbohydrate and lipid metabolism are very prevalent in young women with abdominal obesity and hypertension with every second woman meeting the criteria for the metabolic syndrome. The most pronounced signs of activation of blood coagulation markes was seen in women with abdominal obesity and hypertension. In women with the individual components of the metabolic syndrome there were no significant changes in carbohydrate and lipid metabolism, although we saw an early signs of activation of hemocoagulation