ART OF MEDICINE 2017

 

CLINICAL AND DIAGNOSTIC VALUE OF ENDOTHELIAL DYSFUNCTION AND ARTERIAL STIFFNESS IN PATIENTS WITH ARTEIAL HYPERTENSION IN COMBINATION WITH GOUT AND OBESITY

 

I.P. Vakalyuk, N.M. Seredyuk, M.O. Vatseba

            SHEI "Ivano-Frankivsk National Medical University"Department of Internal Medicine №2, Ivano-Frankivsk, Ukraine

 

Abstract

Abstract. Aim. Study of peculiarities of endothelial disfunction and arterial stiffness in patients with arterial hypertension in combination with gout and obesity.

Materials and Methods. The study involved 50 patients, 32 of which with essential hypertension of second degree with gout and obesity and 18 patients with essential hypertension of second degree without gout and obesity. The average age of the patients was 60,2 ± 1,2 years. The study also included 15 healthy people for control rules parameters. All patients were randomized into two groups: group I - 18 patients with hypertension second degree, the second group - 32 patients with hypertension second degree, gout and obesity. Analyzed the dynamics of aortic stiffness index - ASI (by reference PBP / SV (mm Hg. / Ml.), The thickness of intima-media complex (TIMC mm) and the value of endothelium-dependent vasodilation (EDVD) and CAVI-marker (cardio -ankle vascular index). Definition of CAVI marker conducted by reopletyzmography (velocity of the pulse wave determined on the highway "shoulder-tibia"). CAVI - established by formula of K.Shirai. TIMC determined by means of Doppler common carotid artery ("Logiq 500" Kranzbuhler, Germany). The magnitude of endothelium (EDVD) vasodilation (Test of reactive hyperemia D. Celemajer et al., 1999) established by determining the rate of brachial artery diameter (Δ%) during reactive hyperemia). Also investigated the level of endothelin-1 (ET-1).

Results. After analyzing the results of endothelial dysfunction and arterial stiffness in general, it should be noted that in the main group of patients we have observed significantly higher levels ASI, TIMC, ET-1, PWV and CAVI - marker than in patients without concomitant gout and obesity. Adverse influence on indicators of odds ratio (OR 95% CI) on the course of study of the pathology are all indicators that directly (ET-1, EDVD) or indirectly through increased PWV, CAVI-marker, or enhancing rigidity (ASI, TIMC) worsen function of the vascular walls.

Conclusion Clinical, pathological and functional aspects of endothelial dysfunction and arterial stiffness have not been studied sufficient enough in patients with hypertension, gout and obesity. Changes in arterial stiffness and endothelial dysfunction may have, not only prognostic significance, but also have some impact on therapeutic approaches in the treatment of this group of patients.

 

Keywords: arterial stiffness, endothelial dysfunction, hypertension, gout, obesity.

 

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