The Siberian Medical Journal最新文献

{"title":"The effects of renal denervation on adipokines and pro-inflammatory status in patients with resistant arterial hypertension associated with type 2 diabetes mellitus","authors":"A. Falkovskaya, V. Mordovin, S. Pekarskiy, T. Ripp, V. Lichikaki, E. Sitkova, I. Zyubanova, T. Suslova, A. Gusakova, A. Baev, M. Manukyan, Elmira K. Buhkarova","doi":"10.29001/2073-8552-2019-34-4-118-127","DOIUrl":"https://doi.org/10.29001/2073-8552-2019-34-4-118-127","url":null,"abstract":"Introduction. Pro-inflammatory biomarkers and adipokines are involved in the regulation of blood pressure (BP) and atherogenesis and are also associated with the sympathetic nervous system. Patients with resistant hypertension (RHTN) associated with type 2 diabetes mellitus (T2DM) are characterized by high sympathetic activity, adipokine imbalance, and pro-inflammatory activity. Moreover, renal denervation (RDN) is accompanied by a decrease in sympathetic tone. Aim. To evaluate the effect of RDN on the adipokine profile and the levels of pro-inflammatory markers in patients with RHTN associated with T2DM. Material and Methods. Forty-three patients with RHTN associated with T2DM were included in the single-arm prospective interventional study. Detailed protocols are available on ClinicalTrial.gov, numbers NCT01499810 and NCT02667912. The measurements of body mass index (BMI), waist circumference (WC), office BP, 24-hour ambulatory BP, lab tests (serum concentrations of hsCRP, TNF-α, adiponectin, leptin, resistin, and IL-6) were performed at baseline and at 6and 12-month follow-ups. The one-year follow-up period of observation was completed with 40 patients. Results. Significant and consistent reductions of BP, TNF-α, and hsCRP were observed 12 months after RDN. Additionally, there were substantial increases in both adiponectin and leptin levels. The change in TNF-α was directly related to the reduction in variability of systolic BP, whereas the changes in hsCRP, adiponectin and leptin levels had no relations with BP reduction. The BMI, WC, and resistin and IL-6 levels did not change after RDN. Conclusions. This study demonstrated the ability of RDN to improve the adipokine profile and to reduce the activity of subclinical inflammation in patients with RHTN associated with T2DM. Increased adiponectin and leptin as well as reduced TNF-α and hsCRP production may contribute to BP reduction via metabolic and neuro-hormonal pathways.","PeriodicalId":153905,"journal":{"name":"The Siberian Medical Journal","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127292740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascular endothelial growth factor as a potential marker of subclinical organ damage mediated by arterial hypertension","authors":"Ю. Губарева, E. Gubareva, Irina V. Gubareva","doi":"10.29001/2073-8552-2019-34-3-40-44","DOIUrl":"https://doi.org/10.29001/2073-8552-2019-34-3-40-44","url":null,"abstract":"The authors’ report presents a brief review of the key studies, providing the reason for the use of vascular endothelial growth factor as a marker for stratification of the risk of cardiovascular complications in patients with essential hypertension.","PeriodicalId":153905,"journal":{"name":"The Siberian Medical Journal","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126512925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Features of arterial hypertension in postmenopausal women with abdominal obesity: The role of inflammatory response markers, leptin, and female sex hormones in the pathogenesis of vascular wall stiffness","authors":"K. Avdeeva, T. Petelina, L. Gapon, N. Musikhina, E. Zueva","doi":"10.29001/2073-8552-2019-34-3-103-113","DOIUrl":"https://doi.org/10.29001/2073-8552-2019-34-3-103-113","url":null,"abstract":"Background. Despite overall efforts, arterial hypertension remains one of the most significant medical and social problems. The risk of developing arterial hypertension is tripled in obese individuals compared with people who have normal body weight. According to clinical studies, individual biochemical markers can be predictors of initiation of remodeling processes in systems at a preclinical level. Endothelial dysfunction is the initial stage in the development of atherosclerosis. Mechanisms of the vascular inflammatory response in arterial hypertension with obesity can be considered a factor that largely determines the onset and course of the disease, a cause of its aggravation, development, and progression. Cardiovascular risk factors, genetic predisposition, deficit of sex hormones, and aging affect the endothelium function.Aim. To study specifics of hypertension in postmenopausal women with abdominal obesity and to evaluate the role of inflammatory response markers, leptin, and female sex hormones in the pathogenesis of vascular wall stiffness.Material and Methods. The study included 164 patients divided into three groups. Group 1 consisted of 42 healthy women aged 44.43 ± 14.26 years; group 2 comprised 62 hypertensive women aged 60.69 ± 7.09 years; group 3 comprised 60 hypertensive women with abdominal obesity aged 57.24 ± 7.40 years. Patients of all groups received 24-hour blood pressure monitoring, sphygmography, and assessment of sex hormones, lipids, inflammatory, and biochemical parameters in blood serum.Results. Results of analysis showed that patients of group 3 had significantly higher blood pressure compared with that in group 2. Higher pulse wave velocity was observed in women of group 2. Groups 2 and 3 had lower levels of sex hormones and significant increases in the levels of inflammatory markers compared with those in control group. Multiple multidirectional correlations between the studied parameters were revealed.Conclusions. Features of hypertension in postmenopausal women with obesity consist in a systolic-diastolic variant of hypertension, an increase in systolic blood pressure variability at night, an increase in diastolic blood pressure during the daytime, and increases in systolic and diastolic blood pressure at night. The method of logistic regression allowed to identify biochemical markers that determine the elastic properties of the vascular wall in this category of patients, namely: leptin, highsensitivity C-reactive protein, and endothelin-1. ","PeriodicalId":153905,"journal":{"name":"The Siberian Medical Journal","volume":"95 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134202377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arterial hypertension as a trigger for the development of cardiorenal failure in patients of different genders","authors":"E. Lopina, N. P. Grishina, R. Libis","doi":"10.29001/2073-8552-2019-34-3-114-121","DOIUrl":"https://doi.org/10.29001/2073-8552-2019-34-3-114-121","url":null,"abstract":"Aim. To study the peculiarities of changes in the functional state of the kidneys and heart muscle in patients with arterial hypertension.Materials and Methods. A total of 88 patients with arterial hypertension were included in the study. Chronic kidney disease was detected based on glomerular filtration rate, albuminuria, and cystatin levels in serum and urine. The stage of chronic heart failure was determined according to Strazhesko–Vasilenko classification with functional class according to NYHA; functional class of chronic heart failure was determined based on six-minute walking test. Patient inclusion criteria were the presence of essential hypertension of degree 1–3 and the age from 50 to 70 years. Patients underwent anthropometry, biochemical blood tests, six-minute walking test, and standard echocardiography.Results. Arterial hypertension of degree 1–2 was diagnosed in 50 patients including 33 women and 17 men. Grade 3 arterial hypertension was found in 38 patients (28 women and 10 men). Patients were divided into two groups according to gender. The groups with arterial hypertension degree 1–2 differed in their blood pressure levels. Echocardiography data showed the formation of heart failure with preserved ejection fraction. The groups differed in the values of left ventricular ejection fraction and end-systolic and end-diastolic sizes of the left ventricle. The levels of cystatin C in serum were elevated in both groups. The serum and urine creatinine levels and glomerular filtration rates differed between groups. Women had more significant decreases in the values of glomerular filtration rate, cystatin C, and urine creatinine. Correlation relationships were found between systolic blood pressure and glomerular filtration rate (r = 0.27, p < 0.05) and between systolic blood pressure and left ventricular back wall thickness (r = 0.41, p < 0.05). Inverse relationship was found between left ventricular ejection fraction and albuminuria (r = –0.31, p < 0.05). Cystatin C level had inverse relationship with glomerular filtration rate (r = –0.47, p < 0.05) and direct relationship with left ventricular myocardial mass index (r =  0.24, p  <  0.05).Discussion. Chronic kidney disease and chronic heart failure with preserved left ventricular ejection fraction were detected in patients at early stages. In the group of women, more pronounced changes in the renal and cardiac functions were found. Cystatin C is a marker of kidney function reduction and an alternative marker of chronic heart failure. The study showed that the level of cystatin C in blood serum of patients was increased, which correlated with the functional activities of the kidneys and the heart.Conclusion. In case of arterial hypertension in the presence of chronic kidney disease, the development of the left ventricular hypertrophy and heart failure with preserved ejection fraction was found. Women had more significant changes in the renal and cardiac functions compared with those in me","PeriodicalId":153905,"journal":{"name":"The Siberian Medical Journal","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129984982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of indapamide and bisoprolol monotherapy on cerebrovascular reactivity in hypertensive patients with rheumatoid arthritis","authors":"I. Bogomolova, N. Rebrova, O. Sarkisova, T. Ripp, V. Mordovin","doi":"10.29001/2073-8552-2019-34-3-122-128","DOIUrl":"https://doi.org/10.29001/2073-8552-2019-34-3-122-128","url":null,"abstract":"Aim. To investigate the effect of indapamide and bisoprolol monotherapy on cerebrovascular reactivity (CVR) in patients with combined hypertension (HT) and rheumatoid arthritis (RA).Materials and Methods. A total of 66 patients with HT grade 1-2 and RA (average age of 59.0 ± 7.5 years) were included in an open-controlled randomized study in parallel groups. Group 1 included 33 patients treated with indapamide 2.5 mg/day. Group 2 included 33 patients treated with bisoprolol 6.0 ± 2.6 mg/day. We performed 24-h blood pressure monitoring and transcranial Doppler ultrasound of the middle cerebral arteries (MCA) with assessment of CVR during hyperoxia and hypercapnia tests before and after 24 weeks of treatment.Results. Indapamide treatment improved CVR parameters during hypercapnia test. The MCA peak systolic velocity increased significantly from 53.7 [34.8; 67.8] to 55.8 [37.6; 69.0] сm/s (p = 0.017). Bisoprolol treatment worsened CVR parameters during hypercapnia test. The speed modification of MCA blood flow velocity decreased significantly from 0.10 [0.05; 0.19] to 0.08 [-0.01; 017] cm/s2 (p = 0.032). The index of recovery of MCA blood flow velocity decreased significantly from 1.11 [0.95; 1.27] to 0.84 [0.78; 1.08] (p = 0.006)Conclusion. Indapamide treatment improved CVR parameters, but bisoprolol treatment worsened CVR parameters during hypercapnia test in patients with combined HT and RA. ","PeriodicalId":153905,"journal":{"name":"The Siberian Medical Journal","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124012059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular aspects of the pathological activation and differentiation of valvular interstitial cells during the development of calcific aortic stenosis","authors":"A. Kostyunin","doi":"10.29001/2073-8552-2019-34-3-66-72","DOIUrl":"https://doi.org/10.29001/2073-8552-2019-34-3-66-72","url":null,"abstract":"Calcific aortic stenosis is the most common valvular heart disease. The pathogenesis of this disease is complex and resembles the atherosclerotic process in the blood vessels. It is known that valvular interstitial cell activation and subsequent differentiation into osteoblast- and myofibroblast-like cells is the main driving force of fibrous and calcified aortic valve tissue. However, the molecular mechanisms behind these processes are still not fully understood. Current information on this issue is collected and analyzed in this article. The main molecular pathways mediating the pathological differentiation of the valvular interstitial cells and the reasons for their activation are considered.","PeriodicalId":153905,"journal":{"name":"The Siberian Medical Journal","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115251094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience of transcatheter implantation of CoreValve aortic valve bioprostheses in Clinic of Advanced Medical Technologies named after Nikolay I. Pirogov","authors":"A. S. Vasil’ev, D. Shmatov, M. S. Stolyarov, A. A. Sorokin, D. Ivanov, M. A. Novikov, A. Zyryanova, N. A. Mikhal’chikova","doi":"10.29001/2073-8552-2019-34-3-153-160","DOIUrl":"https://doi.org/10.29001/2073-8552-2019-34-3-153-160","url":null,"abstract":"Background. Every year the number of operations of transcatheter aortic valve implantation increases, and the number of centers performing this intervention increases too. In this article we present the results of the operation of transcatheter aortic valve implantation at the Clinic of Advanced Medical Technologies named after Nikolay I. Pirogov St. Petersburg State University.Material and Methods. From December 2015 to December 2018, the specialists of the Clinic implanted 46 self-expanding transcatheter aortic valves of 2 generations – CoreValve and CoreValve Evolute R. All patients were patients of high and extremely high surgical risk for severe aortic stenosis. The decision on the implementation of TAVI was taken collectively as part of the “Heart Team”.Results. Most operations were performed under general anesthesia with transfemoral access (89%). In 2 cases (4.3%) the conversion of transcatheter surgery into an open cardiac surgery was required due to the development of intraoperative complications. Hospital mortality was 6.5%, non-fatal complications were 21.7%. Now we have mid-term results of CoreValve valves implantation. The functional class of heart failure is estimated to be no higher than II (by NYHA), the observation period is from 6 months to 2.5 years, and the hemodynamic parameters of the valve are satisfactory. Medterm results from the use of CoreValve Evolute R are expected.Conclusion. The TAVI procedure in patients of high and extremely high surgical risk is an alternative to open operation, showing not-worse (non-inferiority) early and medium-term results. Treatment of patients with intraoperative aortic insufficiency of the 2nd degree requires further improvement. Further research is planned with a view to obtaining long-term TAVI results. ","PeriodicalId":153905,"journal":{"name":"The Siberian Medical Journal","volume":"139 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115568997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary hypertension in a patient with kyphoscoliotic heart disease","authors":"M. Karabasheva, N. Danilov, O. Sagaydak, D. I. Darensky, V. Lazutkina, I. Chazova","doi":"10.29001/2073-8552-2019-34-3-172-178","DOIUrl":"https://doi.org/10.29001/2073-8552-2019-34-3-172-178","url":null,"abstract":"Kyphoscoliosis is a combined spinal deformation, which leads to a decrease in the volume of ‘working’ lung tissue with the development of alveolar hypoventilation and hypoxic vasoconstriction of the pulmonary arteries. These changes in a small percentage of cases lead to increases in pulmonary artery pressure and pulmonary vascular resistance. The pathogenesis of pulmonary hypertension in kyphoscoliosis shows resemblance to pulmonary hypertension in the setting of obstructive sleep apnea or hypoventilation in the presence of obesity. Patients with already present pulmonary hypertension may theoretically be candidates for standard pathogenetic therapy, but there is currently no evidence of the effectiveness of this treatment.","PeriodicalId":153905,"journal":{"name":"The Siberian Medical Journal","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125953155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic inflammation in patients with hypertension and coronary artery disease in different age groups","authors":"Yu. O. Ostanina, D. Yakhontov, A. V. Zvonkova, I. I. Zhuravleva, O. V. Dunicheva, P. Yakhontova","doi":"10.29001/2073-8552-2019-34-3-97-102","DOIUrl":"https://doi.org/10.29001/2073-8552-2019-34-3-97-102","url":null,"abstract":"Aim. To determine and compare the levels of systemic inflammation markers (C-reactive protein (CRP) and cytokines) in different age groups of hypertensive patients with coronary artery disease (CAD).Material and Methods. The study involved 106 patients (men) with hypertension and stable angina. Group 1 included 59 young and middle-aged individuals (52 [46.5; 55] years); group 2 comprised 47 elderly individuals (64 [62; 67] years; p < 0.001). The exclusion criteria were female gender, diabetes, myocardial infarction in the previous six months, exacerbation phase of chronic diseases, acute infectious and mental illnesses. The CRP levels were determined by ELISA test system (Biomerica, USA). The serum cytokine levels were assessed using Vector Best test systems (Russia). Statistical processing of data was performed in the freely distributed Rstudio software. The differences were considered statistically significant if p < 0.05.Results. The levels of CRP and the frequencies of its increase did not significantly differ in patients with hypertension and CAD in different age groups and were within the reference values, which was, probably, due to the use of drugs with systemic antiinflammatory effect. Increases in the IL-6 levels were more common in group of young and middle-aged men (47, 85.5%/27, 62.8%, p = 0.032). Increases in the IL-8 levels were also more frequently detected in young and middle-aged patients (10.7 [7.3; 19]/5.9 [4.35; 9.3], p = 0.006).Conclusion. Obtained data suggest both an increased risk of acute cardiovascular events and more aggressive course of CAD in young and middle-aged patients with hypertension, and a possible onset of early vascular aging in this group. ","PeriodicalId":153905,"journal":{"name":"The Siberian Medical Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130724238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal denervation in 2019","authors":"S. Pekarskiy, V. Mordovin, T. Ripp, A. Falkovskaya","doi":"10.29001/2073-8552-2019-34-3-21-32","DOIUrl":"https://doi.org/10.29001/2073-8552-2019-34-3-21-32","url":null,"abstract":"In the 21st century, hypertension remains a major health threat to the adult population worldwide, despite the phenomenal progress in the development of antihypertensive pharmacotherapy. Currently, the rate of pharmacological control of hypertension barely exceeds 50%. Indeed, pharmacotherapy is fundamentally limited by pharmacological/pharmacokinetic tolerance (adaptation) to the drugs as well as by non-compliance of patients with treatment regimens due to depletion of their psychophysiological function of self-control. Renal denervation (RDN) is a new non-drug treatment of hypertension. Renal denervation consists of a mini-electrosurgery on the renal sympathetic system where a catheter ablation is used to create a permanent block of conduction through the renal nerves. This procedure, in accordance with the function of the renal adrenergic receptors, increases glomerular filtration, reduces tubular water reabsorption, and inhibits glomerular secretion of renin. After the over-disputed failure of the early version of RDN using the first-generation single-electrode catheter system in the SYMPLICITY HTN-3 study, therapy was virtually reinvented with a new three-dimensional multi-electrode design and an anatomically optimized procedure. The new device design ensures deployment of the electrodes in a pre-defined fully circumferential pattern. Moreover, this design provides a radial contact that presses the electrodes against the arterial wall thereby maximizing the efficiency of radiofrequency (RF) tissue heating. Another major improvement of RDN therapy is the anatomical optimization of the procedure by extending the treatment into the segmental branches of the renal artery where the renal nerves concentrate the most around renal vessels. This article presents an analysis of the current state-of-the-development and future perspectives of RDN therapy.","PeriodicalId":153905,"journal":{"name":"The Siberian Medical Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130134190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}