Study of the Influence of Humoral Factors on the Development of Remodeling Of the Cardiovascular System in Patients with Chronic Heart Failure

Abstract

The purpose of the study. To study functional-humoral markers of endothelial dysfunction and their relationship with the progression of CHF(chronic heart failure) in patients with postinfarction cardiosclerosis.

Materials and methods of research: The study involved 100 patients with postinfarction cardiosclerosis (PIC) complicated by CHF: men aged 38-60 years (average age - 51.8±1.03 years).The patients were in the cardiology department of the 1st clinic of the Tashkent Medical Academy. All patients underwent ECG, EchoCG, Doppler ultrasonography of the brachial artery with reactive hyperemia(RH) and a nitroglycerin test(NTG), a study of platelet aggregation activity and the level of Willebrand factor in blood plasma.

Results: In patients with I FC CHF, the systolic and diastolic blood flow rate in the BA(brachial artery) was lower compared to the control group. In patients with I FC CHF, the diameter of the BA was less by 2.4%. In patients with CHF, in response to an increase in blood flow rate by 125.4±5.1, the diameter of the BA increased by 8.7±1.0 versus 11.4±1.76% in healthy individuals. In patients with I FC, there was a decrease in endothelium-dependent vasodilation, the indications EIV(endothelium-independent vasodilation) of were 14.8±2.4% versus 17.8±2.4% in healthy individuals.The pulsatile index (Pi) in patients with FC I CHF exceeded by 14.4, and the resistive index (Ri) by 8.8. A decrease in EDV(endothelium-dependent vasodilation) was noted in 68% of patients, pathological vasoconstriction - in 30%, in 2% of patients with EDV of BA persisted. There was a decrease in systolic blood flow rate by 28.2%, diastolic by 62% (P<0.01).In patients with b, the platelet aggregation activity index (PAAI) was significantly lower by 2.6 times.The level of Willebrand factor in patients with CHF I FC was 11.7% higher than the control.

Conclusions: Endothelial dysfunction in patients with CHF is characterized by a decrease in EDV, pronounced paradoxical vasoconstriction, increased platelet aggregation activity and von Willebrand factor, which are more pronounced in patients with CHF III FC.