scholarly journals The effect of the metabolically unhealthy obese phenotype on the vascular wall of the carotid arteries in patients with arterial hypertension who had acute cerebrovascular accident

2019 ◽  
Vol 18 (5) ◽  
pp. 5-9
Author(s):  
E. A. Lopina ◽  
A. G. Dushina ◽  
R. A. Libis
Keyword(s):  
Arterial Hypertension ◽  
Cerebrovascular Accident ◽  
Carotid Arteries ◽  
Vascular Wall ◽  
Acute Cerebrovascular Accident ◽  
Obese Phenotype

scholarly journals Antihypertensive and vasoprotective effectiveness of the chronopharmacotherapy in patients with arterial hypertension after acute cerebrovascular accident

Kardiologiia ◽  
2019 ◽  
Vol 59 (1S) ◽  
pp. 25-33 ◽  
Author(s):  
V. V. Skibitsky ◽  
A. V. Fendrikova ◽  
S. V. Opolskaya
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Cerebrovascular Accident ◽  
Vessel Wall ◽  
Vascular Wall ◽  
Aortic Pressure ◽  
Single Time ◽  
Acute Cerebrovascular Accident ◽  
Central Aortic Pressure ◽  
Wall Stiffness

Aim. To evaluate the effectiveness of combined antihypertensive chronopharmacotherapy and estimate the daily blood pressure profle (BP) parameters, such as: stiffness of the vascular wall and central aortic pressure in patients with arterial hypertension (AH) who underwent transient ischemic atack (TIA) or ischemic stroke (IS).Materials and methods. 235 patients with hypertension who underwent acute cerebrovascular accident were examined. Tere were 116 patients with TIA and 119 with IS. All patients were randomized in 4 groups according to regimen of antihypertensive drugs combination. Te 1st group (n = 59) included patients with AH, who underwent TIA and received indapamide retard 1.5 mg and valsartan 160 mg in the morning regiment of drug therapy. Te 2nd group (n = 57) included patients with AH, who underwent TIA and received indapamide retard 1.5 mg in the morning and valsartan 80 mg twice a day (morning and evening). Te 3rd group (n = 47) included patients with AH, who underwent IS and received indapamide retard 1.5 mg and valsartan at a dose of 160 mg in the morning. Te 4th group (n = 56) included patients with AH, who underwent IS and received indapamide retard 1.5 mg in the morning and valsartan 80 mg twice a day (morning and evening). Ambulatory blood pressure monitoring (ABPM), central aortic pressure (CAP) measurement and vessel wall stiffness values were evaluated before treatment and afer 12 months of therapy.Results.Before the start of combined antihypertensive chronopharmacotherapy, most of the parameters for ABPM, vessel wall stiffness values and CAP in groups 1 and 2, 3 and 4 were comparable. Achievement of the target level of BP afer 8 weeks of treatment, was signifcantly more ofen in groups with a double sartan therapy (group 2 and group 4) in compare with its single time application only in the morning hours (group 1 and group 3) (p<0.05). Statistically signifcant positive dynamics of the main values of the daily profle of blood pressure, stiffness of the vascular wall and central aortic pressure (p <0,05) were registered in all groups. However, more pronounced decline of main parameters of ABPM, stiffness of the vascular wall and central aortic pressure values were noted in group with double use sartan therapy in compare with single time sartan therapy in the morning time. (p <0.05). Signifcant positive dynamics of the main values of the ABPM, stiffness of the vascular wall and CAP were registered in patients who underwent IS and received double application sartan therapy (4th group) in compare with patients with TIA (2nd group) (p = 0.02).Conclusion.Double use sartan therapy, combined with a thiazide diuretics in patients, who underwent IS or TIA more ofen promotes to get target values of blood pressure, improve the main values of the ABPM, stiffness of the vascular wall and CAP in compare with single time sartan therapy in the morning time

scholarly journals Synergism of the pharmacological effect of glycine and thiotriazoline

Pathologia ◽  
2021 ◽  
Vol 18 (1) ◽  
pp. 26-32
Author(s):  
I. F. Bielenichev ◽  
A. A. Yehorov
Keyword(s):  
Oxidative Stress ◽  
Energy Metabolism ◽  
Cerebrovascular Accident ◽  
Carotid Arteries ◽  
Mitochondrial Fraction ◽  
Intragastric Administration ◽  
Experimental Animals ◽  
Acute Cerebrovascular Accident ◽  
Mitochondrial Pore ◽  
Common Carotid Arteries

Aim. To establish the effect of the glycine and thiotriazoline (4:1) combination on the parameters of the energy production of the mitochondria of the rat brain under the conditions of simulating an acute cerebrovascular accident. Materials and methods. The experimental part was performed on 90 male Wistar rats weighing 180–200 g. To model acute cerebrovascular accident (ACVA) by ischemic type, a classical model was used, where common carotid arteries had been ligated bilaterally. All animals were divided into 5 experimental groups: the first – intact (sham-operated rats, which during anesthesia had their common carotid arteries separated without ligation); the second – rats with ACVA (control); the third – rats with ACVA, which underwent intragastric administration of glycine at a dose of 200 mg/kg in the form of a tablet mass every day for 4 days; the fourth – rats with stroke, which every day for 4 days underwent intragastric administration of a combination of glycine and thiotriazoline (4:1) in the form of a tablet mass; the fifth – rats with ACVA, which underwent every day intragastric administration of piracetam in the form of a tablet mass at a dose of 500 mg/kg. The sampling of biological material (brain) for research was carried out on the fourth day of the experiment according to the standard method. The mitochondrial fraction was isolated by differential centrifugation in a refrigerated centrifuge. The manifestations of mitochondrial dysfunction, have been spectrophotometrically studied according to the degree of opening of the mitochondrial pore (MP) and mitochondrial transmembrane potential (Ψ). The assessment of the intensity of oxidative stress was determined by the markers of protein oxidative modification – aldehydephenylhydrazone (APH) and ketonedinitrophenylhydrazone (KPH) – spectrophotometrically. The state of energy metabolism was determined by the level of the most significant intermediates – ATP, lactate, succinate and malate. Results. In the group of animals with ACVA modeling, we noted a decrease in the level of ATP in mitochondria by 1.55 times, an increase in lactate content by 1.1 times, a decrease in SDH activity by 3.8 times and a decrease in succinate concentration by 1.1 times relative to the corresponding data of intact groups. Administration of a combination of glycine and thiotriazoline to experimental animals on the fourth day of ACVA modeling led to a 1.9-fold decrease in the opening of the mitochondrial pore and an increase in the charge of the inner mitochondrial membrane by 1.2 times, an increase in ATP in the mitochondrial fraction by 1.1 times, an increase in SDH activity by 3 times, and the activity of NAD-MDH – by 3.7 times, against the background of a decrease in the level of APH by 76.6 % and KPH by 80.7 %, relative to the group of animals with modeling of stroke by ischemic type. Conclusions. Modeling of ACVA leads to the initiation of oxidative stress and the development of an imbalance of energy metabolism intermediates in the brain mitochondria of experimental animals. Administration of a combination of glycine and thiotriazoline leads to a decrease in oxidative damage to mitochondria, increases the production of ATP due to the activation of compensatory mitochondrial-cytosolic shunts, mainly in malate-aspartate and succinate oxidase. In terms of the degree of influence on the indicators of energy metabolism, the combination of glycine and thiotriazoline reliably exceeds the similar actions of glycine and the reference drug - piracetam.

scholarly journals Arterial stiffness of peripheral vasculature in patients with chronic obstructive pulmonary disease and its association with arterial hypertension

2013 ◽  
Vol 94 (6) ◽  
pp. 808-812
Author(s):  
V V Gajnitdinova ◽  
A B Bakirov ◽  
E Kh Akhmetzyanova ◽  
N F Berdikaeva ◽  
V B Zakirova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Arterial Hypertension ◽  
Pulmonary Disease ◽  
Arterial Wall ◽  
Carotid Arteries ◽  
Vascular Wall ◽  
Renal Arteries ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Common Carotid Arteries

Aim. To study the structural and functional state of vascular wall, arterial stiffness of large peripheral arteries (common carotid arteries, renal arteries) in patients with severe chronic obstructive pulmonary disease and its association with arterial hypertension. Methods. The study included 67 patients of working age, mainly males, having chronic obstructive pulmonary disease. Among them, 52 patients had severe chronic obstructive pulmonary disease (defined by GOLD III, 2011), 15 had concomitant arterial hypertension of I and II stage. Structural and functional status of common carotid arteries, renal arteries was assessed by measurement of intima-media thickness, arterial stiffness indexes were calculated. Arterial elasticity indices: arterial compliance, elastic index, Young’s elastic modulus were calculated based on the results of ultrasonography of main arterial wall parameters (diameter, arterial wall thickness) and blood pressure measurement. Results. A decrease in common carotid arteries and renal arteries wall elasticity was revealed in patients with chronic obstructive pulmonary disease. Increase of stiffness index in patients with severe chronic obstructive pulmonary disease associated with arterial hypertension, marking the decreased arterial wall elasticity, was registered both in common carotid arteries and renal arteries. Conclusion. In common carotid arteries vascular wall thickness contribute the most in vascular wall stiffness increase, compared to altered hemodynamics in renal arteries. Development of arterial hypertension in these patients is a predicting factor for further large vessel remodeling associated with hypoxia.

THE COMBINATIONS OF GENETIC MARKERS OF BLOOD, THAT INFLUENCE ON THE DEVELOPMENT OF COMPLICATIONS OF ARTERIAL HYPERTENSION

2020 ◽  
pp. 54-59
Author(s):  
Людмила Валентиновна Васильева ◽  
Екатерина Юрьевна Суслова ◽  
Елена Владимировна Гостева ◽  
Елена Михайловна Толстых
Keyword(s):  
Gene Polymorphism ◽  
Arterial Hypertension ◽  
Cerebrovascular Accident ◽  
Prognostic Value ◽  
Genetic Characteristics ◽  
Aldosterone Synthase ◽  
Acute Cerebrovascular Accident ◽  
Bradykinin Receptor ◽  
The Family ◽  
Ischemic Attack

В статье представлены исследования, в результате которых выявлены корреляции между сочетанием генетических маркеров крови (фенотипы гаптоглобина, группы крови, резус-фактор), полиморфизмом генов (альдостерон синтазы CYP11B2, рецептора брадикинина BDKRB2,) у больных с гипертонической болезнью. Исследование рассматривает современные аспекты диагностики, прогрессирование и развитие таких осложнений гипертонической болезни, как транзиторная ишемическая атака, острое нарушение мозгового кровообращения. Изучалось наличием отягощённого семейного анамнеза. В результате проведённого исследования установили, что пациенты, имеющие сочетание генетических характеристик (фенотип Нр 2-2, резус-фактор Rh(-), А(II) группа крови) и наличием полиморфизма CYP11B2 C(-344)T с генотипом Т/Т гена альдостерон синтазы, полиморфизма гена рецептора брадикинина BDKRB2 с генотипом (+9/+9)) имеет важное прогностическое значение высокого риска развития более тяжёлого течения артериальной гипертензии и развитием осложнений в виде острого нарушения мозгового кровообращения This article presents trials that have revealed correlations between the combination of genetic blood markers (phenotypes of haptoglobin, blood groups, Rh factor), gene polymorphism (aldosterone synthase CYP11B2, bradykinin receptor BDKRB2) in patients with arterial hypertension (AH). The article concerns up-to-date aspects of diagnosis, progression and development of such complications of AH as transient ischemic attack, acute cerebrovascular accident. It was investigated the family predisposition. As a result of the study, it was found that patients with a combination of genetic characteristics (phenotype Нр 2-2, Rh factor Rh (-), A (II) blood group) and the presence of CYP11B2 C (-344) T polymorphism with C / T genotypes and T / T of the aldosterone synthase gene, polymorphism of the bradykinin receptor BDKRB2 gene with genotype (+ 9 / + 9)) has an important prognostic value of a high risk of developing a more severe course of AH and the development of complications as a acute violation of cerebral circulation

Model Characterization of Pulmonary Arterial Hypertension: Analysis of Lung Pathology with Respect to Human Disease

2020 ◽  
Author(s):  
◽  
Eptisam lambu
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Human Disease ◽  
Vascular Remodeling ◽  
Vascular Wall ◽  
Lung Pathology ◽  
Pulmonary Arterial ◽  
Lung Pathogenesis ◽  
Arterial Endothelial Cells

Pulmonary arterial hypertension (PAH) is a rare multifactorial disease characterized by abnormal high blood pressure in the pulmonary artery, or increased pulmonary vascular resistance (PVR), caused by obstruction in the small arteries of the lung. Increased PVR is also thought to be caused by abnormal vascular remodeling, due to thickening of the pulmonary vascular wall resulting from significant hypertrophy of pulmonary arterial smooth-muscle cells (PASMCs) and increased proliferation/impaired apoptosis of pulmonary arterial endothelial cells (PAECs). Herein, we investigated the mechanisms and explored molecular pathways mediating the lung pathogenesis in two PAH rat models: Monocrotaline (MCT) and Sugen5416/Hypoxia (SuHx). We analyzed these disease models to determine where the vasculature shows the most severe PAH pathology and which model best recapitulates the human disease. We investigated the role vascular remodeling, hypoxia, cell proliferation, apoptosis, DNA damage and inflammation play in the pathogenesis of PAH. Neither model recapitulated all features of the human disease, however each model presented with some of the pathology seen in PAH patients.

CLINICAL CASE OF ACUTE CEREBROVASCULAR ACCIDENT IN A CHILD WITH HEREDITARY THROMBOPHILIA

2020 ◽  
Vol 99 (1) ◽  
pp. 232-236
Author(s):  
P.V. Shumilov ◽  
◽  
A.Ya. Ilyina ◽  
A.L. Mishchenko ◽  
A.S. Barinova ◽  
...  
Keyword(s):  
Cerebrovascular Accident ◽  
Clinical Case ◽  
Acute Cerebrovascular Accident ◽  
Hereditary Thrombophilia

Progressive Early Rehabilitation Program Applied to Patients with Acute Cerebrovascular Accident

2020 ◽  
Vol 25 (3) ◽  
pp. 17-25 ◽  
Author(s):  
G. R. Ramazanov ◽  
L. B. Zavaliy ◽  
L. L. Semenov ◽  
S. A. Abudeev ◽  
A. O. Ptitsyn ◽  
...  
Keyword(s):  
Cerebrovascular Accident ◽  
Lung Ventilation ◽  
Rehabilitation Program ◽  
Artificial Lung ◽  
Early Rehabilitation ◽  
Gravity Gradient ◽  
Acute Cerebrovascular Accident ◽  
Artificial Lung Ventilation ◽  
Bed Days ◽  
Severity Of The Disease

Abstract. Early rehabilitation (ER) of patients with acute cerebrovascular accident (ACA) is one of the priority tasks of the vascular centers; the issue of increasing the volume of rehabilitation measures in the resuscitation and intensive care units (ICU) is relevant. Objective. To evaluate the safety and effectiveness of the progressive ER program in patients with ACA. Material and research methods. The study included 129 patients with ACA in ICU. Each patient of the main group (MGr, n = 61) underwent progressive ER: at least 4–5 vertical adjustments per day, passive mode Kinesiotherapy 49 ± 9.3 minutes, a double load of physiotherapy exercises, preventive physiotherapy; the total time of classes reached 240 minutes per day. In the comparison group (СGr, n = 68), standard ER was performed no more than 120 minutes per day. The groups are comparable by sex, age, severity of the disease and comorbidity. The severity of ACA, the gravity gradient, patient mobility, functional status, degree of dependence, and the presence of complications were evaluated. Results. During a month of work with the MGr, 102 ICU bed-days, 94 days of the artificial lung ventilation use, p < 0.05 were saved. Mortality in MGr decreased -— 8 patients (13.1%) versus 14 (20.6%) in CGr (p < 0.05). In patients within CGr, pulmonary thromboembolism developed in 8.8%, in MGr – in 3.3%. The severity of the apoplectic attack decreased ( by 28% in MGr, and by 20% in CGr ), mobility increased. Comparing the modalities of post resuscitationsyndrome in MGr, it was noted that the score decreased by 2 times from 6 [5; 6] to 3 [2.3; 3.3], but it has not changed in the CGr. Patients in the MGr were 2-–3 days earlier adapted to the vertical adjustment. Conclusions. The progressive ER program in ICU is safe, effective, realisable, and allows reducing the number of bed-days in ICU, the number of days of the artificial lung ventilation use, complications, and mortality in comparison with standard medical care.

SOME ASPECTS OF ACUTE CEREBROVASCULAR PATHOLOGY IN POSTPARTUM WOMEN

Vestnik ◽  
2021 ◽  
pp. 51-56
Author(s):  
Д.А. Митрохин ◽  
Ж.Б. Дюсембаева ◽  
М.М. Ибрагимов ◽  
А.А. Оспанов ◽  
А.Н. Сембинова ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Postpartum Period ◽  
Cerebrovascular Accident ◽  
Hemorrhagic Stroke ◽  
Speech Disorders ◽  
Cerebral Stroke ◽  
Postpartum Women ◽  
Bioelectrical Activity ◽  
Acute Cerebrovascular Accident ◽  
Epileptiform Discharges

В данной статье, представлены результаты обследования 17 женщин, перенесших острое нарушение мозгового кровообращения в послеродовом периоде, с 2017 по 2021 годы, в возрасте от 19 до 39 лет. Показано, что у женщин в послеродовом периоде, перенесших острое нарушение мозгового кровообращения, выявлено преобладание ишемического инсульта над геморрагическим, что составило 64,7% и 35,3% соответственно. Неврологические признаки церебрального инсульта в послеродовом периоде характеризуются двигательными, речевыми расстройствами, нарушением чувствительности, а также часто психоэмоциональными проявлениями. Генерализованные тонико-клонические приступы чаще наблюдались у пациенток с геморрагическим инсультом (33,3%), в сравнении с ишемическим инсультом (9,1%). У женщин в послеродовом периоде, перенесших острое нарушение мозгового кровообращения, наиболее значимыми факторами риска являются: наличие хронических заболеваний, в том числе отягощенный акушерско-гинекологический анамнез, прием пероральных контрацептивов, а также курение. Биоэлектрическая активность головного мозга характеризовалась выраженной дельта и тета активностью, эпилептиформными разрядами в виде острых волн, спайков и комплексов «пик-волна», с преобладанием у пациенток с геморрагическим инсультом. Более значительное повышение индекса когерентности в дельта и тета диапазонах у пациентов, перенесших геморрагический инсульт, может указывать на более грубые межполушарные нарушения, в сравнении с ишемическим инсультом. Отмечено повышение интегрального индекса диапазона медленно-волновой активности и преобладание процентного отношения спектральных мощностей медленных волн (дельта, тета) к быстрым волнам (альфа, бета), особенно выраженное у больных с геморрагическим инсультом (р < 0,05), в сравнении с ишемическим инсультом. Наиболее тяжелое течение послеродового периода наблюдалось у пациенток с геморрагическим инсультом, именно в этом случае было 2 летальных исхода. This article presents the results of a survey of 17 women with acute cerebrovascular accident in the postpartum period, from 2017 to 2021, aged 19 to 39 years. It is shown that the period in women in the postpartum period, who underwent acute cerebrovascular accident, revealed the prevalence of ischemic stroke over hemorrhagic, which amounted to 64,7% and 35,3%, respectively. Neurological signs of cerebral stroke in the postpartum period are characterized by movement, speech disorders, impaired sensitivity, and often psychoemotional manifestations. Generalized tonic-clonic seizures were more often observed in patients with hemorrhagic stroke (33,3%) in comparison with ischemic stroke (9,1%). In postpartum women who have suffered acute cerebrovascular accident, the most significant risk factors are: the presence of chronic diseases, including a burdened obstetric and gynecological history, taking oral contraceptives, as well as smoking. The bioelectrical activity of the brain was characterized by pronounced delta and theta activity, epileptiform discharges in the form of sharp waves, spikes and peak-wave complexes, with a predominance in patients with hemorrhagic stroke. A more significant increase in the coherence index in the delta and theta ranges in patients after hemorrhagic stroke may indicate more severe interhemispheric disorders in comparison with ischemic stroke. An increase in the integral index of the range of slow-wave activity and a predominance of the percentage of the spectral powers of slow waves (delta, theta) to fast waves (alpha, beta), especially pronounced in patients with hemorrhagic stroke (p <0,05), in comparison with ischemic stroke. The most severe postpartum period was observed in patients with hemorrhagic stroke, in this case there were 2 deaths.

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