Endothelial dysfunction and inflammation in patients with non-obstructive coronary arteries

Aim To determine levels of markers for endothelial dysfunction and inflammation, endothelin-1, E-selectin, and tumor necrosis factor α (TNF-α) in patients with ischemic heart disease (IHD) and non-obstructive and obstructive coronary artery (CA) disease.Material and methods This study included 32 patients with verified IHD and non-obstructive (main group, n=19) and obstructive (comparison group, n=13) CA disease. Endothelial dysfunction was diagnosed by photoplethysmography and videocapillaroscopy. Serum concentrations of endothelin-1, E-selectin, and TNF- α were measured in all patients.Results Patients with non-obstructive CA disease showed a tendency towards more pronounced endothelial dysfunction (alternative stiffness index, 7.8 m /s [6.35; 9.08]; reflection index, 36.95 % [23.4; 52.65]; capillary density following reactive hyperemia, 54.33 cap /mm2 [48.92; 75.83]; capillary density following venous occlusion, 74.33 cap /mm2 [67.83; 93.00]) compared to the comparison group (alternative stiffness index, 9.05 m/s [7.08; 10.58]; reflection index, 28.25 % [23.35; 53.75]; capillary density following reactive hyperemia, 66.83 cap /mm2 [50.83; 78.67]; capillary density following venous occlusion, 87.0 cap /mm2 [77.58; 78.67]), although statistically significant differences were not found. Concentration of endothelin-1 was significantly higher in the IHD group with non-obstructive CA disease (0.45 ng/ml [0.28;0.65]) compared to patients with CA atherosclerotic stenosis (0.35 ng/ml [0.25; 0.38], p=0.035). Concentrations of E-selectin did not significantly differ between the groups (main group, 21.1 ng/ml [18.45; 35.03]; comparison group, 28.55 ng/ml [19.08; 35.01], p=0.29). In both groups, concentrations of TNF-α did not exceed the lower threshold of sensitivity (<2.3 pg/ml).Conclusion Endothelial dysfunction and increased endothelin-1 in patients with non-obstructive CA disease along with inflammation may additionally contribute to the pathogenesis of IHD in the absence of hemodynamically significant CA stenoses. Too low level of TNFα in both groups prevented us from using it as a diagnostic marker. Further study is needed that would include a greater number of patients and a search for alternative markers.

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Endothelin-1 inhibits endothelium-dependent vasodilatation in the human forearm: reversal by ETA receptor blockade in patients with atherosclerosis

Clinical Science ◽

10.1042/cs1020321 ◽

2002 ◽

Vol 102 (3) ◽

pp. 321-327 ◽

Cited By ~ 28

Author(s):

Felix BÖHM ◽

Gunvor AHLBORG ◽

John PERNOW

Keyword(s):

Endothelial Dysfunction ◽

Venous Occlusion ◽

Similar Degree ◽

Receptor Blockade ◽

Arterial Infusion ◽

Endothelin 1 ◽

Enhanced Expression ◽

Eta Receptor ◽

Eta Receptor Antagonist

Several cardiovascular disorders, including atherosclerosis, are associated with endothelial dysfunction and enhanced expression of endothelin-1 (ET-1). The role of ET-1 in the development of endothelial dysfunction in vivo remains unclear. The objective of the present study was to investigate the effect of elevated circulating levels of ET-1 on endothelium-dependent vasodilatation (EDV), and to test the hypothesis that ETA receptor antagonism improves EDV in patients with atherosclerosis. EDV and endothelium-independent vasodilatation were determined by brachial artery infusion of acetylcholine and sodium nitroprusside respectively during measurement of forearm blood flow (FBF) with venous occlusion plethysmography. A 60min intra-arterial infusion of ET-1 (n = 10) significantly blunted EDV in young healthy males (33±13% compared with 271±74% increase in FBF induced by 10μg/min acetylcholine; P < 0.01). Noradrenaline, which evoked a similar degree of vasoconstriction, did not attenuate EDV. In a separate set of experiments, a 60min intra-arterial infusion of the selective ETA receptor antagonist BQ123 evoked a significant increase in EDV in patients with atherosclerosis (n = 10; 109±45% compared with 255±101% increase in FBF induced by 10μg/min acetylcholine; P < 0.01), whereas no significant change was observed in healthy age-matched controls (n = 9). Endothelium-independent vasodilatation was not affected by ET-1 or BQ123. These observations demonstrate that elevated levels of ET-1 impair EDV in healthy control subjects. Furthermore, ETA receptor blockade improves EDV in patients with atherosclerosis, indicating that ET-1 attenuates EDV via an ETA-receptor-mediated mechanism.

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Impaired endothelial function irrespective of systemic inflammation or atherosclerosis in mastoscytosis

10.22541/au.160803105.55525226/v1 ◽

2020 ◽

Author(s):

Nida Oztop ◽

Pelin Karaca Özer ◽

semra demir ◽

Sengul Beyaz ◽

Tarık Tiryaki ◽

...

Keyword(s):

Endothelial Dysfunction ◽

Endothelial Function ◽

Systemic Inflammation ◽

Subclinical Atherosclerosis ◽

Elevated Serum ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Necrosis Factor Alpha ◽

Endothelin 1 ◽

Tnf Α

Background: Knowledge on endothelial dysfunction and its relation to atherosclerosis in mastocytosis is limited. Aim: To investigate the endothelial function in mastocytosis by flow mediated dilatation (FMD) and biomarkers related to vascular endothelia, the presence of subclinical atherosclerosis by carotid intima media thickness (CIMT). Method: Forty-nine patients with mastocytosis and 25 healthy controls (HCs) were included. FMD and CIMT during transthoracic echocardiography, biomarkers including endocan, endothelin-1 (ET-1), vascular endothelial growth factor (VEGF) were measured in sera of participants. Tumor necrosis factor-alpha (TNF-α), interleukine-6 (IL-6) and high sensitive c-reactive protein (hsCRP) were determined as inflammatory biomarkers. Result: The mean FMD% was lower in the patients than HCs (11.26±5.85% vs 17.84±5.27% p<0.001) and was the lowest in the advSM and SSM group among the patients (p=0.03). The median value of VEGF was significantly higher in patients than HCs. [73.30 pg/mL; min-max (32.46-295.29) pg/mL vs (46.64 pg/mL; min-max 11.09-99.86 pg/mL; p:0.001] and it was the highest in the advSM and SSM group (p:0.01). FMD was inversely correlated with endocan (r:-.390, p:0.006), ET-1 (r:-.363, p:0.01) and VEGF (r:-.402, p:0.004) but there were no correlations between FMD and TNF-α, IL-6, and hsCRP. No differences in CIMT values between patients and HCs and no correlation between CIMT and the biomarkers were observed. Conclusion: Endothelial dysfunction in mastocytosis becomes evident with decreased FMD and elevated serum VEGF, in the absence of atherosclerosis or systemic inflammation and is related to disease severity. Keywords: CIMT, Endocan, Endothelial function, Endothelin-1, FMD, VEGF

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E-Selectin as a Marker of Endothelial Dysfunction in Patients with Coronary Artery Disease Including Those with Type 2 Diabetes Mellitus

Kardiologiia ◽

10.18087/cardio.2020.4.n1066 ◽

2020 ◽

Vol 60 (4) ◽

pp. 24-30

Author(s):

A. V. Zhito ◽

A. O. Iusupova ◽

M. V. Kozhevnikova ◽

A. A. Shchendrygina ◽

E. V. Privalova ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Endothelial Dysfunction ◽

Comprehensive Evaluation ◽

Functional Condition ◽

Capillary Density ◽

Venous Occlusion ◽

Type 2 Dm

Aim To determine concentration of the endothelial dysfunction (ED) marker, serum E-selectine, in patients with ischemic heart disease (IHD) in combination with type 2 diabetes mellitus (DM) and without DM.Material and methods The study included 60 IHD patients; 31 of them also had type 2 DM. E-selectin was measured in blood of all patients. In addition, a comprehensive evaluation of the morpho-functional condition of large blood vessels and microvasculature (MV) was performed by laser finger plethysmography (LFP) and nailfold computed videocapillaroscopy (CVC).Results Concentration of E-selectin was increased in IHD patients with type 2 DM (35.2 [29.0; 47.35] ng / ml vs. 31.7 [20.85; 36.68] ng / ml for IHD patients; p=0.028). A significant (p=0.018 and 0.016, respectively) decrease in the phase shift was observed in IHD patients with type 2 DM ( – 4.4 [ – 8.7; – 2.45] ms) compared to IHD patients ( – 1.9 [ – 3.95; – 0.38] ms). The capillary density evaluated in the venous occlusion test was reduced in IHD patients with type 2 DM (67.70 [57.83; 80.69]) compared to IHD patients (80.80 [69.05; 99.08]).Conclusion The signs of ED observed in patients of both groups were more pronounced in IHD patients with type 2 DM.

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BIOCHEMICAL MARKERS OF ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH ACUTE INFLAMMATORY DISEASES OF THE ORGANISM OF THE PELVIC ORGANS AGAINST THE BACKGROUND OF DIFFERENT TREATMENT OPTIONS

V F Snegirev Archives of Obstetrics and Gynecology ◽

10.18821/2313-8726-2019-6-1-27-31 ◽

2019 ◽

Vol 6 (1) ◽

pp. 27-31

Author(s):

Natalia A. Burova ◽

S. V Serdyukov ◽

K. A Sadovskaya ◽

N. A Zharkin

Keyword(s):

Endothelial Dysfunction ◽

Inflammatory Diseases ◽

Early Period ◽

Main Group ◽

Reproductive Age ◽

Enzyme Linked Immunosorbent Assay ◽

Endothelin 1 ◽

Pelvic Organs ◽

Healthy Women ◽

Vasomotor Function

Inflammatory diseases of the pelvic organs (IDPO) remain one of the most pressing and debatable problems of modern gynecology. Currently, IDPO acquired an erased course due to immune and vascular changes at the local and systemic level, leading to endothelial dysfunction, which, in the absence of acomprehensive, step-by-step treatment, causes chronicity and disrupts the fertility of women. We examined 184 patients with acute episodes of IDPO divided into 2 groups: the main group included 94 patients and the comparison group consisted of 90 patients. All patients started comprehensive drug anti-inflammatory therapy. Patients of the main group additionally received a vaginal laser-magnetopuncture from the 2nd to the 7th day of treatment. To assess the state of endothelial function, the enzyme-linked immunosorbent assay (ELISA) in the serum was used to determine the level of a metabolite of nitric oxide (NO) iNOS - inhibited endothelial NO synthase and endothelin-1. Similar markers were determined in the blood serum of 20 healthy women volunteers of the reproductive age. As a result of the study, in the acute phase of inflammation there was found an increase in both the vasodilator NO and the vasoconstrictor - endothelin-1, which was 2.5 times higher than in healthy women, which confirms the presence of endothelial dysfunction in IDPO patients, which cannot be stopped when carrying out traditional therapy. The use of improved complex treatment with the inclusion of preformed exposure factors contributed to the reduction in the production of NO and endothelin-1, the normalization of epithelial cells and the restoration of the vasomotor function of the endothelium. The use of laser-magnetic vaginal exposure in the early period of treatment and rehabilitation of IDPO patients may help prevent chronic inflammation and normalize the specific functions of the female body.

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Clinical and immunological efficiency of dry carbon dioxide baths in patients with asthma and obesity at the ambulatory-polyclinic stage of rehabilitation

Bulletin physiology and pathology of respiration ◽

10.36604/1998-5029-2021-80-34-41 ◽

2021 ◽

pp. 34-41

Author(s):

A. A. Uksumenko ◽

M. V. Аntonyuk ◽

E. E. Мineeva ◽

A. V. Yurenko ◽

K. K. Khodosova

Keyword(s):

Carbon Dioxide ◽

Drug Therapy ◽

Cellular Immunity ◽

Inflammatory Cytokine ◽

Comparison Group ◽

Co2 Concentration ◽

Main Group ◽

Medical Rehabilitation ◽

Rehabilitation Treatment ◽

Tnf Α

Introduction. An important part in the rehabilitation treatment of patients with asthma associated with obesity is the ambulatory-polyclinic stage of rehabilitation that includes drug and physiotherapeutic treatment. Recently, dry carbon dioxide baths (DCDB) are increasingly used.Aim. is to assess the clinical and immunological efficiency of DCDB in the complex rehabilitation treatment of patients with asthma and obesity at the ambulatory-polyclinic stage of rehabilitation.Materials and methods. The study included 60 patients with asthma and obesity admitted to the departments of medical rehabilitation and clinical examination of scientists of the Medical Association of FEB RAS. Patients of the main group (30 subjects) received DCDB and drug therapy. Patients of the comparison group (30 subjects) received only drug therapy. The DCDB procedures were carried out using the “Reabox” device at CO2 concentration of 15-20%, a temperature of 28-30ºC, 10 procedures. The changes in symptoms, ACQ-5 test, and respiratory function were assessed. The parameters of cellular immunity CD3+, CD4+, CD8+, CD16+, CD19+ and the levels of tumor necrosis factor (TNFα), interleukins (IL) IL-2, IL-4, IL-6, IL-10, IL-17A in the blood were analyzed.Results. The achievement of asthma control took less time in patients of the main group. The improvement of bronchial patency was evidenced by the positive dynamics of spirometric indices. After DCDB therapy, an increase in suppressive activity of the cellular immunity, a decrease in the levels of pro-inflammatory cytokine IL-4, IL-17A were revealed. The TNF-α/IL-10 ratio statistically significantly changed due to the increase in the level of anti-inflammatory cytokine IL-10. In the comparison group, the positive dynamics was less pronounced.Conclusion. The use of DCDB increases the clinical and immunological efficiency of the rehabilitation of patients with asthma and obesity at the ambulatory-polyclinic stage. The clinical effect is associated with immunocorrective action, which allows achieving control of the disease in a shorter period of time.

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The endothelin-1 receptor antagonist bosentan protects against ischaemia/reperfusion-induced endothelial dysfunction in humans

Clinical Science ◽

10.1042/cs20040317 ◽

2005 ◽

Vol 108 (4) ◽

pp. 357-363 ◽

Cited By ~ 17

Author(s):

Felix BÖHM ◽

Magnus SETTERGREN ◽

Adrian T. GONON ◽

John PERNOW

Keyword(s):

Endothelial Dysfunction ◽

Oral Administration ◽

Receptor Antagonist ◽

Reperfusion Injury ◽

Venous Occlusion ◽

Ischaemia Reperfusion Injury ◽

Endothelin 1 ◽

Ischaemia Reperfusion ◽

Etb Receptor

Endothelial dysfunction may contribute to the extent of ischaemia/reperfusion injury. ET (endothelin)-1 receptor antagonism protects against myocardial ischaemia/reperfusion injury in animal models. The present study investigated whether oral administration of an ETA/ETB receptor antagonist protects against ischaemia/reperfusion-induced endothelial dysfunction in humans. FBF (forearm blood flow) was measured with venous occlusion plethysmography in 13 healthy male subjects. Forearm ischaemia was induced for 20 min followed by 60 min of reperfusion. Using a cross-over protocol, the subjects were randomized to oral administration of 500 mg of bosentan or placebo 2 h before ischaemia. Endothelium-dependent and -independent vasodilatation were determined by intra-brachial infusion of acetylcholine (1–10 μg/min) and nitroprusside (0.3–3 μg/min) respectively, before and after ischaemia. Compared with pre-ischaemia, the endothelium-dependent increase in FBF was significantly impaired at 15 and 30 min of reperfusion when the subjects received placebo (P<0.01). When the subjects received bosentan, the endothelium-dependent increase in FBF was not affected by ischaemia/reperfusion. Endothelium-independent vasodilatation was not affected during reperfusion compared with pre-ischaemia. The vaso-constrictor response induced by intra-arterial infusion of ET-1 was attenuated significantly by bosentan (P<0.001). The results suggest that the dual ETA/ETB receptor antagonist bosentan attenuates ischaemia/reperfusion-induced endothelial dysfunction in humans in vivo. Bosentan may thus be a feasible therapeutic agent in the treatment of ischaemia/reperfusion injury in humans.

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A relation of the indices of systemic inflammation and endothelial dysfunction in patients with chronic pyelonephritis and arterial hypertension

Bukovinian Medical Herald ◽

10.24061/2413-0737.xvii.1.65.2013.15 ◽

2013 ◽

Vol 17 (1 (65)) ◽

pp. 59-63

Author(s):

O. R. Luchko

Keyword(s):

Glomerular Filtration Rate ◽

Endothelial Dysfunction ◽

Arterial Hypertension ◽

Glomerular Filtration ◽

Systemic Inflammation ◽

Filtration Rate ◽

Chronic Pyelonephritis ◽

Stiffness Index ◽

Soluble Cell ◽

Tnf Α

The dynamics of the indicators of systemic inflammation (C-reactive protein - CRP, tumor necrosis factoralpha – TNF-α, IL-1 – IL-1, IL-6 – IL-6, soluble cell-cell adhesion molecule – sICAM-1) and endothelial dysfunction (pulse blood pressure – PBP, aortic stiffness index – ASI, the thickness of intima-media complex – TIMC, the velocity of the pulse wave propagation – VPWP, CAVI, endothelium dependent vasodilatation – EDVD and endothelium independent vasodilatation – EIVD, endothelin-1 – ET-1) in 105 patients with chronic pyelonephritis (CPN) and arterial hypertension (AH), depending on the glomerular filtration rate (GFR). 91 (86,67 %) patients have demonstrated the signs of a systemic inflammation which intensify with decreased GFR <90 ml/min. Reduced resilient- elastic properties of the arteries with increased ASI, VPW, CAVI, the levels of endothelinemia and a decrease of EDVD and EIVD was noted in 87 (82,86 %) patients with CPN and AH. The authors have observed a correlation between the indicators of the systemic inflammatory response (CRP, TNF-α, IL-1β, IL-6, sICAM-1) and the markers of the endothelial dysfunction (EDVD, EIVD, CAVI) in the group mentioned above which increases with a decrease of the glomerular filtration rate which should be considered, when treating such patients.

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Abstract P061: Effects of Black Tea With and Without a Fat Load on Vascular Function in Mildly Hypertensive Subjects

Circulation ◽

10.1161/circ.125.suppl_10.ap061 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Davide Grassi ◽

Richard Draijer ◽

Giovambattista Desideri ◽

Theo Mulder ◽

Claudio Ferri

Keyword(s):

Blood Pressure ◽

Endothelial Dysfunction ◽

Endothelial Function ◽

Vascular Function ◽

Black Tea ◽

Stiffness Index ◽

Maximal Response ◽

Tea Consumption ◽

Double Blind ◽

Reflection Index

Introduction: Endothelial dysfunction is an early biomarker for the development of cardiovascular disease and a predictor of future cardiovascular events. A number of intervention studies in healthy and diseased subjects have reported that endothelial function, as assessed by flow-mediated vasodilation (FMD), is positively affected by black tea consumption. On the other hand, high calorie fatty meals are detrimental to endothelial function. Hypothesis: To assess the effect of black tea with and without a fat load on FMD, digital volume pulse (DVP) and office blood pressure (BP) in never treated grade 1 hypertensive subjects without additional cardiovascular risk factors. Methods: According to a randomized, double-blind, controlled, cross-over design, 19 grade 1 hypertensives were assigned to consume black tea, containing 150 mg polyphenols or a placebo drink matched for caffeine, color and taste, twice a day for eight days, with a wash-out period in between of 13 days. On day 7 all measurements were performed in a fasted state, while on day 8 subjects consumed ultra-heat-treated whipping cream (1 gram fat per kg bodyweight) 30 minutes after consuming the test products. FMD, DVP and BP were measured at baseline and 1, 2, 3 and 4 hours after consumption of the test products. Results: Baseline FMD improved after 1-week tea consumption when compared to placebo (p<0.0001). An additional cup of tea further increased FMD at 1, 2, 3 and 4 hours after consumption when compared to baseline with maximal response 2 hours after intake (p<0.0001). Fat challenge significantly decreased FMD (p<0.0001), which was counteracted by tea consumption. Tea improved reflection index (small vessel tone; p<0.0001) and stiffness index (large arterial stiffness; p<0.0001) with additional effects after acute tea consumption with and without fat load. Further, tea decreased systolic and diastolic BP with and without a fat load (all p<0.0001). Conclusions: We demonstrate for the first time that moderate consumption of black tea protects against oral fat load-induced endothelial dysfunction in hypertensive but otherwise healthy subjects. The vascular benefits of tea are also reflected in improved endothelial function and peripheral arterial hemodynamics as well as blood pressure lowering under fasted and postprandial conditions. Our findings are of clinical relevance and interest, considering that the ingestion of the main daily meal has been suggested to be a trigger for acute myocardial infarction.

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P1012NAIL CAPILLARY DENSITY DURING POSTOCCLUSIVE REACTIVE HYPEREMIA AND VENOUS CONGESTION IS MORE IMPAIRED IN DIABETIC COMPARED TO NON-DIABETIC CKD PATIENTS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1012 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Maria Schoina ◽

Charalampos Loutradis ◽

Evangelos Memmos ◽

Eva Triantafillidou ◽

Eleni Pagkopoulou ◽

...

Keyword(s):

Reactive Hyperemia ◽

Arterial Occlusion ◽

Capillary Density ◽

Venous Occlusion ◽

Venous Congestion ◽

Diabetic Patients ◽

Ckd Stage ◽

Microcirculatory Function ◽

Capillary Circulation ◽

Postocclusive Reactive Hyperemia

Abstract Background and Aims Αlterations in endothelial function and capillary circulation have been associated with increased cardiovascular events and overall mortality. Both diabetes mellitus (DM) and chronic kidney disease (CKD) have been associated with microcirculatory damage. Nailfold video-capillaroscory can provide a thorough assessment of capillary density and microcirculation changes. This is the first study examining in comparison microcirculatory function parameters in diabetic and non-diabetic patients with CKD. Method We included 48 diabetic and 48 non-diabetic adult patients (>18 years) with CKD (eGFR: <90 and ≥15mL/min/1.73m2), matched in a 1:1 ratio for age, sex and eGFR within each CKD stage (2, 3a, 3b and 4). All participants underwent nailfold video-capillaroscopy, during which capillary density was measured at normal conditions (baseline), after a 4-minute arterial occlusion (postocclusive reactive hyperemia) and at the end of a 2-minute venous occlusion (congestion phase). Results Baseline demographic, anthropometric and laboratory characteristics were similar between patients with and without diabetes in total and in CKD stages. Overall, no significant differences at baseline capillary density were observed between groups; however diabetic patients presented significantly lower capillary density during reactive hyperemia (36.3±3.8 vs 38.3±4.3 capillaries/mm2, p=0.022) and at venous congestion (37.8±4.0 vs 39.8±4.2 capillaries/mm2, p=0.015). When stratified according to CKD stages, the between-group differences in parameters of interest were not significant in stages 2, 3a and 4. In stage 3b, capillary density was significantly lower in diabetic compared to non-diabetic subjects at baseline (31.1±2.8 vs 33.4±3.4 capillaries/mm2, p=0.044), during postocclusive hyperemia (36.8±2.7 vs 40.0±4.3 capillaries/mm2, p=0.037) and venous congestion (38.3±2.8 vs 41.5±3.5 capillaries/mm2, p=0.022). Conclusion Capillary density during postocclusive reactive hyperemia and after venous congestion is lower in diabetic compared to non-diabetic CKD patients, a finding indicative that diabetes is an additional factor contributing to microcirculatory functional impairment in CKD. These differences are more prominent in CKD stage 3b, and less prominent in earlier and later stages.

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Vascular Remodeling Markers in Patients with Essential Arterial Hypertension Depending on Presence of Type 2 Diabetes Mellitus

Rational Pharmacotherapy in Cardiology ◽

10.20996/1819-6446-2019-15-3-328-334 ◽

2019 ◽

Vol 15 (3) ◽

pp. 328-334

Author(s):

Yu. A. Danilogorskaya ◽

E. A. Zheleznykh ◽

E. A. Privalova ◽

Yu. N. Belenkov ◽

A. A. Shchendrigina ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Vascular Remodeling ◽

Reactive Hyperemia ◽

Venous Occlusion ◽

Capillary Network ◽

Stiffness Index ◽

Hypertensive Patients

Aim. To study some vascular remodeling markers in hypertensive patients depending on the presence of type 2 diabetes mellitus.Material and methods. The study included patients with essential hypertension 1-2 degrees of increase in blood pressure with/without type 2 diabetes (30 and 32 patients respectively). Using photoplethysmography in combination with reactive hyperemia test structural and functional markers of vascular remodeling were determined: in large vessels – stiffness index and phase shift; in microvessels – reflection index and the occlusion index. Using the computer video capillaroscopy of the nail bed the density of the capillary network at rest, after venous occlusion and after the test with reactive hyperemia was determined. ELISA was used for determining the level of humoral markers of endothelium dysfunction and vascular bed remodeling: metalloproteinase 9, metalloproteinase 9 inhibitor, E-selectin, endothelin, transforming growth factor (TGF-β1), endothelial growthfactor A.Results. In compare with hypertensive patients in hypertensive patients with type 2 diabetes significantly higher stiffness index values (11.15 [10.05; 12.35] vs 10.15 [8.83; 11.83] m/s; p=0.04) were found as well as significantly lower (p=0.00) capillary network density at rest (26.4 [24.2; 27.6] vs 35.1 [33.0; 45.0] cap/mm2; p=0.00) after the tests with reactive hyperemia (29 [24; 33.3] vs 40.0 [35.0;43.3] cap/mm2; p=0.00) and venous occlusion (32.5 [27.8; 34.5] vs 40.0 [33.0; 45.0] cap/mm2). In hypertensive patients with type 2 diabetes significantly higher levels of TFG-β1 (11648 [4117.8; 37933.8] vs 3938.5 [1808.8; 7694] pg/ml; p=0.00) and significantly lower levels of endothelin-1 (0,46 [0,29;1,3] vs 1.73 [0.63; 2.30] ng/ml; p=0.01) was detected in compare with hypertensive patients without type 2 diabetes.Conclusion. In both groups some signs of vascular remodeling were found at the level of both large arteries and microvessels (arterioles and capillaries). However, the group of hypertension + type 2 diabetes mellitus had statistically significantly more pronounced changes in arterial stiffness, capillary network density, as well as humoral markers levels of fibrosis and endothelial dysfunction.

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