Respiratory sleep disorders in vehicle drivers

2016 ◽  
Vol 94 (5) ◽  
pp. 374-378
Author(s):  
Anatoliy A. Elgarov ◽  
M. A. Kalmykova ◽  
M. A. Elgarov

Aim: to determine the frequency of respiratory sleep disorders (RSD) in vehicle drivers, peculiarities of their clinical status and workability. Material and methods. The study included the main group of 106 vehicle drivers (VD) and control group of 104 of subjects of other professions. The following methods were used: fibrooptic endoscopy, standard questionnaire, pulsoxymetry, 24 hour blood pressure and ECG monitoring, psychophysiological testing of 86 VD with RSD, arterial hypertension with and without complications. Results. The clinical and instrumental signs of RSD were found in 65.1% VD of the main group and 47,1% of controls. Transitory ischemic attacks, cardiac arrhythmias and their combination occurred more frequently in VD (82.6, 59.2, and 52.2% respectively) than in controls (51.0, 44.8, and 32.6%). In most observations of VD, the smoking rate (98.1%), alcohol intake (95.3%), increased body mass (74.5%), obese (21,7%) dyslypoproteidemia (73.6%), left ventricular hypertrophy (54.7%) and arterial hypertension (57.5%) were significantly higher than in controls : S (76.9%), AI (75.0%), IBM (56.7%), O (18.3%), DLP (59.6%), LVH (41.3%), AH (39.4%). Chronic obstructive pulmonary diseases was diagnosed in 55.6% of VD and 51.9% of controls, diabetes mellitus in 34.9% and 20.2%, epidemiological forms of ischemic heart disease in 22.6% VD and 20.2% controls. Psychophysilogical testing of VD group revealed deterioration of professional qualities and functions of the drivers with respiratory sleep disorders. Conclusion. Significant frequency of RSD among VD (65.1%) in comparison with subjects of other professions (47.1%) was documented. RSD cause deterioration ofprofessional abilities of VD which increases the risk of traffic accidents.

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Yushko ◽  
S Koval ◽  
I Snihurska ◽  
O Mysnychenko

Abstract Introduction Blood pressure (BP) elevation leads to chronical increasing left ventricular (LV) overload, LV hypertrophy (LVH), impaired LV relaxation, development of LV diastolic dysfunction (DD), left atrial (LA) enlargement, which result in development of hypertension heart disease (HDD), increased risk of atrial fibrillation and heart failure. MicroRNA-133a is one the epigenetics factor, which has cardioprotective properties, but its role in the development of HHD in hypertension patients with obesity is not well understood. Purpose The aim of the study was to investigate the circulating microRNA-133a levels in patients with hypertension and obesity and to define its associations with components of HHD. Methods The study involved 82 patients with arterial hypertension grades 2–3 and obesity (44 men and 38 women) aged 43 to 70. All patients were separate in two groups: 45 patients with HHD (main group) and 37 patients without HHD (comparison group). The control group consisted of 21 practically healthy individuals of comparable gender and age. The HHD was defined as LVH in hypertension patients with/without LV DD. The LVH was determined according to the 2018 ESC/ESH guidelines. The LV DD was determined according to the 2016 ASE/EACVI recommendations. Obesity was diagnosed at body mass index ≥30 kg/m2. Circulating plasma microRNA-133a levels were obtained by polymerase chain reaction using the CFX96 Touch System, “TaqMan microRNA Assay” and “TaqMan® Universal PCR Master Mix” reagent kits. Results The levels of microRNA-133a in main group were significantly lower than in comparison group and control group (0.133 [0.099; 0.184] vs 0.238 [0.155; 0.410], p<0.05 and 0.382 [0.198; 0.474]), p<0.05). In the main group 23 patients had LV DD and 25 patients had normal LV diastolic function. In patients with LV DD the levels of circulating plasma microRNA-133a were significantly lower than in patients with normal LV diastolic function (0.094 [0.067; 0.147] vs 0.152 [0.092; 0.189]), p<0.05). In the main group there was a statistically significant negative correlation between microRNA-133a levels and LV mass index (R=−0.37, p<0.01) and no significant correlation with ejection fraction, LA size or E/e' (averaged) ratio (p>0.05). In patients of the comparison group there were not significant associations of microRNA-133a levels with LV parameters (p>0.05). Conclusion The results of the study indicate a significant role of decreased circulating plasma microRNA-133a levels in patients with arterial hypertension and obesity in the pathogenesis and development of HHD and such its components as LVH and LV DD. Funding Acknowledgement Type of funding source: None


Author(s):  
T.I. Viun ◽  
L.M. Pasieshvili ◽  
S.V. Viun ◽  
A.S. Marchenko ◽  
O.V. Karaya

The prevalence of comorbidities has been growing for the last decades. Therefore, the detection of biomarkers for diagnostic and prognostic purposes is of great practical importance. The aim of this study was to assess the biomarkers of osteo-defficiency in the course of secondary osteoporosis in patients with comorbid chronic pancreatitis and arterial hypertension. We examined 110 patients with chronic pancreatitis: 70 of them had comorbid hypertension, and 40 patients were found as having no comorbidities. The age of patients ranged from 33.2 ± 2.1 (main group) and 32.9 ± 3.1 years (comparison group); women predominated (72.9% and 70%, respectively). The control group includes 78 healthy individuals of the same age and sex. Diagnostic investigation included studying clinical and anamnestic characteristics of patients (duration of the disease, manifestations of the course, frequency of recrudescence, fractures) and biochemical parameters of bone metabolism: osteocalcin, total bone phosphatase and tartrate-resistant acid phosphatase and the establishment of correlations between these parameters and incidence of complications. It was found that in the isolated course of chronic pancreatitis there is a high (R = 0.60) statistically significant (p <0.01) correlation between the levels of osteocalcin and pancreatic elastase-1. A negative statistically significant (p <0.01) mean correlation (R = -0.49) was found between the content of tartrate-resistant acid phosphatase and age of the patients having comorbidity of chronic pancreatitis and hypertension, as well as there is a moderate correlation between the content of tartrate-resistant acid phosphatase and the duration of hypertension, which is statistically significant (R = 0.36, p <0.01). The levels of total bone phosphatase and tartrate-resistant acid phosphatase in the main group exceeded the reference values in 2.5 and 1.9 times respectively (CMU; U = 866.0; p <0.01), while in the comparison group were 2 times (total bone phosphatase) and 1.3 times higher (tartrate-resistant acid phosphatase) times, respectively (CMU; U = 821.0; p <0.01) that enables to diagnose the development of osteopenic conditions. That is, the combined course of chronic pancreatitis and hypertension should be considered as unfavourable tandem in the development of secondary osteoporosis and requires early osteoporotic screening.


2017 ◽  
Vol 23 (1) ◽  
Author(s):  
Wael Rumaneh

Arterial hypertension is an independent predictor of acute myocardial infarction. Nowadays, plasma level of high-sensitive C-reactive protein is a marker of cardiovascular risk. The objective of the research was to evaluate plasma level of high-sensitive C-reactive protein in patients with acute myocardial infarction and arterial hypertension depending on myocardial remodeling type. Materials and methods. 130 patients with myocardial infarction (63 individuals with concomitant arterial hypertension and 67 individuals without it) were observed. Transthoracic echocardiogram was used. To evaluate plasma level of high-sensitive C-reactive protein the ELISA method was applied. Results. Plasma level of high-sensitive C-reactive protein in patients with acute myocardial infarction increased by 5.11 times compared to the control group: (10.67 [5.43; 12.89]) mg/l and (2.09 [1.40; 4.60]) mg/l, respectively (p<0.001). In myocardial infarction and arterial hypertension, this parameter increased by 6.57 times (to (13.73 [7.05; 15.17]) mg/l) (p<0.001), and by 1.27 times (p<0.05) as compared to patients without arterial hypertension. No differences in plasma level of high-sensitive C-reactive protein were detected in patients with different types of left ventricular remodeling.Conclusions. Acute myocardial infarction caused by high plasma level of high-sensitive C-reactive protein is severer in co-existent arterial hypertension. There are no differences in blood levels of high-sensitive C-reactive protein depending on the type of left ventricular remodeling.


2019 ◽  
Vol 8 (2) ◽  
pp. 21-29 ◽  
Author(s):  
L. D. Khidirova ◽  
D. A. Yakhontov ◽  
S. A. Zenin

Aim. To study the clinical course of atrial fibrillation in patients with arterial hypertension and extracardiac comorbid pathology depending on the administered therapy.Methods. 207 men aged 45–65 years with atrial fibrillation (paroxysmal and persistent) and arterial hypertension in combination with diabetes mellitus (n = 40), abdominal obesity (n = 64) and chronic obstructive pulmonary disease (n = 47) were recruited to a observational cohort study. 56 patients with atrial fibrillation and arterial hypertension but without any extracardiac diseases were included in the comparison group. Clinical and anthropometric parameters were assessed in all patients. Adherence to therapy was estimated with the Morisky-Green test. All patients underwent ECG; electrocardiographic holter monitoring, 24-hour blood pressure monitoring with the Daily Monitoring Systems SCHILLER (Schiller, Switzerland), 2D and M-mode echocardiography using a Vivid 7 device (General Electric, USA). The statistical analysis was performed in the Rstudio software (version 0.99.879, RStudio, Inc., MA, USA).Results. 66% of patients with atrial fibrillation and arterial hypertension had concomitant extracardiac comorbid pathology, of them 20% of had diabetes mellitus, 22% with chronic obstructive pulmonary disease, and 24% with abdominal obesity. The clinical groups were comparable in electro impulse and drug therapy. Patients who received medical treatment were frequently admitted to hospitals for atrial fibrillation recurrence (p<0.001), compared with those who underwent electro impulse therapy. Adherence to antiarrhythmic therapy was low in the entire cohort of patients. There were no significant differences found between the clinical groups.Conclusion. Early diagnosis of the factors contributing to the progression of AF, the prescription of additional therapy for the secondary prevention of arrhythmia and the choice of its optimal treatment strategy may slow the progression of arrhythmia and the development of CHF, which will improve not only the clinical status of patients, but also their prognosis.


2019 ◽  
Vol 26 (5) ◽  
pp. 43-52
Author(s):  
V. I. Tseluyko ◽  
L. M. Yakovleva ◽  
D. A. Korchagina

The aim – to study the features of structural and functional remodeling of the left ventricle in patients suffering from arterial hypertension with concomitant hypothyroidism and to determine clinical and past medical history and laboratory factors associated with their development. Materials and methods. 50 patients suffering from hypertension with concomitant hypothyroidism were enrolled into the study. Depending on the level of thyroid stimulating hormone in the serum the examined patients were distributed into two groups of 25 patients with the compensated and 25 with decompensated course of hypothyroidism. The control group consisted of 30 patients with hypertension in which the pathology of the thyroid gland was excluded. The comparison of the main parameters of the echocardiography study of the myocardium has been performed depending on hypothyroidism compensation. Assessment of parameters of transmitral diastolic blood flow has been performed. A regression analysis has been conducted to detect the relation of clinical and past medical history factors and echocardiographic parameters with the development of diastolic dysfunction by E/A ratio. The values of central hemodynamics have been studied for evaluation of the contractile function of the myocardium. Results and discussion. According to the results of the echocardiography of both examined groups it has been found that the final systolic and stroke volume exceeded the parameters of the control group. The mean value of the left ventricle ejection fraction was statistically significantly lower than in the control group (p=0.004). The left ventricle myocardial mass in patients with hypothyroidism was statistically significantly greater than in the control group. It was proved that in patients, who were diagnosed with decompensated hypothyroidism, the mean value of the left atrium size to growth by the degree of 2.7 was statistically significantly higher than in the control group (p=0.01), whereas the average value of the ratio of the size of the left atrium to the surface area of the body had no statistically significant differences between the groups. It has been found that in both groups the proportion of patients with diastolic dysfunction in which the E/A ratio was less than 1.0 was higher than in the control group (р=0.01 and p=0.03, respectively). The independent factors of diastolic dysfunction of the left ventricle in patients with hypertension in the presence of hypothyroidism have been found. Conclusions. In the presence of decompensated hypothyroidism in patients with arterial hypertension, both with obesity and with normal body mass index, left ventricular mass indexes were significantly higher in comparison with a control group. Regardless of the compensation of the thyroid state in patients with arterial hypertension, the ejection fraction was significantly lower. According to regression analysis, independent factors for the development of diastolic dysfunction in patients with arterial hypertension and hypothyroidism with a body mass index ≥ 30 kg/m2 is the index of mass of the left ventricular myocardium, determined by the degree of 2.7, the level of total cholesterol to statistical significance – the level of office systolic blood pressure and the duration of hormone replacement therapy for hypothyroidism; with body mass index < 30 kg/m2 – age and left atrial index, determined by body surface area. For patients with arterial hypertension and reduced thyroid gland function, violation of the left ventricular myocardial relaxation is typical as evidenced by a higher proportion of patients with a decrease in E/A to less than 0.8 in these patients.


2019 ◽  
Vol 15 (5) ◽  
pp. 634-640
Author(s):  
S. Yu. Nikulina ◽  
V. A. Shulman ◽  
A. A. Chernova ◽  
S. V. Prokopenko ◽  
D. A. Nikulin ◽  
...  

Aim. To study the association of single nucleotide polymorphism rs556621 (G> T) with development of stroke in patients of the East Siberian population with cardiovascular pathology and risk factors.Material and methods. The study involved 260 patients (157 men and 103 women) with stroke (mean age 57.0 [51.0-62.0]) and 272 patients (170 men and 102 women) of the control group (mean age 55.0 [51.0-62.0]). The examination of the main group included: collection of complaints, anamnesis, clinical examination, computed tomography of the brain, electrocardiography, echocardioscopy, ultrasound duplex scanning of extracranial brachiocephalic arteries, daily blood pressure and heart rate monitoring, analysis of the blood coagulation system. The patients of the main group have arterial hypertension, paroxysmal supraventricular tachycardias, dyslipidemia, atherosclerosis of the brachiocephalic arteries, disorders of the hemostatic system. The control group was studied in the framework of the HAPIEE international project. Molecular genetic research was performed by real-time polymerase chain reaction.Results. There were no statistically significant differences in the frequencies of genotypes and single nucleotide polymorphism rs556621 alleles (G>T) in the subgroup of patients with stroke and those in the control group. The frequency of the rare TT genotype among patients with stroke was 13.3%±4.16, among healthy individuals – 8.8±3.37% (p=0.1). Gender differences when comparing the frequencies of genotypes and alleles were also not detected (p>0.05). The frequencies of the TT genotype were approximately the same in the subgroup of patients with arterial hypertension (13.1%±4.22) and in the control group (7.4±5.25%; p>0.05). No significant differences were observed in the frequencies of the rare genotype of the studied polymorphism in the subgroup of patients with supraventricular tachycardias (20.0±14.37%), hypercoagulability (15.9±7.64%) and the control group (8.8±3.37%), p>0.05. A statistically significant relationship was found between the rare genotype TT of single nucleotide polymorphism rs556621 (G>T) and the development of stroke in patients with dyslipidemia and atherosclerotic lesions of the coronary arteries (p=0.041; odds ratio 1.86, 95% confidence interval 1.02-3.41).Conclusion. The genotype of TTs of single nucleotide polymorphism rs556621 (G> T) increases the risk of developing stroke in patients with dyslipidemia and atherosclerosis of the brachiocephalic arteries compared with carriers of the GG and GT genotypes. The obtained data are recommended to be considered when prescribing lipid-lowering and antithrombotic therapy. 


2021 ◽  
Vol 12 ◽  
Author(s):  
Agnieszka Jurek ◽  
Paweł Krzesiński ◽  
Grzegorz Gielerak ◽  
Przemysław Witek ◽  
Grzegorz Zieliński ◽  
...  

BackgroundCushing’s disease is a rare condition associated with a high cardiovascular risk and hypercortisolemia-related hemodynamic dysfunction, the extent of which can be assessed with a noninvasive method, called impedance cardiography. The standard methods for hemodynamic assessment, such as echocardiography or ambulatory blood pressure monitoring may be insufficient to fully evaluate patients with Cushing’s disease; therefore, impedance cardiography is being currently considered a new modality for assessing early hemodynamic dysfunction in this patient population. The use of impedance cardiography for diagnosis and treatment of Cushing’s disease may serve as personalized noninvasive hemodynamic status assessment and provide a better insight into the pathophysiology of Cushing’s disease. The purpose of this study was to assess the hemodynamic profile of Cushing’s disease patients and compare it with that in the control group.Material and MethodsThis observational prospective clinical study aimed to compare 54 patients with Cushing’s disease (mean age 41 years; with 64.8% of this population affected with arterial hypertension) and a matched 54-person control group (mean age 45 years; with 74.1% of this population affected with arterial hypertension). The hemodynamic parameters assessed with impedance cardiography included the stroke index (SI), cardiac index (CI), systemic vascular resistance index (SVRI), velocity index (VI), (ACI), Heather index (HI), and thoracic fluid content (TFC).ResultsThe Cushing’s disease group was characterized by a higher diastolic blood pressure and a younger age than the control group (82.9 vs. 79.1 mmHg, p=0.045; and 41.1 vs. 44.9 years, p=0.035, respectively). Impedance cardiography parameters in the Cushing’s disease group showed: lower values of SI (42.1 vs. 52.8 ml/m2; p ≤ 0.0001), CI (2.99 vs. 3.64 l/min/m2; p ≤ 0,0001), VI (42.9 vs. 52.1 1/1000/s; p=0.001), ACI (68.7 vs. 80.5 1/100/s2; p=0,037), HI (13.1 vs. 15.2 Ohm/s2; p=0.033), and TFC (25.5 vs. 27.7 1/kOhm; p=0.006) and a higher SVRI (2,515 vs. 1,893 dyn*s*cm-5*m2; p ≤ 0.0001) than those in the control group.ConclusionsCushing’s disease is associated with significantly greater vasoconstriction and left ventricular systolic dysfunction. An individual assessment with impedance cardiography may be useful in Cushing’s disease patients in order to identify subclinical cardiovascular complications of chronic hypercortisolemia as potential therapeutic targets.


2008 ◽  
pp. 39-44
Author(s):  
G. E. Mironova ◽  
E. P. Vasiliev ◽  
B. T. Velichkovsky

The aim of this study was to investigate human antioxidant defense at various COPD stages and to substantiate administration of vitamins C and E as a part of complex treatment of COPD at the Far North. We followed-up 92 COPD patients aged 20 to 50 yrs (of them, 42 males). The control group consisted of 58 healthy persons of 20 to 45 yrs of age. A total blood antioxidant activity (TAA) was detected using G.I.Klebanov's method. Superoxide dismutase (SOD) and catalase levels in erythrocyte membrane were assessed with chemiluminescent methods. Lipid peroxide (LPO) activity was measured by malone dialdehyde (MDA) plasma concentration. We also investigated hepatic and renal functions, protein, lipoid, and carbohydrate metabolism. Patients with exacerbation of stage II COPD had increased LPO activity (2.97 ± 0.12 nmol/ml compared to 1.86 ± 0.09 nmol/ml in stable phase and 1.36 ± 0.06 nmol/ml in controls) with TAA increased by 40 %. The stage III COPD patients demonstrated more significant growth of LPO activity (2.04 ± 0.08 nmol/ml in stable phase and 3.44 ± 0.15 nmol/ml in exacerbation; p < 0.05) accompanied by less prominent increase in TAA. Early stages of COPD were characterized by increased levels of antioxidant enzymes (2.44 ± 0.06 μg/g of Hb for SOD and 8.30 ± 0.15 –g/g of Hb for catalase compared to 1.56 ± 0.02 and 7.36 ± 0.10 μg/g Hb in controls). At the later COPD stages, the SOD level was less high and catalase concentration even decreased. COPD patients had increased concentrations of oxyproline (1.76 ± 0.48 g/ml to 2.80 ± 0.50 μg/ml; р<0.05 for both when compared to the controls) and α1-antitripsin (for stage II COPD, 284 ± 47 μg/ml in stable phase and 240 ± 20 μg/ml in exacerbation, for stage III COPD, 245 ± 18 μg/ml and 223 ± 15 μg/ml, respectively). Administration of vitamins C and E 25 mg/kg and 5 mg/kg of body weight, respectively, as a part of a complex therapy of the disease exacerbation resulted in shortening of exacerbation, improvement in clinical status and lung function, TAA activation, and lowering of LPO activity. Therefore, COPD is accompanied by significant activation of oxidantive processes, which depend on the stage and phase of the disease. The results allow including antioxidant vitamins in programs of treatment of COPD to be recommended.


2005 ◽  
pp. 102-106
Author(s):  
A. R. Tatarsky ◽  
E. V. Sukhanova ◽  
E. V. Bobkov ◽  
A. B. Kiryukhin

The study was aimed to investigate the efficiency of long-term combined inhaled therapy with ipratropium bromide and ambroxol via compressor pneumatic nebulizer in 86 COPD patients. Significant improvement in clinical status, physical tolerance and cell content (macrophages, neutrophils) of induced sputum was revealed in all the patients in comparison with a control group. Mild to moderate COPD patients had considerable improvement in FEV1. The authors concluded that the proposed treatment had resulted in the positive effects.


Author(s):  
I. Ilienko ◽  
◽  
D. Bazyka ◽  
N. Golyarnyk ◽  
L. Zvarych ◽  
...  

Objective. to establish the connection of radiation-induced changes in gene expression with the realized pathology of the broncho-pulmonary and cardiovascular systems in Chornobyl clean-up workers. Materials and methods. We examined 314 male Chornobyl clean-up workers (main group; age (58.94 ± 6.82) years (M ± SD); min 33, max 79 years; radiation dose (411.82 ± 625.41) mSv (M ± SD); min 1.74, max 3600 mSv) with various nosological forms of cardiovascular and broncho-pulmonary pathology (BPP) and 50 subjects of the control group: age (50.50 ± 5.73) years (M ± SD); min 41, max 67 years. The relative level of BCL2, CDKN2A, CLSTN2, GSTM1, IFNG, IL1B, MCF2L, SERPINB9, STAT3, TERF1, TERF2, TERT, TNF, TP53, CCND1, CSF2, VEGFA genes expression was determined in peripheral blood leukocytes by real-time PCR (7900 HT Fast Real-Time PCR System (Applied Biosystems, USA)). The «gene-disease» association was determined on statistical models stratified separately for each disease and gene. Logistic regression was used to calculate the odds ratio. Results. Increased GSTM1 gene expression and no changes in angiogenesis-related VEGFA gene expression were found in the main group of patients with coronary heart disease (CHD). It was established overexpression of TP53, VEGF and IFNG genes in the group of patients with arterial hypertension (AH). At combination of these diseases an increase of expression of СSF2, TERF1, TERF2 genes was established. The detected changes demonstrate an activation of the antioxidative defense system in patients with CHD, while AH is associated with the expression of genes of angiogenesis and immune inflammation. It was shown an increase in the expression of genes associated with apoptosis and kinase activity (BCL2, CLSTN2, CDKN2), immune inflammation (CSF2, IL1B, TNF) in Chornobyl clean-up workers with BPP. Expression of TP53 and GSTM1 (gene, associated with the glutathione system) was significantly upregulated in the group of individuals with chronic bronchitis, whereas in patients with chronic obstructive pulmonary disease, no increase was detected; the expression of SERPINB9 and MCF2L genes was downregulated. Conclusions. Changes in the expression of genes, associated with the development of somatic pathology in the remote period after irradiation, in particular the genes of the immune response and inflammatory reactions CSF2, IFNG, IL1B, TNF; expression of genes that regulate cell proliferation, aging and apoptosis TP53, BCL2, MCF2L, CDKN2A, SERPINB9, TERF1, TERF2, TERT; genes that regulate cell adhesion and angiogenesis CLSTN2, VEGF. Key words: gene expression, somatic pathology, radiation, Chornobyl.


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