FUNCTIONAL AND INSTRUMENTAL EXAMINATION OF ELDERLY PATIENTS WITH CARDIOVASCULAR PATHOLOGY

2021 ◽  
pp. 134-138
Author(s):  
Михаил Олегович Паршин ◽  
Антон Александрович Титов ◽  
Татьяна Игоревна Субботина ◽  
Борис Дмитриевич Жидких ◽  
Елена Ефимовна Атлас
Keyword(s):  
Heart Failure ◽  
Cardiovascular Diseases ◽  
Chronic Heart Failure ◽  
Elderly Patients ◽  
Arterial Hypertension ◽  
The Elderly ◽  
Functional Study ◽  
Economic Damage ◽  
Control Group ◽  
Cardiovascular Pathology

Сердечно-сосудистые заболевания в пожилом возрасте представляют актуальную проблему многих стран и на протяжении ряда последних десятилетий выступают ведущей причиной преждевременной смерти, нанося значительный экономический ущерб обществу и здравоохранению. Сердечно-сосудистые заболевания и, в частности, хроническая сердечная недостаточность в сочетании с артериальной гипертензией у пожилых встречаются часто, и такая тенденция сохранится и в ближайшие годы. Рассматриваемая патология у пожилых протекает нередко атипично и поэтому выявление ее требует комплексного функционального и инструментального обследования пациентов. Цель исследования - анализ и совершенствование функционального и инструментального обследования пожилых пациентов с сердечно-сосудистой патологией. Диагностическое обследование 86 пациентов 60-74 лет включало функциональное изучение интерлейкинового статуса и эхокардиографию при наличии хронической сердечной недостаточности и артериальной гипертензии. Диагноз хронической сердечной недостаточности устанавливался с учетом критериев NYHA и в соответствии с Рекомендациями Европейского общества кардиологов по диагностике и лечению острой и хронической сердечной недостаточности. Артериальная гипертензия верифицировалась в соответствии с «Национальными рекомендациями по диагностике, профилактике и лечению артериальной гипертензии». Контрольную группу составили 42 пациента пожилого возраста с отсутствием вышеназванных сердечно-сосудистых заболеваний. В ходе исследования установлено, что развитие сочетанной сердечно-сосудистой патологии сопровождается статистически значимым изменением ряда параметров инструментального (эхокардиографического) обследования. Одновременно при развитии сердечно-сосудистой патологии наблюдались изменения в системном интерлейкиновом профиле пациентов пожилого возраста. Они сопровождались преимущественно увеличением содержания в сыворотке крови провоспалительных интерлейкинов и особенно IL-8 до 48,6±2,5 пг/мл против 6,1±1,3 нг/мл в контрольной группе и IL-1β до 78,6±1,9 нг/мл против 13,5±1,0 пг/мл. Вместе с тем наблюдалось у пожилых пациентов с сердечно-сосудистой патологией снижение противовоспалительных интерлейкинов IL-4 и IL-10. Полученные результаты свидетельствуют о важности комплексного обследования пациентов с сердечно-сосудистой патологией Cardiovascular diseases in old age are an urgent problem in many countries and over the past few decades have been the leading cause of premature death, causing significant economic damage to society and public health. Cardiovascular diseases and, in particular, chronic heart failure in combination with arterial hypertension in the elderly are common and this trend will continue in the coming years. The pathology under consideration in the elderly is often isolated, and therefore its detection requires a comprehensive functional and instrumental examination of patients. The aim of the study was to analyze and improve the functional and instrumental examination of elderly patients with cardiovascular pathology. Diagnostic examination of 86 patients aged 60-74 years included functional study of interleukin status and echocardiography in the presence of chronic heart failure and arterial hypertension. The diagnosis of chronic heart failure was established taking into account the NYHA criteria and in accordance with the Recommendations of the European Society of Cardiology for the Diagnosis and Treatment of Acute and Chronic Heart Failure. Arterial hypertension was verified in accordance with the"National guidelines for the diagnosis, prevention and treatment of arterial hypertension". The control group consisted of 42 elderly patients with the absence of the above-mentioned cardiovascular diseases. The study found that the development of combined cardiovascular pathology is accompanied by a statistically significant change in a number of parameters of the instrumental (echocardiographic) examination. At the same time, changes in the systemic interleukin profile of elderly patients were observed with the development of cardiovascular pathology. They were accompanied mainly by an increase in the serum content of proinflammatory interleukins and especially IL-8 to 48.6±2.5 pg / ml versus 6.1±1.3 ng/ml in the control group and IL-1β to 78.6±1.9 ng/ml versus 13.5±1.0 pg / ml. At the same time, a decrease in anti-inflammatory interleukins IL-4 and IL-10 was observed in elderly patients with cardiovascular pathology. The results obtained indicate the importance of a comprehensive examination of patients with cardiovascular pathology

scholarly journals The modern treatment of cardiovascular diseases with b-blockers - focus on the nebivolol.

2009 ◽  
Vol 6 (4) ◽  
pp. 20-25
Author(s):  
Anna Grigor'evna Evdokimova ◽  
Valeriy Aleksandrovich Ol'khin ◽  
Vladimir Vyacheslavovich Evdokimov ◽  
Ekaterina Viktorovna Zolotareva ◽  
Alla Blalovna Khadzegova
Keyword(s):  
Nitric Oxide ◽  
Heart Failure ◽  
Cardiovascular Diseases ◽  
Chronic Heart Failure ◽  
Arterial Hypertension ◽  
First Line ◽  
Modern Treatment

Unlike first-line antihypertensives, nebivolol, a cardioselective b-blocker with vasodilatatory properties caused by its ability to modulate the activity of nitric oxide, positively affects prognosis in patients with arterial hypertension and chronic heart failure and shows metabolic neutrality. The clinical and pathogenetic studies demonstrating the benefits of nebivolol are discussed. Keywords: nebivolol, arterial hypertension, b-blockers.

scholarly journals A modern view of the place of b-blockers in the treatmentof cardiovascular disease: the choice of drug within a class is crucial

2015 ◽  
Vol 12 (4) ◽  
pp. 69-74
Author(s):  
O D Ostroumova ◽  
V M Fomina ◽  
E A Smolyarchuk
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Diseases ◽  
Chronic Heart Failure ◽  
Arterial Hypertension ◽  
Clinical Studies ◽  
Metoprolol Succinate ◽  
Selection Of

In the article discusses questions of application of b-blockers (b-AB) for the treatment of arterial hypertension, coronary heart disease, chronic heart failure. The data from modern Russian and European recommendations about the place of b-AB in the treatment of cardiovascular diseases. Analyzed in detail the selection of b-AB inside the class from the standpoint of pharmacokinetics, selectivity, study in clinical studies. Data about efficiency and safety of application of metoprolol succinate for the treatment of arterial hypertension, coronary heart disease, chronic heart failure.

scholarly journals The Correlation between Gut Microbiota and Serum Metabolomic in Elderly Patients with Chronic Heart Failure

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Zhenhua Wang ◽  
Zhaoling Cai ◽  
Markus W. Ferrari ◽  
Yilong Liu ◽  
Chengyi Li ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Gut Microbiota ◽  
Elderly Patients ◽  
16S Rdna ◽  
Healthy Subjects ◽  
The Elderly ◽  
Inflammatory Factors ◽  
16S Rdna Sequencing ◽  
Rdna Sequencing

Objective. Chronic heart failure (CHF) refers to a state of persistent heart failure that can be stable, deteriorated, or decompensated. The mechanism and pathogenesis of myocardial remodeling remain unknown. Based on 16S rDNA sequencing and metabolomics technology, this study analyzed the gut microbiota and serum metabolome in elderly patients with CHF to provide new insights into the microbiota and metabolic phenotypes of CHF. Methods. Blood and fecal samples were collected from 25 elderly patients with CHF and 25 healthy subjects. The expression of inflammatory factors in blood was detected by ELISA. 16S rDNA sequencing was used to analyze the changes in microorganisms in the samples. The changes of small molecular metabolites in serum samples were analyzed by LC-MS/MS. Spearman correlation coefficients were used to analyze the correlation between gut microbiota and serum metabolites. Results. Our results showed that the IL-6, IL-8, and TNF-α levels were significantly increased, and the IL-10 level was significantly decreased in the elderly patients with CHF compared with the healthy subjects. The diversity of the gut microbiota was decreased in the elderly patients with CHF. Moreover, Escherichia Shigella was negatively correlated with biocytin and RIBOFLAVIN. Haemophilus was negatively correlated with alpha-lactose, cellobiose, isomaltose, lactose, melibiose, sucrose, trehalose, and turanose. Klebsiella was positively correlated with bilirubin and ethylsalicylate. Klebsiella was negatively correlated with citramalate, hexanoylcarnitine, inosine, isovalerylcarnitine, methylmalonate, and riboflavin. Conclusion. The gut microbiota is simplified by the disease, and serum small-molecule metabolites evidently change in elderly patients with CHF. Serum and fecal biomarkers could be used for elderly patients with CHF screening.

scholarly journals Effects of enteral nutrition on heart function, inflammatory markers and immune function in elderly patients with chronic heart failure

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Dan Zhang ◽  
Hongli Li ◽  
Xiang Tian ◽  
Sujuan Zhang
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Enteral Nutrition ◽  
Elderly Patients ◽  
Immune Function ◽  
Inflammatory Markers ◽  
Heart Function ◽  
Inflammatory Factors ◽  
Control Group ◽  
Experimental Group

Objectives: To evaluate the effect of enteral nutrition on heart function, inflammatory markers and immune function in elderly patients with chronic heart failure and its clinical significance. Methods: Eighty patients with moderate and severe heart failure admitted to the Cardiology Intensive Care Unit (CCU) of Baoding First Central Hospital from May 2019 to May 2020 were included in this study and randomly divided into two groups: the experimental group and the control group, with 40 patients in each group. The experimental group was given enteral nutrition support therapy on the basis of conventional therapy for one month, while the control group was given restricted salt and water intake on the basis of conventional therapy, and patients were given free diet according to their wishes. The changes in heart function before and after treatment, changes in inflammatory factors such as TNF-a, CRP, IL-6, changes in levels of immunoglobulins such as IgA, IgM, and IgG, and the improvement of the performance status of the two groups were compared and analyzed. Results: After treatment, indicators such as BNP, LVEDD, LVEF and 6min walking distance in the experimental group were significantly improved compared with the control group, with statistically significant differences (p<0.05), and the levels of inflammatory factors such as TNF-a, CRP and IL-6 in the experimental group were significantly reduced compared with those in the control group (p=0.00). The levels of IgG, IgA, IgM and other immunoglobulins in the experimental group improved more significantly after treatment than those in the control group, with statistically significant differences (IgG, IgA, p=0.00; IgM, p=0.01). Moreover, the experimental group was significantly superior to the control group in the improvement rate of performance status score (ECOG) after treatment (p=0.04); The incidence of gastrointestinal adverse reactions in the experimental group was 20%, and that in the control group was 15%. No statistically significant difference can be observed in the gastrointestinal tolerance of both groups (p=0.56). Conclusions: Reasonable enteral nutrition boasts a variety of benefits for the recovery of elderly patients with chronic heart failure. With reasonable enteral nutrition, the heart function of elderly patients with chronic heart failure can be significantly improved, inflammatory factors can be reduced, immunity and performance status can be enhanced, and gastrointestinal tolerance can be ameliorated without obvious gastrointestinal reactions. doi: https://doi.org/10.12669/pjms.38.1.4451 How to cite this:Zhang D, Li H, Tian X, Zhang S. Effects of enteral nutrition on heart function, inflammatory markers and immune function in elderly patients with chronic heart failure. Pak J Med Sci. 2022;38(1):---------.  doi: https://doi.org/10.12669/pjms.38.1.4451 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

THE NEW GENETIC ASPECTS OF ATRIAL FIBRILLATION IN PERSONS OF THE RUSSIAN POPULATION

2020 ◽  
pp. 27-33
Author(s):  
Aksyutina N.V. ◽  
Shulman V.A. ◽  
Aldanova E.E. ◽  
Nikulina S.Yu. ◽  
Mordovskii V.S. ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Chronic Heart Failure ◽  
Molecular Genetic ◽  
Genetic Research ◽  
Heart Rhythm ◽  
Control Group ◽  
Atrial Remodeling ◽  
Cardiovascular Pathology ◽  
Heart Rhythm Disorders

Atrial fibrillation (AF) is one of the most common and dangerous heart rhythm disorders. Lone AF is due to a genetic predisposition. Foreign studies have proven the association of rs2200733 polymorphism of chromosome 4q25 with AF. No such studies have been conducted in the Russian Federation. Purpose of the study: to determine the association of the rs2200733 polymorphism of chromosome 4q25 with the development of AF, and to exclude the possible connection of the studied polymorphic marker with concomitant cardiovascular pathology. A total of 247 patients with AF were examined (113 from lone AF, 134 from secondary). Control group - 182 healthy people. Behavior: ECG, EchoCG, Holter ECG monitoring, blood test for thyroid hormones, VEM, CAG, molecular genetic research. In the group of patients with AF, the TT genotype was detected in 12.95%, which is statistically significant more often than in the control group (4.94%), p<0.05. In the presence of a genotype with a rare T allele, the risk of developing AF increases by 1.5 times. The TT genotype was statistically significant more often in the subgroup of patients with isolated AF (17.70%) in comparison with the control group (4.94%), p<0.05. The risk of developing isolated AF in the presence of a genotype with a rare allele T is 1.8 times increased. Chronic heart failure, no statistically significant differences were found (p>0.05). In patients with the TT genotype, the mean LA size was 3.738 ± 0.494 cm, it was statistically significantly smaller than in patients with the CC genotype, which corresponded to 3.925 ± 0.629 cm, p<0.05; and than in individuals with a heterozygous CT genotype, its value in this subgroup is 4.018 ± 0.639 cm, p<0.05. Conclusions: Homozygous genotype for the rare TT allele and the T allele of the rs2200733 polymorphism of chromosome 4q25 are predictors of lone AF. The rs2200733 polymorphism has no association with any cardiovascular pathology, such as hypertension, ischemic heart disease and chronic heart failure. The TT genotype and the T allele of the rs2200733 polymorphism do not affect left atrial remodeling in patients with AF.

scholarly journals Changes in quality of life after discharge from hospital in the elderly patients with acute worse of chronic heart failure

2005 ◽  
Vol 12 (4) ◽  
pp. 417-418
Author(s):  
Kenzo Shibayama ◽  
Naomi Kotera ◽  
Natsuki Nakayama ◽  
Yukari Aoyama ◽  
Chie Yamada ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Elderly Patients ◽  
The Elderly ◽  
Discharge From Hospital

scholarly journals The research of neurohormonal biomarkers in arterial hypertension diagnosis in adolescents

2016 ◽  
Vol 63 (2) ◽  
pp. 140-147
Author(s):  
Victoria Grosu ◽  
◽  
Victoria Melnicov ◽  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Arterial Hypertension ◽  
Myocardial Hypertrophy ◽  
Myocardial Damage ◽  
Control Group ◽  
Hemodynamic Parameters ◽  
Biochemical Tests ◽  
Hypertension Diagnosis

Arterial hypertension (AHT) is currently considered one of the most common pathologies of the cardiovascular system and one of the risk factors of atherosclerosis and chronic myocardial dysfunctions. Essential hypertension is accompanied by metabolic disorders, hypercatecholaminemia, hypertriglyceridemia, hyperinsulinemia, excessive fat storage in adipocytes in obese patients as well as other factors. To assess the degree and prognosis of arterial hypertension, it is important to use early diagnosis, first of all the signs of heart remodeling, metabolic and neurohormonal disorders, and changes in the arterial wall. Objectives of the study. Indices evaluation of neurohormonal biomarkers in arterial hypertension diagnosis in adolescents. Material and methods. The hemodynamic parameters of cardiac performance and neurohormonal biomarkers have been evaluated in this study of 113 children, divided in two groups. The first group included 52 patients, having chronic heart failure secondary to arterial hypertension and the second control group included 85 children. Obtained results. The EcoCG parameters in patients with arterial hypertension detected left myocardial hypertrophy and the septum myocardial hypertrophy, and the modification of the LVEF, LVSF. The determination of specific biochemical tests assessing myocardial damage biomarkers in patients with congestive heart failure secondary to arterial hypertension confirmed a statistically significant increase in serum content epinephrine in comparison with the control group (p<0.001), of the conclusive norepinephrine the control (p<0.05) and increase in urine content catecholamine in activity significance compared to the control group (p<0.001), with further increase concentration level in the dynamic therapy (p<0.001). Conclusions. The investigation performed shows that the patients with chronic heart failure develop hypoxic and ischemic processes, that lead to modified of hemodynamic parameters and metabolic and neurohormonal biomarkers.

scholarly journals Cardiovascular pathology in patients with newly diagnosed tuberculosis and chronic obstructive pulmonary disease

2021 ◽  
pp. 142-148
Author(s):  
N. V. Bagisheva ◽  
A. V. Mordyk ◽  
I. A. Viktorova ◽  
D. I. Trukhan
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Heart Disease ◽  
Chronic Heart Failure ◽  
Arterial Hypertension ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Newly Diagnosed ◽  
Obstructive Pulmonary Disease ◽  
Cardiovascular Pathology

Introduction. Chronic obstructive pulmonary disease and cardiovascular diseases (arterial hypertension, ischemic heart disease, chronic heart failure) are among the comorbid conditions that mutually aggravate each other. The addition of tuberculosis in this category of patients requires additional efforts from the doctor to improve treatment outcomes.Purpose. Тo assess the prevalence of chronic obstructive pulmonary disease, arterial hypertension, coronary heart disease and chronic heart failure in patients with newly diagnosed tuberculosis hospitalized in an anti-tuberculosis hospital.Materials and methods. We examined 462 patients with newly diagnosed tuberculosis, hospitalized in a tuberculosis dispensary, aged 17 to 88 years, the median (Me (P25; 75) age was 43.68 (32.00; 54.00) years, including 266 men (57.6%) and 196 women (42.4%) All patients underwent clinical, laboratory, instrumental examination to establish or confirm the diagnosis.Results. The incidence of chronic obstructive pulmonary disease among patients with newly diagnosed tuberculosis was 31.4%, with arterial hypertension – 12.1%, coronary heart disease – 6.1%, chronic heart failure – 6.1%. The incidence of cardiovascular pathology in the group of tuberculosis + chronic obstructive pulmonary disease was 40%, in the group of tuberculosis without chronic obstructive pulmonary disease 6%.Conclusions. The prevalence of comorbid cardiovascular pathology in patients with tuberculosis + chronic obstructive pulmonary disease is significantly higher than among patients with only tuberculosis, which requires the involvement of doctors of various specialties to manage this category of patients to prevent adverse treatment outcomes, disability and mortality.

scholarly journals Heart remodeling in elderly patients with isolated systolic arterial hypertension and chronic heart failure with preserved left ventricular ejection fraction

2021 ◽  
Vol 23 (3) ◽  
pp. 331-337
Author(s):  
S. O. Sheiko ◽  
N. O. Kolb
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Ejection Fraction ◽  
Elderly Patients ◽  
Arterial Hypertension ◽  
Comparison Group ◽  
Left Ventricular ◽  
Main Group ◽  
Volume Index ◽  
Left Ventricular Ejection

The aim of the work was to study the structural and functional state of the left ventricle (LV) in elderly patients with isolated systolic arterial hypertension (ISAH) and chronic heart failure with preserved ejection fraction (CHF with PEF). Materials and methods. After receiving an informed consent, 134 elderly patients with ISAH were enrolled in the study. The main group included 91 patients aged 71.1 ± 3.5 years with ISAH and ejection fraction (EF) of the LV >50 % and a level of natriuretic peptide (NT-proBNP) >125 pg/ml. Among them, there were 61 women (67 %) and 30 (33 %) men. The comparison group consisted of 43 patients (27 women and 16 men aged 70.4 ± 3.7 years) with ISAH, LV EF >50% and NT-proBNP <125 pg/ml. The geometric changes of the LV were evaluated taking into account the LV myocardial mass index and the relative LV wall thickness. Results. Cardiac remodeling in elderly ISAH patients with CHF and PEF was represented by the following geometric variants of the LV. In the main group patients, concentric LV hypertrophy (LVH) prevailed – 73 (80.2 %) patients, while in the comparison group, concentric modeling (CR) – 25 (58.1 %) patients (P < 0.01 by criterion χ2). CR in the ISAH patients with CHF and PEF was diagnosed in 18 (19.8 %) cases. Concentric LVH was verified in 18 (41.9 %) patients of the comparison group (P < 0.01). It was determined that the hyperfunction of the left atrium (LA) in the patients with ISAH without CHF was compensatory. The maximum volume index of the LA (VILAmax.) in these patients was in the range of 27–32 ml/m2. Hyperfunction of the LA in the ISAH patients with CHF and PEF was accompanied by a statistically significant increase in VILAmax. over 34 ml/m2. Conclusions. The prevalence of ISAH among elderly patients is 35.6 %. The formation of a hypertensive heart in the ISAH patients with CHF and PEF is characterized by a predominant concentric LVH (80.2 %) and hyperfunction of the LA. A significant increase in the LA volumes testifies to increase in its contribution to the LV filling with the formation of LV diastolic dysfunction. The presence of concentric LVH and an increase in VILAmax. ≥34 ml/m2 is a criterion for identifying individuals at high and very high risk among elderly ISAH patients with CHF and PEF.

Sign in / Sign up

Export Citation Format

Share Document