CONDITION OF INTRACARDIAC HEMODYNAMICS AND MICROCIRCULATION IN PATIENTS WITH CHRONIC ISCHEMIC HEART DISEASE AND CONCOMITANT DIFFUSE LIVER DISEASES
Abstract
Introduction. It is known that patients with ischemic heart diseases have endothelial dysfunction, but there is lack of research about microcirculation in these patients with diffuse liver diseases, especially diagnosed with digital capillaroscopy. Aim. To investigate hemodynamic disorders and microcirculation in patients with chronic ischemic heart disease depending on the presence of diffuse liver diseases and its severity with the digital capillaroscopy. Materials and methods. Our prospective study included 187 patients according to the criteria of inclusion. The data of echocardiography and digital capillaroscopy were analysed. Results. In our research in patients with ejection fraction less than 40% there was revealed thickening of the wall of the left ventricle, low blood supply in arterial and venous parts of capillaries. Patients with ejection fraction less than 40% and progressive diffuse liver diseases had advanced thickening of the wall of the left ventricle. Patients with liver cirrhosis had more adverse changes in hemodynamics. Patients with ischemic heart disease and diffuse liver disease had the worst capillary blood supply. Patients with ejection fraction less than 40% and diffuse liver diseases had structural changes of capillaries such as bi-, trifurcation and bushy forms. Conclusions. So, diffuse liver diseases, especially severe, cause endothelial dysfunction in patients with ischemic heart diseases. Digital capillaroscopy is a noninvasive method for microcirculation diagnosis and patients’ monitoring.
References
Sanchez-Garcia ME, Ramirez-Lara I, Gomez-Delgado F et al. Quantitative evaluation of capillaroscopic microvascular changes in patients with established coronary heart disease.2018 Feb 23;150(4):131-137. doi: 10.1016/j.medcli.2017.06.068. Epub 2017 Sep 1. English, Spanish.
Gorshkov AY, Klimushina MV, Boytsov SA et al. Increase in perfused boundary region of endothelial glycocalyx is associated with higher prevalence of ischemic heart disease and lesions of microcirculation and vascular wall. Microcirculation. 2018 May;25(4):e12454. doi: 10.1111/micc.12454.
Held M, Bender D, Krauß S et al. Quantitative Analysis of Heel Skin Microcirculation Using Laser Doppler Flowmetry and Tissue Spectrophotometry. Adv Skin Wound Care. 2019 Feb; 32(2):88-92. doi:10.1097/01.ASW.0000549610.99102.01.
Petrischev N. Physiology and pathophysiology of endothelium. Dysfunction of endothelium. Etiology, mechanisms. Pharmacological therapy. - S.-P. 2003: 338.
Amosova E. Intracardiac hemodynamic in patients with diffuse liver diseases. Materials of Ukrainian therapeutists. 1998: 80- 81.
Patt B.T., Jarjoura D., Haddad D.N. et al. Endothelial dysfunction in the microcirculation of patients with obstructive sleep apnea. Amer J of Resp and Crit Care Med. 2010. 182: 1540–1545. doi: 10.1164/rccm.201002-0162OC.
Thijssen D.H., Green D.J., Hopman M.T. Blood vessel remodeling and physical inactivity in humans. J of Appl Phys. 2011. 111: 1836 – 1845. doi: 10.1152/japplphysiol.00394.2011.
Scalia R. The microcirculation in adipose tissue inflammation. Rev in Endo and Met Dis. 2013. 14:69–76. doi: 10.1007/s11154-013-9236-x.
Kulikov D., Glazkov A., Dreval A. et al. Approaches to improve the predictive value of laser Doppler flowmetry in detection of microcirculation disorders in diabetes mellitus. Clin Hemor and Microc. 2018. 70 (2): 173–179.
Sorelli M, Francia P, Bocchi L et al. Assessment of cutaneous microcirculation by laser Doppler flowmetry in type 1 diabetes. Microvasc Res. 2019 Jul; 124:91-96. doi: 10.1016/j.mvr.2019.04.002. Epub 2019 Apr 6.
Babak O. Cirrhos pecheni i ego oslozhnenija. – K. 2011: 576.
Abragamovich O. Stan sistemi krovoobigu y chvorich na difuzni urazhennia pechinki: ogliad suchasnoi literature ta opis vlasnogo klinichnogo vipadku. Lviv med Chasopis. 2011; 3:114-125.
Plotnikova E. Virazhennost adaptacionnih narushenii pri cirrhoze pecheni. Clin perspektivi gastroenter, hepat. 2013; 3: 10–17.
Kitura O. Strukturno-funkcionalnoe sostoyanie miocarda u bolnih chronicheskim hepatitom i cirrhosom pecheni. Vestnik problem biol i med. 2014;3(112): 131–134.
Views:
214
Downloads:
149
Copyright (c) 2019 The authors
This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.
CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.
