Highlights. The article presents a review of literature data on the diagnostic role of endothelial dysfunction biomarkers. The review provides an overview of the main indicators, their significance in various pathologies, and presents possible therapeutic strategies for preventing endothelial dysfunction.Abstract. Endothelial dysfunction is a characteristic feature of each stage of the cardiovascular continuum – a series of events from hypertension to the development of atherosclerosis and coronary heart disease, thrombus formation, myocardial infarction, and heart failure. Due to the prominent role of endothelial dysfunction in the pathogenesis of many vascular diseases, it is a significant therapeutic target. It is important to note that circulating markers of endothelial activation and damage characterize the severity of the disease and can be used to evaluate the efficacy of treatment and subsequent prognosis. The purpose of this review is to provide up–to-date data on endothelial function, discussing its clinical relevance in the cardiovascular continuum, the latest insights in molecular and cellular biology, and their implications for clinical practice, with a focus on new methods of therapeutic approaches for correcting endothelial dysfunction.
Highlights. The importance of psychological assessment and psychological support in Cardiology Departments has been demonstrated. For the first time, predominant coping strategy in cardiac patients was revealed.Background. Why do patients with the same disease, disease course, prognosis and treatment have different outcomes? One hypothesis points to the influence of internal resources used in coping with the disease. A.B. Smulewicz in 1984 identified the association between the clinical symptoms and mental state of the patient.Aim. To determine characteristics of coping behavior and attitude toward health in cardiac patients from Surgical and Therapeutic Departments.Methods. 122 patients admitted to the State Autonomous Healthcare Institution “N.A. Semashko Republican Clinical Hospital” were included in the study. The 1st group consisted of in-patients from the Department of Surgical Treatment of Heart Rhythm Disorders and Electrical Cardiac Stimulation (61 patients); the 2nd group consisted of patients from the 1st Cardiology Department (61 patients). A questionnaire developed by R. Lazarus and S. Falkman in 1988 was used to determine coping strategies, and a questionnaire developed by R. A. Berezovskaya in 2005 was used to assess attitudes towards health.Results. Active coping strategy predominates in surgical patients, and distancing and avoidant strategies predominate in therapeutic patients. Correlation between characteristics of coping strategy and attitudes toward health was analyzed: active coping strategies are accompanied by high behavioral, cognitive, and emotional aspects. An inverse correlation is noted in distancing and avoidant coping strategies.Conclusion. Psychological comfort and correct attitude of patient to his/her disease is an important part of rehabilitation that highlights the significance of psychometric testing in cardiac patients.
Background. Attitude towards one's own illness significantly affects the course of the disease, the effectiveness of treatment and the possibility of rehabilitation. The formation of certain types of response to the disease determines adherence to treatment. Aim. To study the types of attitude to the disease in patients with coronary heart disease, depending on the severity of coronary atherosclerosis and the planned treatment tactics. Material and methods. To study the type of patient's response to the disease, a personal questionnaire of the Bekhterev Institute was used. The study included 240 patients with coronary heart disease (150 men and 90 women): the first group 26 people without coronary artery disease; the second group 41 people who were subject to conservative treatment, with hemodynamically unexpressed atherosclerosis of the coronary arteries; the third group 84 patients with severe atherosclerotic lesions of the coronary arteries, who were candidates for surgical revascularization methods; the fourth group 38 people hospitalized for coronary artery stenting; the fifth group 51 people hospitalized for coronary artery bypass grafting. The sixth group was represented by healthy volunteers (40 people). To assess the statistical significance of the differences between the two groups in terms of any parameters with the non-normal distribution of features the MannWhitney test was used. To assess the relationship between two features, the Spearman rank correlation coefficient with an assessment of its significance was used. Differences were considered significant at p 0.05. Results. Patients with ischemic heart disease chose statements characteristic of ergopathic and harmonious (p 0.05) types of attitude to the illness. In 56% (p 0.05) of the representatives of the control group, the anosognosic type prevailed. A higher frequency of the euphoric type of attitude towards the disease was found in patients of the second group in comparison with the third one (p=0.009). The fifth group was dominated by sensitive (42.5%) and paranoid (32.5%) types of response; less common were anxious (27.5%) and neurasthenic (30%) ones. A direct correlation was demonstrated between the age of patients and the detectability of hypochondriacal (p=0.027, r=0.15), apathetic (p=0.005, r=0.2) and paranoid (p=0.011, r=0.17) types of attitude towards illness. Conclusion. Patients with coronary heart disease have predominantly ergopathic and harmonious types of response, which determine whether they have a sober assessment of their state of health, as well as the significance of work activity for the individual.
Introduction. Despite significant advances in the diagnosis and treatment of patients with cardiovascular pathology, it is diseases associated with atherosclerosis that are still the main cause of mortality and disability. Atherosclerosis is based on local inflammation of the vascular wall and disruption of the lipid profile. Neutrophillymphocyte ratio is an indicator that can serve as a new diagnostic criterion of atherosclerotic changes. Materials and methods. The study enrolled 240 patients with coronary heart disease (150 men and 90 women). The subjects gave voluntary informed consent to participate in the study. All patients with CHD underwent coronary angiography, echocardiography and general blood analysis. Statistical processing of the results was performed using "Microsoft Office Excel" for Windows and "Statistica 10.0" software. Mann-Whitney test was used to assess the statistical significance of differences between the two groups for any parameters in the distribution of features other than normal. The Spearman rank correlation coefficient and its significance were used to assess the relationship between the two traits. Results. An increase in NLS values with progression of atherosclerotic coronary lesion severity was found; an inverse correlation between NLS value and LV ejection fraction (EF) was detected. Discussion. Our results, demonstrating an increase in this index with increasing severity of atherosclerotic lesions of the coronary arteries, are consistent with the literature data. Conclusion. Taking into account the fundamental role of inflammation in atherogenesis, as well as the difficulties of routine determination of expensive markers in everyday practice, the inclusion of an uncomplicated and economically affordable index of LVEF to assess the severity of coronary atherosclerosis and stratify the risk of adverse outcomes in patients with CHD is of undoubted scientific and practical interest and dictates the need for further study of its use in various patient cohorts.
Despite the mass population immunization, the total spread of the COVID-19 pandemic once again made scientists around the world doubt the effectiveness of currently existing methods of prevention and treatment of a novel coronavirus infection. The rationale for a potentially new approach to the preventive therapy of COVID-19 using probiotic bacterial strains was the presence of a bidirectional “gut-lung” axis, which interacts between these organs through transported soluble microbial metabolites in blood. The study aimed to determine the relationship between the correction of the gut microbiota with the polycomponent synbiotic Maxilac® and clinical and laboratory markers of the severity of the new coronavirus infection. During the open-label, prospective, observational study 60 patients with a confirmed diagnosis of COVID-19, a moderate severity and the presence of gastrointestinal symptoms were divided into 2 groups: the 1st performed the outpatient complex standard treatment with the addition of synbiotic, the 2nd - without addition. All patients of group 1 showed positive dynamics of clinical and laboratory indicators of COVID-19 severity, compared with group 2, where 2 patients needed hospitalization due to the aggravation of the course of novel coronavirus infection. A reduction in the duration of clinical symptoms and the duration of outpatient treatment was revealed in a group of patients taking Maxilac®. The dynamics of clinical and laboratory indicators reflecting the course of COVID-19 indicate the effectiveness of symbiotic’s usage as adjuvant therapy and the possibility of recommending its use in the complex treatment of patients with a novel coronavirus infection.
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