The content of some vasoactive humoral-metabolic factors in patients with cirrhosis and their participation in pathogenesis of comorbid syntropical damages of cardiovascular system

The content of some vasoactive humoral-metabolic factors in patients with cirrhosis and their participation in pathogenesis of comorbid syntropical damages of cardiovascular system

Introduction. Liver cirrhosis is an inveterate polyetiological disease that regards to the 6 main reasons of patients’ mortality at the age of 35-60. The management of treatment and prediction for patients with cirrhosis particularly are defined by syntropic polymorbidal damages of other organs and...

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Bibliographic Details
Main Authors: Abrahamovych M., Abrahamovych О., Farmaha M.
Format: Article
Language:English
Published: Publishing House "Kyrylytsya" 2017-12-01
Series:Львівський клінічний вісник
Subjects:
the improvement of diagnostics and treatment of those patients supposes the studying their pathogenesis. For the time being
the most probable pathogenetic chains are endothelial dysfunction
imbalance in renin-angiotensin-aldosterone system
and also overproduction of brain natriuretic peptide. Aim. To examine the content of vasoactive humoral-metabolic factors
i.e. endothelium-dependent (cyclic guanosine monophosphate
endothelin-1)
indexes of renin-aldosterone system (renin
aldosterone) and brain natriuretic hormone in blood plasma in patients with cirrhosis and discover their participation in pathogenesis of comorbid syntropical damages of cardiovascular system. Materials and methods. Randomly with the previous stratification due to the presence of cirrhosis there were 603 patients (445 men (73.8 %) and 158 women (26.2 %) at the age of 19-80 (average age 49.2 ± 10.6) who were treated in the Lviv Regional Hepatological Centre
they had the complex clinical-laboratorial and instrumental research of all organs and systems before treatment due to the orders of the Ministry of Healthcare of Ukraine. Using these results we have seperate 490 (81.3 %) cirrhosis patients with extrahepatic damages of cardiovascular system (investigational group which is stratified into 3 subgroups
i.e. those who have only syntropic cardiomyopathy (103 patients) – group A
only syntropic hypotension (89 patients) – group B and others (306 patients))
and also those who don’t have the damages of cardiovascular system (113 patients; 18.7 %) – the comparison group). Randomly
to achieve the aim the part of the patients from every subgroup (30 patients from A-group
27 – from B-group and 25 from group of comparison) were screened for the content of the vasoactive humoral-metabolic factorsm. There were 17 almost healthy volunteers of the same gender and age in the control group. Results and discussion. The patients of both investigational groups have reasonably higher number of vasoactive humoral-metabolic factors. In particular
patients with cirrhosis and syntopetic cardiomyopathy dominate the effects of endothelin-1
renin and brain natriuretic peptide
and in patients with cirrhosis and syntropic arterial hypotension – cyclic guanosine monophosphate and aldosterone are the main factors. Additionally we recorded the pathological interaction among vasoactive material. Unlike of the results in comparison group
in patients with liver cirrhosis and syntropic cardiomyopathy
the local vasoactive compounds are in such interactions with each other that result in hyperactivity of the renin-angiotensin-aldosterone system and endothelial dysfunction with a significant increase in both vasoconstrictor endothelin-1 and vasodilator NO
and in patients with liver cirrhosis and arterial hypotension – to severe endothelial dysfunction with overproduction of NO. Conclusions. Cyclic guanosine monophosphate
endothelin-1
renin
aldosterone
and brain natriuretic peptide
have a pathological effect on each other and are involved in the pathogenesis of syntropic damages of the circulatory system in patients with liver cirrhosis. In patients with cirrhosis and syntropic cardiomyopathy
heart damage occurs through toxic myocardial damage due to excessive effects of renin
and brain natriuretic peptide with the onset of systolic and diastolic dysfunction and overload of the heart with blood volume. And in patients with cirrhosis and syntropic arterial hypotension
the damage occurs due to the endothelial dysfunction with excessive cyclic guanosine monophosphate and hyperaldosteronism
which leads to the expansion of peripheral vessels
the depositing of excess blood in the organs and
consequently
brain natriuretic peptide
cyclic guanosine monophosphate
liver cirrhosis
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