Endothelial Dysfunction as a Factor in the Pathogenesis of Chronic Heart Failure of Various Genesis

T. I. Salyzhyn

Abstract


The objective of the research was to study the pathogenetic role of the levels of endothelin-1 (ET-1), tumor necrosis factor-alpha (TNF-alpha) and C-reactive protein (CRP) in the development of endothelial dysfunction (ED) in patients with preserved and lost renal function.

Materials and methods. The study involved 86 patients: Group I included 42 patients with arterial hypertension and chronic heart failure (CHF) IIA FC ІІІ; Group II consisted of 44 patients with terminal chronic kidney disease (stage V CKD) with concomitant CHF IIA FC ІІІ who were on treatment by outpatient program hemodialysis (HD).

Results. In patients of Group II the levels of ET-1 and inflammatory markers were significantly higher than those in the comparison and control groups (p<0.001 and p<0.001). In patients of Group I there was a direct moderate correlation between TNF-alpha and ET-1 (r=0.48; p<0.05) and between CRP and ET-1 (r=0.56; p<0.05). In Group II, the relation between TNF-alpha and ET-1 was significantly stronger (r=0.58; p<0.05); between the levels of CRP and ET-1 it was weaker (r=0.37, p<0.05). Increased levels of ET-1, TNF-± and CRP affected the development of ED in both groups.

Conclusions. It was found that CRP levels of TNF-alpha, ET-1 in patients on HD were significantly different from the same data in patients with preserved renal function, which is clearly associated with more pronounced signs of inflammation and ED in a cohort of dialysis patients. The impact of TNF-± in the development of ED in both groups was proved. Despite the higher level of CRP in patients with stage V CKD being corrected by HD with CHF, this biomarker had less impact on the prognosis of ED than in the general population of patients with CHF.

Keywords


chronic heart failure; chronic kidney disease; hemodialysis, endothelial dysfunction; chronic inflammation

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References


Beloglazov VA, Klimchuk AV. I antiendotoxic immunity and the level of C-reactive protein in patients with chronic kidney disease who are on dialysis. Tavricheskiy mediko-biologicheskiy vestnik. 2013; 4: 25-28.

Voronkov LH. “Path” of patients with chronic heart failure: as long as possible, as comfortable as possible. Sertseva nedostatnist. 2014; 1: 7-10.

Zaremba YeKh, Besedina AS, Zaremba-Fedchyshyn OV. Determination of endothelin-1 level to assess the correction of endothelial dysfunction in patients with chronic heart failure. Medychna i klinichna khimiia. 2011; 13 (4): 73-74.

Zaremba YeKh, Smaliukh OV. Inflammatory markers and endothelial function in patients with coronary artery disease (literature review). Bukovynskyi medycnhyi visnyk. 2014; 18,4 (72): 192-195.

Zolotariova NA, Romanchenko MI. Endothelial dysfunction: diagnostic significance, methods for determination. Odeskyi medychnyi zhurnal. 2013; 2: 77-84.

Kurapova MV, Nizyamova AR, Romasheva EP, Lavydkin IL. Endothelial dysfunction in patients with chronic kidney disease. Izvestiya Samarskogo nauchnogo tsentra Rossiyskoi akademii nauk. 2013; 3: 1823-1826.

Kuryliv HM. The severity of endothelial dysfunction in patients with chronic heart failure. Aktualni problemy suchasnoi medytsyny: visnyk VDNZU “Ukraiinska meduchna stomatolohichna akademiia”. 2013; 13 (3): 168-172.

Riabenko DV. Pharmacotherapy of chronic heart failure in the nineteenth century. Sertseva nedostatnist. 2014; 2: 24-33.

Sheiko SO. Endothelial dysfunction in elderly patients with chronic heart failure and anemia syndrome symptoms depending on the stage of heart failure and left ventricular ejection fraction. Medychni perspectyvy. 2010; ХV (1): 41-47.

Allon M. Evidence-Based Cardiology in Hemodialysis Patients. Journal of the American Society of Nephrology. 2013; 24: 1934–1943.

Lee MJ, Han SH, Lee JE, et al. Endothelial Dysfunction Is Associated With Major Adverse Cardiovascular Events in Peritoneal Dialysis Patients. Medicine. 2014; 93: 73-82.

Ioannou K, Stel VS, Dounousi E, et al. Inflammation, Endothelial Dysfunction and Increased Left Ventricular Mass in Chronic Kidney Disease (CKD) Patients: A Longitudinal Study. PLoS one. 2015; 10: 1-9.

Teixeira BC, Lopes AL, Oliveira Macedo RC, et al. Inflammatory markers, endothelial function and cardiovascular risk. Jornal Vascular Brasileiro. 2014; 13: 108-115.

Nessler J, Nessler B, Golebiowska-Wiatrak R, et al. Serum biomarkers and clinical outcomes in heart failure patients treated de novo with carvedilol. Cardiology Journal. 2013; 20: 144-151.


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