THE INFLUENCE OF RENEAL DISFUNCTION DEGREE IN THE DEVELOPMENT OF ENDOTEL DISFUNCTION IN PATIENTS WITH CHRONIC HEART FAILURE
Abstract
The results of our research established that patients with CHF have endothelial dysfunction (ED), and the severity and nature of this dysfunction depend on the presence and characteristics of DL. The analysis of the vascular wall's response to changes in blood flow velocity is crucial for assessing endothelial function. Thus, in patients with CHF developing against a background of varying DL severity (groups II and III), an inadequate vasodilation is observed in response to a significant increase in stimulus. Despite a significant acceleration of blood flow after the reactive hyperemia test, their vessel diameter was smaller than that of the control group, which is a sign of ED manifested as impaired endothelium-dependent vasodilation (EDVD). The data obtained indicate a decrease in endothelium-dependent vasodilation in patients with CHF. The combination of RD and CHF further exacerbates this pathological process. Thus, the results of the ultrasound study established an impairment of endothelium-dependent vasodilation of the brachial artery in patients with CHF. An increase in the severity of RD aggravates this pathological process. This is evidenced by the smallest BA diameter with the highest blood flow acceleration during the reactive hyperemia test. Numerous available data indicate that endothelial function is influenced not only by metabolic and hemodynamic parameters but also by age-related aspects. Specifically, our analysis revealed a negative correlation between EDVD and patient age, disease duration, and time since AMI. This indicates that the presence of RD in patients with CHF aggravates the endothelial dysfunction already present with age, IHD, and post-infarction cardiosclerosis.
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