scholarly journals The functional state of the endothelium in patients with viral hepatitis and liver cirrhosis

2014 ◽  
Vol 95 (1) ◽  
pp. 41-45
Author(s):  
M V Chistyakova ◽  
A V Govorin ◽  
E V Radaeva

Aim. To study the functional state of endothelium in patients with chronic viral hepatitis and liver cirrhosis and impact of left and right ventricle diastolic malfunction and pulmonary hypertension on endothelial function. Methods. 74 patients with chronic viral hepatitis (group 1), 62 patients with cirrhosis (group 2) and 17 healthy volunteers were examined. Doppler echocardiography and brachial artery ultrasonography with endothelium-dependent vasodilation measurement were performed. Results. Endothelium-dependent vasodilatation was reduced in patients of the 1 stgroup (6.2%), and of the 2 ndgroup (2.2%) compared to the controls (13.8%, р 0.05). Sensitivity coefficient for the brachial artery was measured as 0.31 (0.19; 0.35) in patients with chronic viral hepatitis, 0.25 (0.09; 0.35) in patients with cirrhosis compared to 1.27 (0.72; 1.29) in control group, demonstrating the marked endothelial dysfunction in patients of the 1 stand 2 ndgroups (р 0.05). Moderate pulmonary hypertension was accompanied by a more pronounced endothelium-dependent vasodilation impairment in both groups (р 0.05). In patients with viral hepatitis, endothelial malfunction was less common (62%) compared with patients with liver cirrhosis (85%, p=0.002). Presence of left and right ventricle diastolic malfunction did not influence the endothelial function. Conclusion. In patients with viral hepatitis and cirrhosis, endothelium-dependent vasodilatation is affected depending on the severity of the disease and increased if pulmonary hypertension was present. Presence of left and right ventricle diastolic malfunction did not influence the endothelial function.

2019 ◽  
Vol 4 (1) ◽  
pp. 31-35
Author(s):  
Maria A. Rashidova ◽  
Leonid F. Sholokhov ◽  
Marina A. Darenskaya ◽  
Lyubov I. Kolesnikova

Background.Chronic viral hepatitis is a complex global problem and is still far from being solved. Many researchers point out influence of viral hepatitis on the reproductive system of women.Aim.To identify features of the functional state of pituitary-thyroid units of neuroendocrinal regulation, and to evaluate lipid peroxidation – antioxidant protection with determination of the oxidative stress coefficient in perimenopausal women with chronic form of hepatitis.Materials and methods. Study included 44 women with chronic viral hepatitis and 28 healthy women of the same age. Immunoabsorbent, spectrophotometric, fluorometric and statistical methods were used.Results.In patients with chronic viral hepatitis, we detected an increase in thyroxine levels – by 29.6% (р < 0.001) and free triiodothyronine values – by 65.7% (р = 0.008) in comparison with the control group. In the group with chronic viral hepatitis, the TBA-reactive products level increased by 1.9 times (р = 0.006), and superoxide dismutase activity decreased by 1.3 times (р < 0.001), total antioxidant activity – by 1.7 times (р < 0.001) and α-tocopherol level – by 1.3 times (р = 0.005) in comparison with the control group.Conclusions. The obtained data demonstrate the features of the pituitary-thyroid system functioning and the lipid peroxidation – antioxidant protection system in patients with chronic hepatitis. The chronic form of hepatitis is characterized by metabolic disorders that require a more careful approach in diagnosis and management.


2001 ◽  
Vol 100 (5) ◽  
pp. 499-508 ◽  
Author(s):  
Mohamad Y. EL-MIR ◽  
Maria D. BADIA ◽  
Nazaret LUENGO ◽  
Maria J. MONTE ◽  
Jose J. G. MARIN

The aim of this work was to investigate the reappearance during liver neoplasia of bile acids (BAs) species, which are unusual in healthy adults, but common in fetuses. Serum and urine samples were collected from patients with hepatocellular carcinoma (HCC; n = 27), and for comparative purposes, with liver cirrhosis (n = 49), liver metastasis (n = 19), chronic viral hepatitis (n = 11) and healthy volunteer (control group; n = 26) groups. BAs were identified and measured by GC–MS. Hypercholanaemia was found in all groups of patients. In HCC, this was characterized by a marked increase in the chenodeoxycholate/cholate ratio in both serum and urine. Although increased levels of BAs, with hydroxylations at unusual positions, and oxo-BAs were found in HCC, these were not significantly different from those observed in other groups. However, BAs with a flat structure, i.e. Δ4-unsaturated- and 5α- or allo-BAs, which were almost absent in healthy subjects, were markedly increased in the serum and urine of HCC patients. They were also detected, although in much lower amounts, in liver metastasis and liver cirrhosis, but not in viral hepatitis. Flat-BAs were better detected in urine than in serum. Urinary Δ4-unsaturated-BA output was significantly lower in patients with small tumours (< 3 cm) compared with those with higher size tumours. No correlation between flat-BA output into urine and serum alpha-fetoprotein or total BAs was found. These results suggest that Δ4- and/or allo-BAs are particularly elevated in patients with HCC, which may be a potentially useful complementary, rather than alternative, marker for early detection of liver neoplasia.


2020 ◽  
Vol 16 (1) ◽  
pp. 47-53
Author(s):  
Vicente Benavides-Córdoba ◽  
Mauricio Palacios Gómez

Introduction: Animal models have been used to understand the pathophysiology of pulmonary hypertension, to describe the mechanisms of action and to evaluate promising active ingredients. The monocrotaline-induced pulmonary hypertension model is the most used animal model. In this model, invasive and non-invasive hemodynamic variables that resemble human measurements have been used. Aim: To define if non-invasive variables can predict hemodynamic measures in the monocrotaline-induced pulmonary hypertension model. Materials and Methods: Twenty 6-week old male Wistar rats weighing between 250-300g from the bioterium of the Universidad del Valle (Cali - Colombia) were used in order to establish that the relationships between invasive and non-invasive variables are sustained in different conditions (healthy, hypertrophy and treated). The animals were organized into three groups, a control group who was given 0.9% saline solution subcutaneously (sc), a group with pulmonary hypertension induced with a single subcutaneous dose of Monocrotaline 30 mg/kg, and a group with pulmonary hypertension with 30 mg/kg of monocrotaline treated with Sildenafil. Right ventricle ejection fraction, heart rate, right ventricle systolic pressure and the extent of hypertrophy were measured. The functional relation between any two variables was evaluated by the Pearson correlation coefficient. Results: It was found that all correlations were statistically significant (p <0.01). The strongest correlation was the inverse one between the RVEF and the Fulton index (r = -0.82). The Fulton index also had a strong correlation with the RVSP (r = 0.79). The Pearson correlation coefficient between the RVEF and the RVSP was -0.81, meaning that the higher the systolic pressure in the right ventricle, the lower the ejection fraction value. Heart rate was significantly correlated to the other three variables studied, although with relatively low correlation. Conclusion: The correlations obtained in this study indicate that the parameters evaluated in the research related to experimental pulmonary hypertension correlate adequately and that the measurements that are currently made are adequate and consistent with each other, that is, they have good predictive capacity.


Author(s):  
A.V. Kuznetsova ◽  
◽  
A.V. Ivolgina ◽  
Ye.V. Dubotolkina ◽  
T.Ye. Makarova ◽  
...  

The article presents an extract from an outpatient case history card of a 47-year-old patient observed at the Central Hospital for Chronic Hepatitis C. In 2017, he received a course of therapy for this disease (Pegasis in combination with ribavirin). A sustained virological response (SVR) has been achieved. According to elastometry data dated 12/13/2017 – the degree of fibrosis F4 Metavir, 13.1 KPa. In January 2021, he suffered a coronavirus infection (according to the CT scan of the lungs, the lesion was 20 %). The disease proceeded against the background of chronic viral hepatitis C complicated by liver cirrhosis. He was treated symptomatically on an outpatient basis. He did not receive anticoagulant therapy. In February 2021, abdominal ultrasound (ABP) revealed a thrombus in the portal vein. The presence of a thrombus in the portal vein contributes to the further progression of liver cirrhosis


Author(s):  
T. Ye. Makarova ◽  
◽  
N.N. Dudareva ◽  
N.N. Poletaeva ◽  
E.A. Medvedeva ◽  
...  

The problem of chronic viral hepatitis C currently remains relevant due to the high incidence, frequent outcomes in liver cirrhosis, high disability of the population, and expensive treatment. The article discusses timely approaches to the treatment of chronic viral hepatitis C, using interferon-free therapy regimens.


Author(s):  
ANARKAN SHABOLOTOVNA TASHPOLOTOVA ◽  
GULMIRA SAIBILDAEVNA SURANBAEVA ◽  
MYSKAL MAMAZIAEVNA ABDIKERIMOVA ◽  
ALTYNAI BORUBAEVNA MYRZAKULOVA ◽  
ANARA SHAMSHIDINOVNA DJUMAGULOVA ◽  
...  

Author(s):  
Nidhi Pandey ◽  
Poonam Goel ◽  
Anita Malhotra ◽  
Reeti Mehra ◽  
Navjot Kaur

Background: The objective of the study was to assess vascular function in normal pregnant women and women with gestational diabetes and to study its temporal relationship with gestational age at 24-28-week POG and at 36-38-week POG and changes in FMD in postpartum period.Methods: Assessment of vascular function was done at 24-28-week POG, 36-38-week POG and at 6-12-week postpartum by flow mediated dilation of brachial artery in 37 healthy pregnant women and 37 pregnant women with GDM.Results: In GDM group mean FMD at 24-28 weeks of POG, at 36-38 weeks POG was lower as compared to the control group (11.225±6.20,8.464±6.09 versus 14.49±5.21, 10.898±4.12) although the difference in mean FMD in two groups was not statistically significant. It was found that the decrease in FMD at 36-38-week POG as compared to 24-28 weeks POG was statistically significant in both the groups (p<0.001).Conclusions: This study revealed that when endothelial function as assessed by FMD was compared at different period of gestation, the mean decrease in FMD at 36-38-week POG as compared to 24-28-week POG and 6-week post-partum was statistically significant in patients with GDM and as well as the control group, however this trend of change was same in both the groups and was not statistically significant when compared between the two group (GDM versus control). A negative correlation of FMD was found with BMI, and HBA1c, that was stronger in GDM group.


BMC Nursing ◽  
2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Ying’ai Cui ◽  
Michiko Moriyama ◽  
Kazuaki Chayama ◽  
Yanhui Liu ◽  
Chunmei Ya ◽  
...  

Abstract Background Chronic hepatitis, mainly B or C, increases the risk of hepatocellular carcinoma and remains an emerging issue in the globe. China has high rates of liver cancer incidence and mortality in the world. To address such challenges, adequate management of chronic hepatitis is required. Self-management education is one alternative for improving the hepatitis patients’ knowledge of the disease, mental health, and clinical management. This study aimed to examine the quality of life (QOL), psychological effects, and behavioral changes of a self-management program which allows continuity of care for chronic hepatitis B and C patients. Method In a six-month, randomized controlled trial, we invited 73 chronic hepatitis B/C inpatients to receive (i) two face-to-face education sessions provided by a nurse during hospitalization, and monthly telephone counseling at home after discharge; (ii) or usual care treatment (control group). The primary endpoint (patients’ QOL) and secondary outcomes (including self-efficacy, depression symptoms, perceived cognition of illness and behavioral changes) were assessed. In addition, we conducted qualitative data analysis to facilitate the evaluation of the interventions. Results Sixty (82.2%) out of 73 eligible patients with chronic hepatitis B/C (aged 34.9 ± 8.9 years) participated in the study. The intervention group (n = 30) significantly improved on outcomes including QOL, self-efficacy, perceived cognition of illness, and behavioral changes, whereas the control group significantly decreased their healthy behaviors. In terms of behavioral changes, alcohol avoidance, dietary adherence, and stress management also improved in the intervention group. However, there were no significant improvements in symptoms of depression. Most participants (80%) in the intervention group stated that they benefited from the program. Conclusions This program contributed to patients’ acquisition of self-management skills to cope with their illnesses, and significantly improved their QOL. This program serves as a reminder for nurses who care for patients with chronic viral hepatitis to acquire these skills as it would help them address the daily needs of their patients. Trial registration UMIN000025378. Registered December 23, 2016.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
G Stronati ◽  
F Guerra ◽  
L Zuliani ◽  
L Manfredi ◽  
A Ferrarini ◽  
...  

Abstract Background Systemic sclerosis (SSc) is a progressive autoimmune disease which has been proven to affect the heart. While it is widely known that the disease can cause pulmonary artery hypertension and therefore secondary right heart impairment, new studies have detected a subclinical heart involvement of both the left and right ventricles. The similar changes in myocardial deformation of both chambers assessed by speckle tracking imaging are consistent with the definition of SSc-related cardiomyopathy as a standalone entity with peculiar characteristics. Purpose The aim of the present study is to describe the progression of myocardial deformation as assessed through speckle tracking in patients with SSc and no pulmonary hypertension. Methods Prospective, longitudinal study on 48 patients affected by SSc. Patients with a history of heart failure, known structural heart disease, atrial fibrillation, and pulmonary hypertension were excluded. For every patient, standard echocardiographical and speckle-tracking derived variables for the systolic and diastolic function of the left ventricle (LV) and right ventricle (RV) were acquired at baseline and after 15±6 months. Results While common parameters of systolic function (Simpons's left ventricular ejection fraction, right ventricular fractional area change, TAPSE, tricuspidal S') did not change during follow-up, mean global longitudinal strain (GLS) significantly worsened for both left (from −19.1%±4.2% to −17.2%±5.0%) and right ventricle (from −17.9%±5.2% to −15.9%±4.8%) over 15 months. The increased impairment seen in SSc patients was homogeneous across endocardial layers (LV: from −21.8%±4.8% to −18.8%±5.2%; RV: from −20.6%±4.5% to −19.4%±4.9%), midventricular layers (LV: from −19.2%±4.5% to −17.7%±4.9%; RV: from −17.7%±4.7% to −16.7%±4.6%) and epicardial layers (LV: from −16.3%±4.7% to −16.0%±4.3%; RV: from −15.4%±5.0% to −14.6%±4.1%), as well as across myocardial segments (Figure 1). No difference in progression rate was seen between the diffuse and limited version of SSc, nor between different serotypes. Figure 1 Conclusions While traditional echocardiographical parameters are useless in order to follow the natural history of SSc-related cardiomyopathy during its early stages, GLS impairment progresses during a 15-month follow-up and involves similarly both the left and right ventricle. Whether, how, and how much the altered myocardial deformation contributes to the incidence of pulmonary arterial hypertension in these patients is still to be assessed. Acknowledgement/Funding Marche Polytechnic University


2001 ◽  
Vol 101 (6) ◽  
pp. 707-713 ◽  
Author(s):  
Hiroki TERAGAWA ◽  
Masaya KATO ◽  
Junichi KUROKAWA ◽  
Togo YAMAGATA ◽  
Hideo MATSUURA ◽  
...  

In order to evaluate peripheral endothelial function in patients with vasospastic angina (VSA), we measured flow-mediated dilation (FMD) of the brachial artery in patients with VSA and compared it with FMD in patients without VSA. Endothelial dysfunction is considered one of the mechanisms underlying VSA. However, its exact role remains to be clarified. The study included 30 patients with positive spasm-provocational test results without evidence of significant coronary stenosis (VSA group) and 30 patients with negative spasm-provocational test results without evidence of significant coronary stenosis (control group). In each patient, brachial artery diameter responses to hyperemic flow and glyceryl trinitrate spray were measured using high-resolution ultrasound. The carotid intima-media thickness was also measured as a marker of systemic atherosclerosis. FMD was lower in the VSA group (4.8±0.5%) compared with the control group (9.4±0.7%, P < 0.0001). In the VSA group, FMD was not affected by coronary risk factors or the presence of atherosclerotic changes on coronary angiography. Glyceryl trinitrate-induced dilation did not differ between the two groups. The intima-media thickness was comparable between the VSA (0.85±0.04mm) and control groups (0.81±0.05mm). These findings indicated that peripheral endothelial function is impaired only in the VSA group, whereas the atherosclerotic changes were similar in the two groups. We conclude that endothelial dysfunction may be an independent factor responsible for the development of VSA.


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