Кафедра внутрішніх та професійних хвороб
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Browsing Кафедра внутрішніх та професійних хвороб by Author "Rodionova, Yuliia"
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Item Combined influence of diabetes mellitus and obesity on left ventricle remodeling in hypertensive patients(2021-01) Shelest, Borys; Kovalova, Yuliia; Shelest, Oliksii; Rodionova, Yuliia; Hilova, YaroslavaThe aim of the study was to evaluate the effect of type 2 diabetes mellitus (T2DM) and obesity influence on the left ventricular (LV) remodeling peculiarities in hypertensive patients. Materials and methods. In total, 327 patients, aged 38–74 years, were comprehensively examined. The enrolled patients were divided into 4 groups in dependence of the presence of associated disease: the 1st group – n = 87 hypertensive patients with T2DM combined with obesity, the 2nd group – n = 71 hypertensive patient with T2DM and the 3rd group – n = 65 hypertensive patients with obesity; the comparison group consisted of 74 patients with essential hypertension (EH) but without obesity or diabetes. Echocardiography was performed according to the standard method of H. Feigenbaum to estimate the LV parameters. HbA1c was determined by turbidimetric method. Serum glucose levels were determined by ELISA. Results. When comparing the three patient groups with those who had only EH, the most significant influence was found in combined influence of T2DM and obesity on the development of unfavorable type of LV remodeling with values of χ2 = 29.371 and Pearson’s contingency coefficient (C) ‒ 0.393 (P < 0.05). The presence of concomitant T2DM without obesity had a significant moderate relationship with the development of unfavorable LV geometry, χ2 = 11.029 and C ‒ 0.266 (P < 0.05), which indicates a much smaller impact on the process compared to the polymorbid effect of T2DM with obesity. Comparison of patients with a combination of EH and obesity with those who had only EH did not show a significant effect of concomitant obesity on the development of unfavorable types of LV geometry with values of χ2 and C: 0.529 and 0.062, respectively (P > 0.05). Conclusions. Essential hypertension with type 2 diabetes mellitus and obesity polymorbidity, but not in combination with type 2 diabetes mellitus or obesity alone, has the most significant association with hypertrophic types of LV remodeling. The co-existence of type 2 diabetes mellitus and obesity in hypertensive patients leads to the development of predominantly LV concentric hypertrophy.Item Soluble ST2 in Predicting Adverse Outcome after Revascularization with Percutaneous Coronary Intervention in Patients with ST-Elevation Myocardial Infarction(2021-05) Kopytsya, Mykola; Hilova, Yaroslava; Rodionova, Yuliia; Polivenok, Igor; Shelest, BorysAim: The aim of the study was to investigate the relationship between the soluble suppression of tumorigenicity 2 (sST2) level and the degree of epicardial blood flow recovery in patients with myocardial infarction with ST-segment elevation (STEMI) after percutaneous coronary intervention. Material and Methods: The study involved 61 patients (83.6% males), with a mean age of 59.85±10.01 years. sST2 level was measured by enzyme immunoassay. Patients were divided into two groups. The first group (n=12) included patients with thrombolysis in myocardial infarction (TIMI) ≤II flow grade, the second group (n=49) with TIMI III flow grade. Results: The sST2 level was significantly higher in the first hours of the disease in the group with decreased epicardial blood flow (TIMI ≤II) after percutaneous coronary intervention (p=0.003). Receiver operating characteristics curve analysis showed that sST2 levels over 34.2 ng/ml, detected on admission, was an independent predictor of adverse revascularization (TIMI ≤II) in patients with STEMI with a sensitivity of 92.3% and a specificity of 62.5%; the area under curve was 0.811 (95% CI: 0.651 - 0.873; p=0.001). Both the univariate (OR: 1.020, 95% CI: 1.001-1.041, p=0.028) and multivariate (OR: 1.030; 95% CI: 1.002-1.057; p=0.033) analyzes showed that sST2 was a significant predictor of the unfavorable outcome of epicardial vascular revascularization (TIMI ≤ІІ). Conclusion: sST2 is highly associated with the degree of blood flow recovery after percutaneous coronary intervention in patients with STEMI and is of great clinical importance as a prognostic marker.