Email this article Clinical and pathogenetic features of inflammatory and atrophic changes in the gastroduodenal zone in patients with varying severity of chronic heart failure associated with coronary artery disease
- Authors: Osadchiĭ VA1, Bukanova TI.1
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Affiliations:
- Issue: Vol 87, No 2 (2015)
- Pages: 15-19
- Section: Editorial
- URL: https://ter-arkhiv.ru/0040-3660/article/view/31679
- ID: 31679
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Abstract
Aim. To study the clinical features of inflammatory and atrophic changes (IAIs) in the gastroduodenal zone (GDZ) in people with varying severity of chronic heart failure (CHF) associated with coronary artery disease (CAD) and to determine gastric secretion, local microcirculation, and the presence of Helicobacter pylori. Subjects and methods. Seventy-four patients with CHF and gastric duodenal (GD) IAIs who were divided into 2 groups according to its severity were examined. The specific features of impaired gastric secretory function and blood flow in the GD mucosa and its contamination with Н. pylori were elucidated. Results. GD IAIs were ascertained to be mainly focal in the patients with Stages I-IIa CHF and focal or diffuse in those with Stages IIb-III. According the clinical findings, these changes were generally shown in the concurrence of transient and unstable (in early-stage circulatory insufficiency) and prolonged and persistent (during severe congestive events) phenomena. The development of IAIs in the GDZ was linked to its thrombohemorrhagic microcirculatory disorders, the severity of which increased as the symptoms of CHF progressed. In Stages I-IIa circulatory insufficiency, this was accompanied by the normal activity of acid-peptic factor, by the decreased production gastromucoproteins, and, in 58.3% of cases, by H. pylori. The patients with Stages IIb-III showed the suppressed production of all constituents of gastric secretion and H. pylori in 63.2% of cases. Conclusion. The clinical manifestations and mechanisms of GD IAIs in CHF associated with CAD have a number of substantial differences in relation to its severity, which should be kept in mind when elaborating therapeutic and diagnostic measures.
References
- Белобородова Э.И. Состояние желудка и тонкой кишки при застойной сердечной недостаточности.: Дис. ... д-ра мед. наук. Томск 1983.
- Лазебник Л.Б., Звенигородская Л.А. Хроническая ишемическая болезнь органов пищеварения. М: Анахарсис 2003.
- Mogensen U.M., Ersbøll M., Andersen M. et al. Clinical characteristics and major comorbidities in heart failure patients more than 85 years of age compared with younger age groups Eur J Heart Fail 2011; 13: 1216-1223.
- Bank A.J., Lee P.C., Kubo S.H. Endothelial dysfunction in patients with heart failure: relationship to disease severity. J Card Fail 2000; 6: 29-36.
- Edvinsson M.L., Uddman E., Edvinsson L., Andersson S.E. Brain natriuretic peptide is a potent vasodilator in aged human microcirculation and shows a blunted response in heart failure patients. J Geriatr Cardiol 2014; 11 (1): 50-56.
- Некачалов В.В. Патоморфологическая характеристика заболеваний желудка по материалам эндоскопических биопсий. СПб 1997.
- Fennerty M.B. Pathophysiology of the upper gastrointestinal tract in the critically ill patient: Rationale for therapeutic benefits of acid suppression. Crit Care Med 2002; 30 (6): 351-355.
- Павлов О.Н. Ассоциация нестабильного течения ишемической болезни сердца с инфекцией Helicobacter pylori. Проф мед 2012; 1: 47-51.
- Aceti A., Are R., Sabino G. et al. Helicobacter pylori-active infection in patients with acute coronary heart disease. J Infect 2004; 49: 8-12.
- Мареев В.Ю., Агеев Ф.Т., Арутюнов Г.П. и др. Национальные рекомендации ОССН, РКО и РНМОТ по диагностике и лечению ХСН (четвертый пересмотр). Сердеч недостат 2013; 7: 379-472.
- Стандарты оказания медицинской помощи. Гастроэнтерология. М: Ремедиум 2013.
- Беленков Ю.Н., Привалова Е.В, Данилогорская Ю.А. и др. Структурные и функциональные изменения микроциркуляторного русла на уровне капилляров, у больных сердечно-сосудистыми заболеваниями, которые можно наблюдать в ходе компьютерной видеокапилляроскопии. Кардиол и сердечно-сосудистая хир 2012; 2: 49-55.
- Скворцов А.А., Мареев В.Ю., Насонова С.Н. и др. Рекомендована ли тройная комбинация нейрогормональных модуляторов для лечения умеренной и тяжелой ХСН? (результаты исследования САДКО-ХСН). Тер арх 2006; 8: 14-20.
- Cugno M., Mari D., Meroni P.L. et al. Haemostatic and inflammatory biomarkers in advanced chronic heart failure: role of oral anticoagulants and successful heart transplantation. Br J Haematol 2004; 126 (1): 85-92.
- Mihály E., Micsik T., Juhász M. et al. Gastritis and gastropathy. Orv Hetil 2014; 155 (2): 43-61.
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