CLINICAL ASPECTS OF ENDOTHELIN LEVELS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ARTERIAL HYPERTENSION

Kapustnik V. A., Arkhipkina O. L.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

There is considerable evidence that the patents with COPD are at increased risk for cardiovascular events. Today COPD is more likely to be associated with arterial hypertension (AH). The role of endothelin in cardiovascular disease has been intensively studied. Endothelial dysfuncton is much more complex process than it is described as rising of endothelin but there is stll a lack of understanding about its pathophysiology. The aim was to study the level of endothelin in patents with COPD and COPD with accompanying AH. The study involved 141 patents with COPD, who meet the criteria GOLD II. A study group consisted of 82 patents with COPD and concomitant AH (stage II). A group of comparison was formed from 59 patents suffering only from COPD. The control group included 31 normotensive persons with normal spirographic data. The quanttatve determinaton of ET was measured in plasma using the Endothelin (1-21) ELISA Assay Kit «Biomedica» according to the manufacturer’s protocol. Ultrasound examinaton of the heart was performed on a diagnostc apparatus Radmir UltmaPro. Lef ventricle (LV) diastolic (DD) and systolic (SD) diameters, posterior wall thickness (PWS), interventricular septum (IVS), lef ventricular ejecton fracton (EF%) measurement were performed. LV mass was calculated by Devereux R. et al. and indexed for body surface area (lef ventricular mass index – LVMI). Pulsed Doppler evaluaton of LV and RV diastole indexes was performed. We found an elevated level of endothelin in all patents with COPD, regardless of the presence of arterial hypertension. It was shown that all patents with COPD had a high risk of realizing vasoconstrictor potental of endothelin. Probably, rising of ET in COPD patents can be explained by affecton of endothelium cells by persistent systemic inflammaton, oxidatve stress or hypoxia. COPD per se should be considered by physicians as an additonal factor of development of endothelial dysfuncton. Also, it was found negatve correlaton between ET and FEV1. Besides that, patents with COPD who had accompanying arterial hypertension had enhanced negatve potental of cardiovascular risk factors (smoking and excess body weight). According to the results of echocardiographic study plasma levels of ET were linked to lef ventricular hypertrophy in patents with COPD and the development of preclinical manifestatons of systolic and diastolic dysfuncton of both ventricles. Comorbid patents also had pulmonary arterial hypertension compared with those without arterial hypertension. The role of endothelin in COPD and cardiovascular risk or congestve heart failure requires further investgaton.

chronic obstructve pulmonary disease, arterial hypertension, endothelin

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«Bulletin of problems biology and medicine» Issue 1 Part 2 (143), 2018 year, 125-129 pages, index UDK 616.24-036.12-007.271:616.12-008.331.1-078

10.29254/2077-4214-2018-1-2-143-125-129