NODULAR THERAPY AS A WAY TO TREAT COMORBID DISEASES (LITERATURE REVIEW)

Sribna V.O., Dochak T.S., Voznesenska T.Y., Blashkiv T.V.

LITERATURE REVIEWS

Scentific article

Today, comorbidity is called a global medical problem that has far-reaching social consequences at the population level and already determines the individual prognosis for each patient (duration and quality of life). In recent decades, chronic heart failure (CHF) has become a global pandemic, affecting more than 26 million people worldwide, and in developed countries, about 1–5 % of the adult population suffers from some form of CHF. In Ukraine, the prevalence of CHF is about 2 %, and in people over 65 reaches 10 %. The prevalence of CHF increases with age and the presence of comorbidities such as hypertension, abdominal obesity, chronic obstructive pulmonary disease, type 2 diabetes, renal dysfunction, anemia, but almost 50 % of all new cases of heart failure are directly related to ischemic causes. The quality of life profile in patients with CHF with a high level of comorbidity was significantly lower than in patients with chronic heart failure with low comorbidity, on all scales that determine both physical and psychological components of health The aim of the work was to collect and analyze data from the literature on: 1) chronic heart failure and existing comorbidities to CHF; 2) renal dysfunction in CHF; 3) heart failure in patients with diabetes; 4) terminology, basic forms, methods of assessing comorbidity; 5) nodal therapy as a way to treat comorbid diseases. Based on the analysis of literature data, we have made several conclusions, in particular: comorbidity continues to be actively studied, however, the mechanisms of development of comorbid diseases have not yet been established; special forms of comorbid diseases – syntropies – have similar genetic, epigenetic, pathogenetic mechanisms, their phenotype is not a simple sum of individual diseases; one of the alternatives to the inevitable polypragmatism in syntropic comorbid diseases may be «nodal therapy». Chronic heart failure is becoming more common (as is its comorbidity), so progress in nodal therapy may have practical applications. Given the high frequency of detection of comorbid pathology, animal studies are becoming relevant both to identify possible mechanisms of syntropy development and to search for new approaches (including pharmacological substances) and to assess the effectiveness of experimental treatment based on nodal therapy (for this category of patients). It will also be important to study the features of the functioning of reproductive function in experimental heart failure, chronic kidney disease and experimental diabetes mellitus.

comorbidity, chronic heart failure, renal dysfunction, diabetes, nodal therapy

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«Bulletin of problems biology and medicine» Issue 2 Part 1 (164), 2022 year, 68-78 pages, index UDK 616–021: 616.1: 616.61–002.2: 616.379–008.64

10.29254/2077-4214-2022-2-1-164-68-78