Patologìâ (Apr 2013)
Influence of oxidative stress on cardiovascular parameters in patients with combined flow of chronic obstructive pulmonary disease and arterial hypertension
Abstract
Introduction. It is well known that active forms of oxygen, such as hydrogen peroxide, superoxide anion, hydroxyl radical and others are involved in different pathological conditions, such as cell necrosis, senescence, apoptosis, autophagy, inflammatory responses, remodeling of extracellular matrix and blood vessels, endothelial dysfunction, inactivation of antiproteases, and impaired tissue repair. The pathological increased production of mentioned active forms is called “oxidative stress”. From the literature data, we know that oxidative stress is involved in pathogenesis of arterial hypertension (AH), chronic obstructive pulmonary disease (COPD), atherosclerosis and others. The influence of oxidative stress on cardiovascular disorders in patients with combined flow of COPD and AH is not clearly known. Objective. To study peculiarities and links between parameters of oxidative stress and lesions of heart and vessels in patients with combined flow of COPD and AH. Materials and methods. A total of 101 patients with COPD, AH and with combined flow of COPD and AH were examined. The patients were divided into 3 groups. The first group was formed by patients with AH (n=29) the second group was formed by patients with COPD (n=29), the third group was formed by patients with combined flow of COPD and AH (n=57). Control group was formed from healthy persons of the same age and sex (n=22).All patients underwent spirography, echocardiography, ultrasound measurement of common carotid artery intimal-medial thickness and estimation of endhothelium-dependent vasodilatation. As oxidative stress markers, the levels of oxidative protein modification, spontaneous and iron induced aldehydephenylhydrazone’s (APH), ketondinitrophenylhydrazone’s (KPH) and medium size molecules (MSM) were measured. Results. Patients with combined flow of COPD and AH had higher levels of spontaneous APH (p<0,01) comparing with first and second group. The levels of spontaneous KPH were significantly different only with control. The concentration of MSM was higher in patients with combined COPD and AH, comparing with AH (p<0,05) and control (p<0,01). While measuring iron induced APH and KPH, we received significant increasing of their levels comparing with isolated COPD (p<0,001), AH (p<0,001) and control (p<0,001). The higher levels of iron induced fraction show decreased function of antioxidant system in patients with combined flow of COPD and AH. The correlation links between spontaneous APH and end-systolic diameter of left ventricle (R=+0,39; p<0,05), systolic pressure in pulmonary artery (R=+0,37; p<0,05), E/A ratio of right ventricle (R=+0,44; p<0,05). The concentration of spontaneous KPH correlated with vascular intima-media thickness or right (R=+0,41; p<0,05) and left (R=+0,39; p<0,05) common carotid artery. The levels of iron induced KPH have correlation links with right ventricle diameter (R=+0,39; p<0,05) and endhothelium-dependent vasodilatation (R=-0,39; p<0,05) Conclusion. The patients with combined flow of COPD and AH have increased levels of oxidative stress markers – spontaneous and iron induced APH and KPH. The significant correlation links between oxidative stress markers and systolic, diastolic parameters of left and right ventricle, vascular intima-media thickness and endothelial function were found.
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