HYPERHOMOCYSTEINEMIA AND FUNCTIONAL STATE OF ENDOTHELIUM IN PATIENTS WITH PERIPHERAL ARTERY DISEASE WITH ARTERIAL RECONSTRUCTIONS
Journal Title: Novosti Khirurgii - Year 2018, Vol 26, Issue 2
Abstract
Objective. To study the relationship between homocysteine and markers of the functional state of the endothelium in patients with obliterating atherosclerosis in operations on the aorta and arteries of the lower limbs. Methods. The study included 68 patients with peripheral artery disease, the average age was 57.8±7.3 years, with II B – III degree of chronic arterial insufficiency according to R. Fontaine-A.V. Pokrovsky, who were divided into three groups: I group underwent the femoropopliteal bypass (n=32), II – the aorto-femoral bypass (n=20), III – x-ray endovascular angioplasty and stenting of the iliac arteries (n=16). A correlation analysis was made between the content of homocysteine and the markers of the endothelium functional state of: the oxidized lowdensity lipoproteins (oxidized LDL), a molecule of adhesion of the vascular endothelium type 1 (sVCAM-1), the tissue type 1 plasminogen activator inhibitor (PAI-1), the tissue plasminogen activator (t-PA), Annexin V in the systemic and local bloodstream prior to surgery and after the arterial reconstructions. Results. Correlation relationships between homocysteine and oxidized LDL were established both in the systemic blood flow and the affected limb, this association persisted after the reconstructive intervention, the most significant in the local bloodstream after femoro-popliteal bypass surgery. Preoperative positive correlation of the systemic level of homocysteine and sVCAM-1 in group I was marked. The effect of homocysteine on the fibrinolytic function of the endothelium was shown, as indicated by the direct correlation between homocysteine and PAI-1 in the systemic blood flow and in the affected limb, which persist after open reconstructions. Significant links between homocysteine and the level of Annexin V were revealed in the group of patients with the lesion of the femoropopliteal arterial segment. Conclusions. Hyperhomocysteinemia contributes significantly to the disturbance of the endothelium functional state, affecting apoptosis, the activation of atherogenic LDL, and the procoagulant potential, which persist even after arterial reconstructions both in the systemic and local bloodstream.
Authors and Affiliations
V. A. LAZARENKO, E. A. BOBROVSKAYA
Keywords
Related Articles
- EP ID EP557445
- DOI 10.18484/2305-0047.2018.2.188
- Views 118
- Downloads 0
СТРУКТУРНАЯ РЕОРГАНИЗАЦИЯ СУСТАВНОГО ХРЯЩА КОЛЕННОГО СУСТАВА ПРИ ДИСТРАКЦИОННОМ ОСТЕОСИНТЕЗЕ БЕДРА В КОМБИНАЦИИ С НАКОСТНОЙ ПЛАСТИНОЙ
Цель. Проанализировать динамику изменений суставного хряща коленного сустава при дистракционном остеосинтезе бедра в комбинации с накостной пластиной. Материал и методы. В эксперименте у 6 беспородных собак при дистракци...
POSTOPERATIVE PROLONGED INFILTRATION ANESTHESIA FOR MULTIMODAL PERIOPERATIVE PAIN MANAGEMENT IN PATIENTS WITH HIP REPLACEMENT ARTHROPLASTY
Objective. To improve the efficiency of multimodal perioperative pain management in patients in case of the hip replacement arthroplasty using postoperative prolonged infiltration anesthesia in the area of surgical inter...
POLYMORPHISM OF IL-8 CYTOKINE GENE IN PATIENTS WITH PANCREATOGENIC PERITONITIS
Objective. This preliminary study was conducted to assess the possible association of IL-8 (-251А/Т) polymorphism with clinical course and outcome of acute pancreatitis aggravated by pancreatogenic peritonitis. Methods....
МОРФОМЕТРИЧЕСКИЕ ПОКАЗАТЕЛИ ДЕСТРУКТИВНОГО ИНДЕКСА ЛЕГОЧНОЙ ТКАНИ ПАЦИЕНТОВ ПРИ РАЗЛИЧНЫХ ФОРМАХ БУЛЛЕЗНОЙ ЭМФИЗЕМЫ, ОСЛОЖНЕННОЙ СПОНТАННЫМ ПНЕВМОТОРАКСОМ
Цель. Определить морфометрические показатели деструктивного индекса легочной ткани у пациентов с локальной, распространенной и генерализованной формами буллезной эмфиземы, осложненной спонтанным пневмотораксом, для прогн...
USE OF ENDOVASCULAR AND COMBINED INTERVENTIONS IN OBLITERATING OCCLUSIVE-STENOTIC ARTERIAL DISEASES OF THE LOWER LIMBS
Objective. To improve the results of treatment in patients with lower limb artery occlusive-stenotic diseases, where open operations are impossible or involve a high risk, by using endovascular interventions. Methods. 53...