Platelet and coagulation hemostasis in conditions of the combined cardiac and gallbladder disorders
Journal Title: Український терапевтичний журнал - Year 2019, Vol 0, Issue 3
Abstract
The changes in cardiac function resulting from the gallbladder (GB) disorders are known as a cholecystocardial syndrome. The complexity of its pathogenesis can be explained by simultaneous effects of several mechanisms (pathologic afferent impulses from GB, changes of myocardial metabolism as a result of infective and toxic influences and GB functional disorders, hyperlipidemia, activation of systemic inflammatory response, autonomic nervous system dysfunction, inhibition of interferon system activity, oxidative stress, genetic abnormalities etc). Objective — to study the peculiarities of the course of stable coronary heart disease (CHD), state of the heart, hemostasis and prognosis in conditions of various GB state. Materials and methods. The investigation involved 73 patients (54 males and 19 females; men age 60 y. o.), to whom the following additional measurements were performed: platelet count and determination of their aggregation activity with adenosine diphosphate, fibrinogen levels, soluble fibrin-monomer complexes (SFMC), D-dimer and prothrombin index. Participants were divided into 2 groups depending on the GB ultrasound results: intact GB (n = 40), GB disorders (sludge, signs of cholecystitis, deformations, cholelithiasis, removed GB) (n = 33). Results and discussion. It has been established, that in case of GB alterations, the CHD was significantly more often accompanied by congestive heart failure of ІІ—ІІІ functional classes (82 % vs 45 %, р = 0.001), lower levels of hemoglobin and erythrocytes, higher concentrations of creatinine and urea. CHD with sludge, signs of cholecystitis and GB deformations was accompanied by hypercoagulation with predominance of different elements, and cholelithiasis — by tendency to hypocoagulation, which underlines the importance of control of coagulation hemostasis (D-dimers, SFMC, total fibrinogen). Conclusions. Patients with CHD and GB changes were characterized by more often and more prominent dilatation of left heart chambers, diastolic and systolic dysfunction. The results of 3-year survival analysis after Kaplan-Meier showed that GB disorders are the prognostic factor of high risk of cardiovascular complications in patients with stable CHD forms.
Authors and Affiliations
A. L. Filipyuk, L. M. Strilchuk
Keywords
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- EP ID EP668766
- DOI 10.30978/UTJ2019-3-53
- Views 94
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