Репозиторий Университета

© 2018 Limited Liability Company KlinMed Consulting. All Rights Reserved. Background: Literature data on hepcidin (H) level - the main regulator of systemic iron homeostasis in patients with chronic heart failure (CHF) - are contradictory. Relationships of H with markers of inflammation elevated level of which is characteristic of CHF are insufficiently studied. The latter problem remains practically unexplored in elderly and very old patients with CHF. Aim: to study the role of H in formation of anemia of chronic disease (ACD) and iron deficiency anemia (IDA) in elderly and very old patients with CHF. Material and methods: We examined 65 elderly and very old patients with ischemic heart disease (IHD) (35 with CHF and ACD, 10 with CHF and IDA, 20 without CHF, ACD, and IDA [control group]). H level in blood serum was measured using competitive solid-phase immunoenzyme assay. Results and discussion: In patients with CHF and ACD mean H levels were significantly high relative to those in patients with CHF and IDA, while in the latter group H levels were insignificantly low relative to those in patients of control group. High H level, high level of inflammatory tests as well as positive correlations between them, and negative correlation between H and hemoglobin (Hb) are indicative of inflammation as a cause of H level elevation, which in turn facilitates development of anemia in elderly and very old patients with CHF and ACD. Low H level, normal levels of inflammatory tests, absence of links between them, as well as absence of correlation between H and Hb are indicative of lack of H role in development of anemia in these patients with CHF and IDA. We did not study influence on development of anemia of each of possible causes (inflammation, decompensation of CHF) separately, therefore contribution of each of them is unknown. The data obtained also do not exclude effect of other not investigated in this work and presently unknown factors. Received by us data indicate to necessity of precise identification of origin of anemia in every case in an elderly or very old patient with CHF with the aim of elimination of its cause and conduct of pathogenetically valid therapy.

© 2018 Limited Liability Company KlinMed Consulting. All Rights Reserved. Purpose: to assess prevalence of dyslipidemia in patients with ischemic heart disease (IHD) older than 75 years as well as to evaluate possible associations between serum lipids and various cardiovascular and other diseases in these patients. Methods: We enrolled in this cross sectional study 555 hospitalized IHD patients aged 75-98 years (mean age 86.8 years, 74.5% women). Levels of lipids (total cholesterol [TC], triglycerides [TG], low and high-density lipoprotein cholesterol [LDLC, HDLC]) were measured by enzyme method on the biochemistry analyzer Konelab 60i. Results: Elevated TC; hypertriglyceridemia and elevated LDLC were observed in 13.3, 10.4 and 26.3% of patients, respectively. In the majority of patients severity of dyslipidemia was mild. With increasing age serum levels of TC and LDLC decreased. Negative correlation between TC level and patient's age was significant (r= -0.13; p=0.001). Mean TC level was 5.43, 5.0 and 4.7 mmol/l in patients aged <80 (group 1), 80-89 (group 2), and ≥90 (group 3) years, respectively (p=0.001 for differences between groups 1-and 3). Similar results were registered in respect of LDLC: mean LDLC level was 3.7 and 2.7 mmol/l in groups 1 and 3, respectively (p=0.004). Mean concentrations of all lipids in women were higher than in men: TC 5.1 vs 4.5 (p<0.0001), LDLC 3.1 vs 2.5 (p=0.0002), HDLC - 1.26 vs 1.17 mmol/l (p=0.01). Lower lipids levels (especially those of TC) were significantly associated with clinically significant heart failure (p<0.0001) and atrial fibrillation (p<0.0001). Higher TC and TG correlated positively with higher systolic and diastolic blood pressure (p=0.001). Significant positive correlations existed between TG and glucose concentration (p<0.0001) as well as between TG and uric acid level (p=0.001). Higher TG and lower HDLC levels were registered in patients with higher creatinine level (p=0.001 and 0.0003, respectively). Only 11.4% of study patients received statins. Conclusion: The study results evidence for considerable peculiarities of lipid profile in the very elderly patients with IHD. Significant associations between dyslipidemia and a number of diseases were also revealed.

© 2018 Limited Liability Company KlinMed Consulting. All Rights Reserved. The article describes the definition of dementia, its diagnostic criteria, classification. Differences in the pathogenesis and clinical manifestations of different types of dementia are considered. The issues of interrelation of arterial hypertension and the risk of development of cognitive disorders and dementia in old and very old people are discussed in detail. Data on the effect of antihypertensive drugs of different groups on the risk of dementia and the state of cognitive functions are presented. The evidence base of dihydropyridine calcium antagonist amlodipine and thiazide-like diuretic indapamide-retard is discussed with respect to the prevention of dementia and cognitive decline and their beneficial effect on cognitive function in patients with arterial hypertension.