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Chronic kidney disease puts an individual at a higher risk of all-cause and cardiovascular death. Coronary artery calcium score reflects the accumulation of calcium in the walls of the coronary arteries and a higher coronary artery calcium score is associated with lower survival rates. It is unclear if control of conventional risk factors is enough to reduce cardiovascular risk in patients with chronic kidney disease. The aim of this study was to investigate if the association between estimated glomerular filtration rate and coronary artery calcium score in the Ukrainian population differs by sex, age, blood pressure, and total cholesterol.This cross-sectional study was conducted on a sample of patients who underwent measurement of coronary artery calcium score at Dnipropetrovsk Mechnikov Regional Hospital, Dnipro, Ukraine. Inclusion criteria: age >40 years old, available data about coronary artery calcium score and estimated glomerular filtration rate. Exclusion criteria: the presence of known cardiovascular disease, diagnosis of diabetes mellitus, estimated glomerular filtration rate <30 ml/min and extreme coronary artery calcification (coronary artery calcium score >1500 Agatston units). 137 patients (54 males and 83 females), median age 59.0 [54.0;67.0] years were enrolled in the study. In the patients with lower eGFR there was non-significantly higher coronary artery calcium score (p=0.07). In males with eGFR ≥90 ml/min, 60-89 ml/min, and 30-59 ml/min coronary artery calcium score didn’t differ significantly, while in females a lower estimated glomerular filtration rate was associated with a higher coronary artery calcium score. A lower estimated glomerular filtration rate was significantly associated with a higher coronary artery calcium score in the patients with systolic blood pressure ≥140 mmHg (p=0.04), but not in patients with diastolic blood pressure ≥90 mmHg. In the patients with total cholesterol <5.0 mmol/l and ≥5.0 mmol/l coronary artery

The aim. To analyze the relationship between serum aldosterone levels and myocardial remodeling and changes in elastic properties of arteries in patients with chronic kidney disease (CKD) and hypertension (AH).Materials and methods. A cross-secitonal study of 44 patients (14 men and 30 women, aged 56.0 [52.0; 60.5] years) with CKD and AH who were treated with angiotensine-converting enzyme inhibitors or angiotensine receptor blockers at a stable dose for at least of 3 months was performed. Serum aldosterone levels, elastic properties of the arteries, and transthoracic echocardiography using a standard method were performed. Arterial stiffness was defined as a pulse wave velocity, which was calculated using equation proposed by Arterial Stiffness Society and was measured using a device BAT41-2.Results. In 8 patients (18.2 %) we detected serum aldosterone levels above 90 pg/ml. The proportion of female patients among patients with normal aldosterone levels was significantly higher (P = 0.03). Patients with elevated aldosterone levels had a 5-year higher median age and 10 ml/min lower glomerular filtration rate. Serum aldosterone levels correlated significantly with myocardial structural and functional parameters (left ventricle (LV) end-systolic and end-diastolic dimensions and volumes, LV myocardial mass and LV mass index, thickness of interventricular septum) in men and patients over 55 years of age. Women showed a weak correlation of aldosterone levels with systolic and diastolic blood pressure.Conclusions. An association was found between serum aldosterone levels above 90 pg/ml in patients with CKD and hypertension with dilatation of left ventricular and atrial cavities, and with left ventricular hypertrophy (by LV mass and mass index). This association was stronger for males and for patients aged >55 years. A correlation between aldosterone level and arterial stiffness (augmentation index on the brachial artery and aorta) has only been found in patients over

The aim of our study was to evaluate the changes in the parameters of the function of external respiration in patients after kidney transplantation due to chronic kidney disease and to assess the relationship between the level of cyclosporin A and tacrolimus in the blood with FVD indices. The study included 37 patients after kidney transplantation. The first group included 27 patients who received cyclosporine at an average dose of 225 [175-350] mg/day under the immunosuppressive therapy regimen, the second group included 10 patients who received tacrolimus at an average dose of 8.25 [5.0-9.0] mg/day. A significant difference (p˂0.05) between the indicators of the VCmax (78 [71-90]% and 76.5 [72-78]%), FVC (93 [85-99]% and 95 [91-98]%), PEF (82 [64-94]% and 80 [69-84]%), MEF25-75 (75 [66-112]% and 82.5 [67-90]%) was found in patients of the first and second groups relative to the FVD of the comparison group: VCmax (102.5 [98-113]%), FVC (107.5 [105.5-124]%), PEF (99.5 [95-102.5]%), MEF25-75 (98.5 [97.5-101.5]%). In both groups, a statistically significant negative correlation between the indicators of the VCmax, FVC and the level of cyclosporin A (R=-0.69, p<0.0001 and R=-0.4, p<0.037) in the blood in the first group and FVC and tacrolimus (R=-0.72, p<0.018) in the second group was found. A moderate decrease in the VCmax values in patients after kidney transplantation requires monitoring of the function of external respiration and managing such patients by nephrologists together with specialists in the pulmonological profile.

Our aim was to assess the level of proteinuria and changes in vascular endothelial function in patients with chronic kidney disease (CKD) in combination with subclinical hypothyroidism (SHT) under the influence of antihypertensive combination therapy (valsartan 160 mg and amlodipine 5 mg). We examined 48 patients with CKD I-II stages and AH 1 and 2 degrees. Depending on the functional state of the thyroid gland, patients were divided into 2 groups. Within 12 weeks patients took a fixed combination of amlodipine 5 mg and valsartan 160 mg. Target BP levels were achieved in 19 (86.3%) patients of the main group and 22 (84.6%) of the comparison group. More often violation of brachial artery flow-mediated dilation and higher level of daily proteinuria were found in the main group patients. At the end of the study, the level of daily proteinuria in the main group decreased by 46.03% (p<0.01), and in the comparison group – by 55.3% (p<0.01). SHT can be considered as an additional factor that affects the course of CKD and AH by worsening the state of endothelial function and increasing the level of daily proteinuria. Combination of valsartan 160 mg and amlodipine 5 mg has lead to achieving of target blood pressure levels, improving of endothelial function and decreasing of daily proteinuria in both groups.

The importance of the problem of heart failure for modern medicine is due to its growing prevalence and poor prognosis, despite a tendency to decrease of deaths from major cardiovascular diseases: coronary heart disease (CHD) and arterial hypertension (AH). Objective: to evaluate the risk factors, the state of cardiac hemodynamics and kidney function in patients with chronic heart failure (CHF) and acute myocardial infarction (AMI) in history. A retrospective analysis of 144 case histories of patients with CHF with preserved systolic function, aged 40 to 80 years and with disease duration from 1 year to 10 years was made. The patients were divided into 2 groups depending on the presence of anamnestic data in favor of past AMI: group 1 – 35 patients (24%) with CHF and AMI in anamnesis, 2 group, 109 patients (75,7%) with CHF without AMI in anamnesis. It was found that prevalence and severity of hypertension as well as arrhythmia were not significantly different in patients of both age groups. Among patients with stable angina and CHF with preserved ejection fraction there was established a high prevalence of hypertension, diabetes and obesity. The presence of AMI in anamnesis was associated with worse control of hypertension on the background of normal indicators of lipidogram, compared to patients with CHF without AMI in anamnesis. There was established a higher incidence of revealing patients with impaired renal function among patients with CHF with a trend to increase of manifestations of chronic renal failure and hyperuricemia among patients with postinfarction cardiosclerosis, regardless of patients’ age.

There are presented and analyzed the most common and important risk factors (RF) in patients with chronic heart failure and atrial fibrillation (AF). The data indicate the need for more careful attention to this group of patients and the need in early diagnosis of AF RF and their active modification, which is very important for the development of effective measures both for the primary prevention of AF and prevention of progression of this disease.

Aim. 28 Patients have been observed to examine correlation between functional condition of vascular endothelium, and weight in patients with coronary heart disease in combination with non-alcoholic fatty liver disease and also its dynamics under influence of statin therapy.Methods and results. In 20 patients endothelium-dependent vasodilation (EDVD) has been detected based on reactive hyperemia and its dynamics depending on the body mass index under the influence of statin therapy.Conclusion. In patients with ischemic heart disease, obesity and NAFLD first degree expressed positive dynamics on endothelial function (57%) in contrast to patients with overweight (44%) has been revealed during therapy with pitavastatin 2 mg for 8 weeks; besides an increase of hepatic transaminases has not been detected, which means that the abolition of the drug was not required.

The article analyzes the blood lipid spectrum, level of systemic inflammation and their dynamics depending on body mass index in patients with coronary heart disease (CHD) in combination with nonalcoholic fatty liver disease (NAFLD) under the of influence statin therapy. 20 men (mean age 56,4±1,44 years) with CHD and NAFLD were examined. Levels of triglycerides (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), C-reactive protein (CRP) were studied. 2 groups of patients according to BMI were distinguished: group 1 consisted of 9 (45%) patients who are overweight (BMI 25 to 30 kg/m2), group 2-8 (40%) with first degree of obesity (BMI 30 to 35). It was at found that at the initial state BMI increase at the range of 25-35 kg/m2 was not associated with a significant difference in the lipid spectrum, on the other hand on the background of treatment with pitavastatin in the dose of 2 mg for 8 weeks in patients with BMI of 25-30 kg/m2 more intensive reduction of TG (56.6%), LDL-C (31,8%), total cholesterol (22%), CRP (29.8%) and increased HDL-C (14,7%) was registered in contrast to the patients with BMI 30-35 kg/m2 – 33,7%, 22,8%, 8,8%, 10,1%, 11,9% respectively. Thus, in patients with CHD and NAFLD, pitavastatin in the dose of 2 mg has a moderate lipid-lowering effect, causes no significant increase in liver transaminases, which required dose adjustment or discontinuation of the drug.