Kazakov Yu. M., Manusha Yu. I., Trybrat T. A., Chekalina N. I., Shut’ S. V.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

According to WHO, ischemic heart disease (IHD) ranks first among the causes of worldwide mortality. The recent scientific research confirm that the chronic systemic inflammations (CSI) low-intensity have an leading place in occurrence and progression of atherosclerosis, pathogenic basic of it is endothelial disfunction (ED) and dyslipidemia. The hepatocytes is involved in support of lipidic homeostasis. The functional disorders influence on potentiation of dyslipidemia (PD) and respectively development and progressing of IHD. According to modern representations of non-alcoholic fatty liver disease (NAFLD) is considered as a risk factor for cardiovascular disease. The question about formatting of fatty liver infiltration is also quite relevant. NAFLD is a stadium process that provides voluntary livers fatty infiltration with the further progression of diseases like as steatohepatitis, hepatocellular carcinoma or cirrhosis of liver. The increase of prevalence of this comorbidity disease is required a further deep research of features of the functional livers state with the goal of looks for new more effective methods of diagnostic and treatment of IHD in combination with NAFLD. The research have 135 involved patients with IHD: stable angina, І-ІІ of functional class, 0-І of heart failure in combination with NAFLD and 30 healthy persons. At the moment of primary clinical examination of patients with IHD in combination with NAFLD is revealed that patients periodically feel abdominal pain and dyspeptic syndrome with moderate and mild intensity of pain. The feeling of moderate periodical pain and/or feeling of discomfort of right subcostal region is noted by 98 (89%) patients. The dyspeptic syndrome in the form of belching air, feeling of bitterness in the mouth, nausea, bloating is observed in 75 (68%) patients. In 5 (20%) patients with IHD is effected of periodical discomfort in epigastric region of the abdomen, 7 (5,5%) patients have belching, nausea, bloating that connected with chronic comorbid disease of upper gastrointestinal tract. An objective examination showed an increase in liver size in 68 (61.8%) patients with comorbid pathology. The presence of pain during palpation in the area of the right hypochondrium is observed in 35 (31.8%) patients, bloating in the course of the colon in 31 (28%) patients. The increasing livers size isn’t observed in patients with IHD. Slight paint full sensations is observed at the moment of palpation in the area of the right subcostal region by 6 (24%) patients, that can be explained by the presence of other concomitant diseases of the gastrointestinal tract. According to ultrasound liver diagnostics in patients with IHD in combination with NAFLD ultrasound signs of hepatosis are revealed in 110 (100%): increased echostructure, increased echogenic and decreased sound conductivity of the liver, increased liver size (hepatomegaly) is revealed in 68 (61.8%) patients, diagnosed with chronic cholecystitis (sealing the wall of the gallbladder) in 42 (38.2%) and previously performed cholecystectomy in 13 (11.8%). The increasing livers size and echogenicity aren’t observed in patients with IHD. The pulse Doppler of the liver vessels are used with the purpose of estimating livers blood flow. Increasing of blood flow velocity in the portal and hepatic veins in patients with IHD in combination with NAFLD can be a result of possible compaction of the parenchyma of the liver against the background of impaired functional status and the response of vessels to chronic low-intensity vascular inflammation.

functional state of the liver, ischemic heart disease, non-alcoholic fatty liver disease, comorbidity, chronic low-intensity vascular inflammation.

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«Bulletin of problems biology and medicine» Issue 3 (152), 2019 year, 118-121 pages, index UDK 616.36 – 003.826 – 06:616.127 – 005.4] – 092

10.29254/2077-4214-2019-3-152-118-121