For the first time, medicinal plants of arid landscapes of the south of Russia were studied for amino acid composition, vitamins. The features of the accumulation of organic acids and vitamins in medicinal plants were established, the concentrations were correlated from the type and genus of the plant. The component composition of amino acids of the studied LR samples was studied. A total of 9 amino acids were found, of which 5 are irreplaceable. The content of aminoacidum in the studied samples have high levels of variation within the species list, regardless of the plant family, and have a range of total amino acid composition ranging from 3.28% to 12.42%. In general, the content of AC prevails in plants of the species Plantágo májor (12.42%), Polygonum aviculare (9.47%), Capsella bursa-pastoris (8.06%). The lowest indicators of the total number of AC were found for plants of the species Artemisia austriaca (3.28%), Cardaria draba (3.71%). The content of oxalic acid is noted in the aster family and astragalus of the esparcet family of legumes < 250 mg/kg, in other plant samples the content of oxalic acid is > 200 mg/kg. This may be due to the fact that many plants of arid territories accumulate nutrients in the form of salts of organic acids. Studies have shown that the vitamin C content in almost all plant samples is higher than the vitamin K content, with the exception of the common shepherd's purse and the bird's bittern, this may be due to specific features and growing conditions. The percentage of sugar in plant samples has a high level of variation from 1.05 to 5.32%, this may also be due to the specific species of plants, regardless of the family affiliation. A direct correlation has been established between the contents of biologically active organic acids and nutrients in vegetation. The study showed that organic acids have a strong variation in indicators and depend on the type of selected plants and the properties of the functional zone of growth.
Relevance. Acute kidney injury (AKI) and arrhythmias negatively affect the prognosis of myocardial infarction (MI). Aim. To evaluate the features of heart rhythm and conduction disturbances and electrocardiographic changes in men under 60 years old (y.o.) with AKI in MI to improve understanding of the mechanisms of development and prevention. Material and methods. The study included men aged 19-60 years old with MI and AKI were studied. The patients were divided into two age comparable groups: I - study group, with AKI - 25 patients; II - control, without it - 486 patients. A comparative analysis of the frequency of observation of arrhythmias and ECG changes in the selected groups, analysis of the influence of various factors (Pearson's Chi-square) on the risk of arrhythmia in the study group were performed. Results. The compared groups did not differ in the frequency and structure of cardiac arrhythmias and conduction disorders. For the development of arrhythmias in the study group, the most important were: diastolic (absolute risk (AR): 100%; relative (RR) - 5.3; p = 0.02) 120 mm Hg. and more and systolic (AR: 83.3%; RR: 5.3; p = 0.02) blood pressure (BP) 180 mm Hg or more, the early and late left ventricular (LV) filling velocity relationship less than 0,7 (AR: 66.7%; p = 0.002), left atrial 38 mm or more (AR: 53.3%; p = 0.007), LV end-systolic volume index (52.4 ml / m2 or more) and LV end-diastolic index (88.0 ml / m2 and more) (AR: 66.7% each; RR: 4.67 each; p = 0.01). For the development of life-threatening arrhythmias (ventricular fibrillation and asystole) in the study group, a body weight of 110.0 kg or more was of additional importance (AR: 50.0%; p = 0.01). New arrhythmias in the subacute MI period were recorded only in the control group of patients. Conclusions. For AKI in MI in men under 60 y.o., there were no specific heart rhythm and conduction disturbances. For the arrhythmias development in MI with AKI, signs of pronounced hypertension, dilatation of the left heart and LV systolic and diastolic dysfunction are primary importance. Obesity is an additional importance for the life-threatening arrhythmias development in MI with AKI.
Relevance. The significance of changes in intracardiac hemodynamics during myocardial infarction for the acute kidney injury development is assessed in different ways. Aim. To evaluate the intracardiac hemodynamics features in men under 60 years old with myocardial infarction complicated by acute kidney injury to improve prevention and outcomes. Material and methods. The study included men 19-60 years old with type I myocardial infarction. The patients were divided into two age-comparable groups: I - study group, with acute kidney injury - 25 patients; II - control, without it - 168 patients. A comparative analysis of the left ventricular systolic and diastolic function indicators in the first 48 hours (1) and at the end of the third week of the disease (2), their dynamics, analysis of their influence (ANOVA) on the risk of acute kidney injury development were performed. Results. In the first hours of the disease, the study group differed from the control group by the prevalence of end-diastolic values (164.3±48.0 and 145.7±56.2 (ml), respectively; p=0.04), left ventricular stroke volume (73.7±20.6 and 62.4±21.7 (ml); p=0.01) and its index (35.6±9.9 and 30.9±11.1 (ml/m2); p=0.04). At the end of the third disease week in the study group, compared with the control group, there was a lower level of the left ventricular early and late diastolic filling velocity relationship (0.76±0.12 and 0.91±0.35; p=0.01), lower dynamics of the stroke index (8.4%; p<0.0001 and 20.5%; p<0.0001) and left ventricular ejection fraction (14.6%; p<0.0001 and 20.4%; р<0.0001). The most significant risk markers of the acute kidney injury development were the levels of the left ventricular early and late diastolic filling velocity relationship1≤0.88, the end-diastolic volume index1≥72.2 ml/m2, stroke1≥64.4 ml and end systolic its volume1≥79.9 ml and its index1≥38.8 ml/m2. Conclusions. Men under 60 years old with acute kidney injury in myocardial infarction are characterized by more left ventricular systolic dysfunction in the first hours of the disease, as well as its systolic and diastolic dysfunction at the end of its subacute period. The above values of the intracardiac hemodynamics parameters should be used during the high-risk groups’ formation for the acute kidney injury development, as well as for prognostic modeling.
Relevance. Changes in lipid metabolism during myocardial infarction (MI) complicated by acute kidney injury (AKI) are potentially important for evaluating the effects of therapy and expanding the possibilities of prevention. Aim. To evaluate the changes in lipid metabolism during acute and subacute MI periods and their role in the complication’s development in men under 60 years old (y.o.) with AKI to im-prove prevention and outcomes. Material and methods. The results of inpatient examination and treatment of men aged 20-60 y.o. with MI were studied. Patients were divided into two age-comparable groups: the study group, with AKI - 22 patients and the control group, without it - 141 patients. The parameters of lipid metabolism and their dynamics were compared in the first hours (1) and at the end of the third week of MI (2) in selected groups, their influence was assessed (risk analysis by Pearson's Chi-square test) on the risk of AKI development and complications MI in the study group. Results. In the study group, the following were observed: higher levels of low-density lipo-protein2 (LDL2) (5.53±2.50 mmol/l) compared to the control group (3.33±2.45 mmol/l; p=0.02); an increase in the levels of very low-density lipoproteins, a coefficient and an atherogenic index, a decrease in triglycerides (TG) at the end of the third week of the disease. The risk of AKI development was associated with the concentration of TG1≥1.88 mmol/l (p=0.007). Complicated course of MI in the study group is characterized by levels of LDL1≥4.0 (p=0.02), high-density lipoprotein1 (HDL1)˂1.1 (mmol/l; p=0.02), and their ratio (LDL1/HDL1) ≥4.5 (p =0.02). Conclusions. In AKI, persistent atherogenic changes in lipids are noted both in the acute and at the end of the subacute period of MI. The risk of developing AKI increases at levels of TG1≥1.88 mmol/l, and the complicated course of MI in the study group is associated with lev-els of LDL1≥4.0, HDL1˂1.1 (mmol/l) and LDL1/HDL1≥4.5. It is expedient to use them in predictive modeling.
Abstract. Relevance. Acute kidney injury (AKI) in myocardial infarction worsens the prognosis and increases the duration of treatment of patients. Aim. To evaluate predictors of acute kidney injury in myocardial infarction in men younger than 60 years of age with gout to assess opportunities to improve prevention. Material and methods. The study included men 42-59 years old (y.o.) with type I MI and gout. Patients were divided into two age-comparable groups: I - study group, with AKI - two pa-tients; II - control, without it - 24 patients. Comparative evaluation of data on cardiovascular risk factors, parameters of the disease course in selected groups was performed. Quantitative parameters were determined twice, in the first 48 hours (1) and at the end of the third week (2) of MI. Pearson's chi-square method was used to assess the absolute (AR) and relative (RR) risks of developing AKI under the influence of the listed factors. Results. A significant effect on the possibility of developing AKI in the examined patients was obtained for: a history of urolithiasis (AR 50.0%; p=0.01), MI in the winter period (AR 40.0%; p=0.03 ); levels of low-density lipoproteins1<2.5 mmol/l (AR 50.0%; p=0.04), ratios of total cholesterol1/high-density lipoproteins1<3.7 (AR 50.0%; p=0.04), glucose1 ≥8.9 mmol/l (AR 100.0%; RR 14.0; p=0.008); potassium1 ˂3.8 mmol/l (AR 100.0%; RR 13.0; p=0.01), glomerular filtration rate (СKD-EPI)1≥123.0 ml/min/1.73 m2 (AR 100.0%; RR 14.0, p=0.008); polytopic extrasystole (AR 100.0%; RR 14.0; p=0.008), thromboembolism (AR 100.0%; RR 14.0; p=0.08) in the structure of MI complications; levels of systolic blood pres-sure (BPsyst)1≥200 mm Hg. (AR 66.7%; p=0.002), mean BP1≥133.0 (AR 66.7%; p=0.002), stroke index1≥39.8 ml/m2 (AR 66.7%; p=0.002), transverse dimension of the right atrium (RA)1 ˃52 mm (AR 50.0%; p=0.01). Conclusions. The most important for the risk of AKI development during MI in men under 60 y.o. with gout were arterial hypertension (BPsyst≥200 mHg), hyperglycemia (≥8.9 mmol/l), RA dilation (˃52 mm), history of urolithiasis. Combinations of the above parameters should be used to form high-risk groups for AKI development in this category of patients to improve preventive measures, as well as for predictive modeling.
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