Adaptation to hypoxia and ischemic preconditioning: pathophysiologic and clinical aspects of cardioprotection in patients with coronary disease

Лямина, Н. П.; Павловна, Лямина Надежда; Котельникова, Е. В.; Владимировна, Котельникова Елена; Карпова, Э. С.; Станиславовна, Карпова Элла; Александровна, Бизяева Екатерина; Лямина, С. В.; Владимировна, Лямина Светлана

doi:10.26442/cs45132

CardioSomatics

2015

DOI: 10.26442/cs45132

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Adaptation to hypoxia and ischemic preconditioning: pathophysiologic and clinical aspects of cardioprotection in patients with coronary disease

Н. П. Лямина

Лямина Надежда Павловна²,

Е. В. Котельникова

et al.

Abstract: Research of cardioprotection and endogenous methods of nonspecific myocardial protection - adaptation to hypoxia and ischemic preconditioning grows rapidly nowadays. In cardiovascular patients the use of cell mechanisms based on adaptation to hypoxia, and the phenomenon of ischemic preconditioning is a perspective and promising approach to solve the problem of myocardium protection in ischemic injury. In consequence of basic and clinical research in intracellular functional and methabolic mechanisms of adaptat… Show more

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Cited by 3 publications

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Effect of Concomitant Chronic Obstructive Pulmonary Disease on Markers of Collagen Metabolism in Patients with Ischemic Heart Disease

Myasoedova

2019

Kardiologiia

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Aim. To study parameters of collagen myocardial metabolism in patients with ischemic cardiomyopathy (ICMP) and to assess the effect of concomitant chronic obstructive pulmonary disease (COPD) on their levels.Materials and methods. We examined 130 patients with ICMP (mean age 55.5 [43; 63] years) and 42 patients with ICMP and COPD (mean age 54.8 [41; 63] years). Determination of serum levels of matrix metalloproteinase-1 (MMP-1), its tissue inhibitor (TIMP-1), transforming growth factor-β1 (TGF-β1), and autoantibodies to collagen types I and III was carried out with the help of commercial test systems based on the method of solidphase enzyme immunoassay. Calculation of the volume fraction of interstitial collagen (VFIC) of the myocardium was carried out by the method of J. Shirani.Results. In patients with ICMP combined with COPD, as well as in patients with ICMP we found disbalance in the metabolism of collagen of the extracellular matrix. At the same time, in patients with ICMP+COPD, processes of collagen degradation at the background of extracellular matrix fibrosis were found to be even more pronounced than in patients with ICMP. This was evidenced by the absence of statistically significant differences in the myocardial VFIC (p=0.703), and the level of TGF-β1 (p=0.074), as well as statistically significant higher activity of MMP-1 (p=0.037), MMP-1 / TIMP-1 ratio (p=0.045), and production of autoantibodies to collagen types I and III (p=0.042, p=0.039, respectively).Conclusion. The presence of COPD in patients with ICMP is associated with increased disbalance of the proteolysis-antiproteolysis system in the direction of collagen breakdown that can lead to more pronounced structural changes of the myocardium, and, as consequence, to aggravate functional impairment of the organ.

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Effect of Concomitant Chronic Obstructive Pulmonary Disease on Markers of Collagen Metabolism in Patients with Ischemic Heart Disease

Myasoedova

2019

Kardiologiia

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Pathogenetic rationale for the use of intermittent normobaric hypoxytherapy in the rehabilitation of patients with chronic obstructive pulmonary disease

Масик¹,

Nechiporuk²

2021

УТЖ

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Objective — to determine affects of the intermittent normobaric hypoxytherapy on the dynamics of general non‑specific adaptive reactions in the complex rehabilitation of patients with chronic obstructive pulmonary disease (COPD). Materials and methods. The treatment and examinations involved 450 patients with COPD, including GOLD 2 in 55.56 % (250 people) and GOLD 3 in 44.44 % (200 patients). The mean age was (52.65 ± 14.80) years, proportion of female and male subjects was equal. All patients received basic drug therapy according to the Order of MoH of Ukraine. The disease duration was 10 to 30 years, the remission stage was established in all patients. Patients were randomized into two groups: main (400 people) and control (50 people) with the same COPD severity distribution. Patients of the main group received additional 30 minutes sessions of interval normobaric hypoxytherapy for 20 days. The examination were performed for the dynamics of clinical symptoms, respiratory function, nonspecific resistance of an organism. Results. Most patients had symptoms of the disease against the background of basic COPD medication even on the remission stage. Unfavorable and intense adaptive reactions were determined in 71.33 % of COPD patients, and eustress reactions only in 16.89 %. Sanogenetic types of adaptive reactions were found in 28.45 % of subjects, maladaptive types — in 21.78 % of persons, pathogenetic — in 63.33 % of patients. At GOLD 2, tense reactions were diagnosed in 69.6 % of subjects, and in GOLD 3 in 73.0 %. As the severity of the disease increased, there was an increase in the development of intense training and activation responses. Upon completion of the course of hypoxytherapy, the exercise tolerance increased, and shortness of breath appeared only after severe physical activity in 90.25 % of patients in the main group, whereas in the control group similar changes were observed only in 20.0 % of patients. The respiratory function indicators in patients of the main group increased on average by 17.52 %, while in the control group — by 3.3 %. In the main group, favorable adaptation reactions prevailed in 88.25 % of patients, while in the control group this indicator was 32.0 %. The percentage of adverse reactions in the main group decreased significantly and was 11.75 % after treatment, the proportion of stress reactions — 46.25 %. In GOLD 2, the proportion of pathogenetic reactions decreased to 17.33 % and 56.00 % of the main and control groups, and in GOLD 3 — in 20.44 % and 44.0 %, respectively (p < 0.05). Conclusions. The use of a course of normobaric hypoxytherapy promoted the reduction of the main clinical COPD symptoms, increase of the frequency of favorable adaptive reactions up to 88.25 %, it raised clinical effectiveness of the treatment, which allowed to avoid disease exacerbations during the year in 80.95 % of patients.

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Influence of Interval Normobaric Hypoxytherapy on the Processes of Ischemic Preconditioning in the Myocardium of Patients With Chronic Obstructive Pulmonary Disease

2022

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The aim: Determination of cardioprotective effect of interval normobaric hypoxia in medical rehabilitation of patients with COPD. Materials and methods: 123 patients with COPD who received basic drug therapy were examined and were divided into 2 groups. Patients of the main group (93 persons) additionally received 2 courses of 20 sessions of interval normobaric hypoxia. All patients underwent echocardiographic examination at the beginning and after 1 year of follow-up. Results: Prior to treatment, all patients had changes in the myocardium of both ventricles, due mainly to hypoxic and inflammatory effects and to a lesser extent to increased pulmonary artery pressure. Interval normobaric hypoxytherapy caused adaptive-adaptive reactions of the cardiovascular system, which manifested a positive effect on the state of both left and right ventricles: increase in stroke volume and expulsion fraction, decrease in E-DV and E-SV of the left and right ventricular E-DS, elimination of myocardium. However, the result is more effective in patients with GOLD 1 and GOLD 2 compared to GOLD 3. Conclusions: The use of interval normobaric hypoxytherapy in the rehabilitation of COPD, initiated by ischemic preconditioning, is pathogenetically justified because it triggers endogenous mechanisms of cardioprotection and metabolic adaptation.

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Adaptation to hypoxia and ischemic preconditioning: pathophysiologic and clinical aspects of cardioprotection in patients with coronary disease

Cited by 3 publications

References 13 publications

Effect of Concomitant Chronic Obstructive Pulmonary Disease on Markers of Collagen Metabolism in Patients with Ischemic Heart Disease

Effect of Concomitant Chronic Obstructive Pulmonary Disease on Markers of Collagen Metabolism in Patients with Ischemic Heart Disease

Pathogenetic rationale for the use of intermittent normobaric hypoxytherapy in the rehabilitation of patients with chronic obstructive pulmonary disease

Influence of Interval Normobaric Hypoxytherapy on the Processes of Ischemic Preconditioning in the Myocardium of Patients With Chronic Obstructive Pulmonary Disease

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