Prevalence and predictors of hypertension in cardiac recipients

Шевченко, А. О.; Никитина, Е. А.; Можейко, Н. П.; Tyunyaeva, I. Yu.; Колоскова, Н. Н.

doi:10.15825/1995-1191-2017-3-33-39

Cited by 3 publications

(3 citation statements)

References 15 publications

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“…Общими факторами риска для венозных тромбоэмболий и атеросклероза являются индекс массы тела ≥30 кг/м 2 , артериальная гипертензия (АГ) и дислипидемия [5]. Указанные факторы риска являются таковыми и для ХБП [6][7]. Тромбоэмболические осложнения -значимый фактор, влияющий на прогноз у больных ХБП [8].…”

Section: Introductionunclassified

The Measurements of Blood Clotting in Cardiorenal Syndrome in Elderly

Наумов

Шевченко

Orlova

et al. 2018

Cardiovasc Ther Prev

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Aim. To assess the changes in hemocoagulation parameters according to the grade of renal dysfunction in elderly patients with cardiorenal syndrome types II and IV.Material and methods. In 56 patients of the elderly age group (mean age 78±10 y.o.), with coronary heart disease and chronic heart failure, the parameters of blood clotting were assessed and the relations with kidney dysfunction grade measured by the level of glomerular filtration rate (GFR). Patients were selected to 3 groups. In 47 (83,9%) there was decline of GFR <60 mL/min/1,73 m2, of those in 8 (17,3%) <30 mL/min/1,73 m2; in 9 GFR >60 mL/min/1,73 m2, with no signs of proteinuria (16,1%). All patients underwent coagulological assessment of the blood with measurement of the activated partial thromboplastin time, thrombin time and prothrombin time, international normalized ratio and fibrinogen concentration, as the complete blood count with platelet number, mean platelet volume, thrombocyte distribution width, and thrombocrit.Results. The number of platelets did differ significantly in groups 1 and 3 (p=0,040), as 2 and 3 (p=0,007). Thrombocrit values did differ significantly only in 2 and 3 (p=0,029). In the group 3 the rate of the mentioned values was below the respective reference values. Fibrinogen levels did differ significantly in groups 1 and 3 (p=0,042), and 2 and 3 (p=0,037). In the group 3 the parameter was higher than upper limit of reference range. Correlation found for GFR and fibrinogen level (r=-0,425; p=0,004), for GFR and platelet number (r=0,271; p=0,049). The platelet number correlated with creatinine level (ρ=-0,392; p=0,004). Creatinine level also correlated with fibrinogen level (ρ=0,375; p=0,012).Conclusion. In the elderly, with the decline of GFR there is decline of thrombocyte number and increase of fibrinogen concentration together with an increase of the severity of kidney dysfunction. The pathological changes that were found might probably serve as additional factor influencing the risk of adverse events related to disorder of blood clotting. The importance of the revealed relations, as the aimfulness for clinical application, should be evaluated in controlled studies.

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Section: Introductionunclassified

The Measurements of Blood Clotting in Cardiorenal Syndrome in Elderly

Наумов

Шевченко

Orlova

et al. 2018

Cardiovasc Ther Prev

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“…Уровни артериального давления на фоне антигипертензивной терапии в зависимости от наличия АГ в анамнезе муносупрессивной терапии[10][11][12]. Согласно публика ции IJ Sanchez Lazaro, эффективно назначение блокато ров кальциевых каналов в комбинации с иАПФ или АРА II[10].…”

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“…А. О. Шевченко и др. утверждают, что реципиенты после ТС «хорошо переносят ингибиторы АПФ, антаго нисты кальция и диуретики, назначаемые дополнительно к основной медикаментозной терапии»[12]. По нашим данным, на фоне антигипертензивной тера пии у реципиентов в большей степени характерна худшая коррекция ДАД, несмотря на нормализацию уровня САД (табл.…”

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Arterial hypertension after heart transplantation

et al. 2020

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Aim To evaluate incidence of arterial hypertension (AH) in the posttransplantation period and to identify risk factors for this complication.Materials and methods From January, 2010 through December, 2017, 96 heart transplantations (HT) (70 men and 26 women aged 46.5±13.9 years) were performed. During the first month following HT, 8 recipients died and were excluded from the analysis. The retrospective evaluation of results included 88 patients followed up for more than one year.Results For the entire post-HT period (maximum 92 months), AH was observed in 75 of 88 (85%) recipients. Post-HT AH was correlated with male gender (r=0.24; p=0.031), history of smoking before HT (r=0.45; p<0.001), history of ischemic heart disease (IHD) (r=0.28; p=0.01), older age (r=0.35; p=0.001), higher body weight index (r=0.37; p=0.0005), creatinine level (r=0.37; p=0.001), and low-density lipoprotein cholesterol level (r=0.27; p=0.04). Interrelations with other AH risk factors were not found. Most patients developed AH within the first two years after HT. During the first year, AH was diagnosed in 60% (53 of 88) of patients (relapse, 85% (n=29); newly diagnosed, 45% (n=24), p=0.0003). At two years, AH was detected in 79% (46 of 58) of patients (relapse, 53% (n=18); newly diagnosed, 53% (n=28), p=0.9). All recipients received an adequate antihypertensive therapy. 40-63% of patients required a single-drug therapy at different points of follow-up; from 29 to 45% of patients required a two-drug therapy, and 5-15% of patients required three or more drugs. During all 5 years of treatment, most patients used angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) (70-87%) and slow calcium channel blockers (SCCB) (48-53%). The presence of AH following HT was associated with development of all cardiovascular events (CVE; r=0.31; p=0.012) whereas persistent AH, which required a combination antihypertensive treatment, was associated with a high mortality (r=0.61; p=0.015).Conclusion AH is a frequent complication of HT (85%), which is newly diagnosed in most patients during the first two years. AH incidence was higher for male recipients with a history of IHD, hypertension, and smoking. Approximately half of patients required only a single-drug antihypertensive therapy. After HT, the most frequently prescribed drugs included ACE inhibitors or ARBs and SCCBs (70-87% and 48-53%, respectively, depending on the time elapsed after HT). Persistent AH requiring a treatment with two or more antihypertensive drugs was associated with development of all CVEs and a higher long-term mortality.

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Experience of outpatient follow-up of heart transplant recipients at Shumakov center

Muminov,

Koloskova,

Poptsov

et al. 2023

RJTAO

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Heart transplantation (HT) is considered the optimal therapy for end-stage heart failure. In recent years, the number of operations performed has been growing, which has led to a rise in the number of heart transplant recipients requiring outpatient follow-up.Objective: to evaluate the effectiveness of the model of dual personalized follow-up of heart transplant recipients in the consultative and diagnostic department of Shumakov National Medical Research Center of Transplantology and Artificial Organs.Materials and methods. The study included 1,436 patients under outpatient follow-up from January 2008 to December 2022. Recipient data, results of laboratory and instrumental examination methods, nature and frequency of complications at different follow-up periods were analyzed.Results: At the time of discharge from the hospital, 98.7% of patients had received triple-drug immunosuppressive therapy; 6 months later, methylprednisolone was discontinued in 72.2% of recipients. Mean tacrolimus level during the 1-year follow-up was 8.7 ± 2.7 ng/mL; in the period from 1 to 5 years of followup, the mean was 5.1 ± 2.4 ng/mL. At year 1 after transplantation, 23 (1.7%) recipients had been converted to everolimus; by the end of year 5 of follow-up, the number had increased to 8.6%. The most frequently detected complications during outpatient follow-up were: hypertension (48.65%), post-transplant diabetes mellitus (7.24%), nephropathy (35.97%), and malignant neoplasms (4.2%). Recipient survival, excluding in-hospital mortality, was 96.5%; and 88.0% at year 1 and 5 of follow-up, respectively.Conclusion: The dual personalized approach model for outpatient follow-up and treatment of heart transplant recipients will improve recipient survival and quality of life in the long-term post-HT period.

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Prevalence and predictors of hypertension in cardiac recipients

Cited by 3 publications

References 15 publications

The Measurements of Blood Clotting in Cardiorenal Syndrome in Elderly

The Measurements of Blood Clotting in Cardiorenal Syndrome in Elderly

Arterial hypertension after heart transplantation

Experience of outpatient follow-up of heart transplant recipients at Shumakov center

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