CONSTELLATION OF BIOCHEMICAL AND PHYSICAL MARKERS OF THE FUNCTIONAL STATE OF THE BODY IN PATIENTS WITH MYOCARDIAL INFARCTION WITH OF SISTOLIC AND DIASTOLOGICAL ARTERIAL PRESSURE LEVELS AND THE POSSIBILITY OF THEIR USING IN THE REHABILITATION PROCESS
DOI:
https://doi.org/10.11603/mcch.2410-681X.2019.v0.i1.10013Keywords:
myocardial infarction, comorbid pathology, arterial hypertension, cardio-rehabilitationAbstract
Introduction. Providing full medical care to patients with myocardial infarction (MI) with comorbid pathology (CP) on the background of arterial hypertension remains a complicated medical problem, which has not been resolved to date.
The aim of the study – to study the peculiarities of the clinical course of myocardial infarction with comorbid pathology depending on the levels of systolic and diastolic blood pressure, to identify the early marker and limiting parameters of the functional parameters of the body and stratification risks to control the effectiveness of the rehabilitation process in this category of patients.
Research Methods. We examined 371 patients with myocardial infarction aged (66.2±10.4) years. In 93.8 % of the surveyed, concomitant pathology was detected. The basic functional indicators of a patient's body condition on the MI with CP and their relationship with SAP and DBP, as well as indicators of physical activity tolerance were studied.
Results and Discussion. There was a direct correlation between the levels of SBP in the acute MI period and the duration of the history of arterial hypertension (r = 0.130; P = 0.040); left ventricular posterior wall thickness (r = 0.189; P <0.001); left ventricular ejection fraction (r = 0.275; P <0.0001) and the size of aorta (r = 0.228; P <0.0001). There was also a direct relationship between the levels of DBP and the left ventricular posterior wall thickness (r = 0.130; P = 0.022); the size of the aorta (r = 0.172; P = 0.002); the size of the left atrium (r = 0.188; P = 0.001), left ventricular ejection fraction (r = 0,210; P <0,001), as well as blood creatinine levels (r = 0,119; P = 0,023). Authentic feedback between SBP/DBP levels and paroxysmal atrial fibrillation, cardiogenic shock, pulmonary edema, and left ventricular aneurysm may indicate a depletion of hemodynamic reserves reduced due to acute ischemic damage to the myocardium.
Conclusions. SBP/DBP indicators in the acute MI period are early prognostic markers of biochemical, morphological and hemodynamic changes in patients with MI with CP, adequately reflect the overall functional state of the patient and cardiovascular risks, and therefore they should be monitored during the rehabilitation process. There is a significant direct correlation between creatinine levels in such patients with DBP in acute MI and morphological changes in the cardiac muscle, so it can be successfully used as a marker for systemic hemodynamic control at the stages of cardio-rehabilitation.
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