EVALUATION OF CLINICAL MANIFESTATIONS AND LABORATORY PARAMETERS OF ENDOTOXICOSIS SYNDROME IN CHRONIC HEART FAILURE
DOI:
https://doi.org/10.11603/1811-2471.2025.v.i4.15808Keywords:
chronic heart failure, endogenous intoxication, integral hematological indicesAbstract
SUMMARY. Chronic heart failure (CHF) is accompanied by the development of endogenous intoxication (EI) syndrome, which is associated with the accumulation of toxic metabolites, activation of inflammatory processes, and enhancement of oxidative stress.
The aim – to establish the dependence of the severity of CHF with left ventricular diastolic dysfunction on the degree of endogenous intoxication (EI).
Material and Methods. We examined 39 patients, divided into three groups according to the stage of CHF, and 10 practically healthy control individuals. The methods included analysis of complaints and clinical status, general clinical and biochemical blood tests, determination of integral hematological indices, levels of middle molecular weight compounds, circulating immune complexes, pro-inflammatory cytokines, and evaluation of lipid peroxidation parameters and antioxidant enzyme activity.
Results. The clinical picture showed an increase in EI symptoms with increasing CHF stage. Laboratory results confirmed the activation of EI. Integral blood indices demonstrated a significant increase in inflammatory activity and toxic load with the progression of CHF. An elevation in the level of middle molecular weight peptides, immune complexes, and pro-inflammatory cytokines was detected. The content of malondialdehyde (MDA) increased by 2.9–3.4 times, while the activity of superoxide dismutase (SOD) decreased by almost 40 %, indicating an enhancement of oxidative stress.
Conclusions. Patients with CHF showed a progressive EI syndrome, the severity of which increases with the stage of the disease. Markers of inflammation and toxic load on the body, including middle molecular weight peptides, immune complexes, and pro-inflammatory cytokines, significantly increase with the worsening of the patient's condition. The increase in MDA level and decrease in antioxidant enzyme activity indicate an increase in oxidative stress and the depletion of protective mechanisms.
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