Preview

Rational Pharmacotherapy in Cardiology

Advanced search

Vascular Remodeling Markers in Patients with Essential Arterial Hypertension Depending on Presence of Type 2 Diabetes Mellitus

https://doi.org/10.20996/1819-6446-2019-15-3-328-334

Full Text:

Abstract

Aim. To study some vascular remodeling markers in hypertensive patients depending on the presence of type 2 diabetes mellitus.
Material and methods. The study included patients with essential hypertension 1-2 degrees of increase in blood pressure with/without type 2 diabetes (30 and 32 patients respectively). Using photoplethysmography in combination with reactive hyperemia test structural and functional markers of vascular remodeling were determined: in large vessels – stiffness index and phase shift; in microvessels – reflection index and the occlusion index. Using the computer video capillaroscopy of the nail bed the density of the capillary network at rest, after venous occlusion and after the test with reactive hyperemia was determined. ELISA was used for determining the level of humoral markers of endothelium dysfunction and vascular bed remodeling: metalloproteinase 9, metalloproteinase 9 inhibitor, E-selectin, endothelin, transforming growth factor (TGF-β1), endothelial growth
factor A.
Results. In compare with hypertensive patients in hypertensive patients with type 2 diabetes significantly higher stiffness index values (11.15 [10.05; 12.35] vs 10.15 [8.83; 11.83] m/s; p=0.04) were found as well as significantly lower (p=0.00) capillary network density at rest (26.4 [24.2; 27.6] vs 35.1 [33.0; 45.0] cap/mm2; p=0.00) after the tests with reactive hyperemia (29 [24; 33.3] vs 40.0 [35.0;43.3] cap/mm2; p=0.00) and venous occlusion (32.5 [27.8; 34.5] vs 40.0 [33.0; 45.0] cap/mm2). In hypertensive patients with type 2 diabetes significantly higher levels of TFG-β1 (11648 [4117.8; 37933.8] vs 3938.5 [1808.8; 7694] pg/ml; p=0.00) and significantly lower levels of endothelin-1 (0,46 [0,29;1,3] vs 1.73 [0.63; 2.30] ng/ml; p=0.01) was detected in compare with hypertensive patients without type 2 diabetes.
Conclusion. In both groups some signs of vascular remodeling were found at the level of both large arteries and microvessels (arterioles and capillaries). However, the group of hypertension + type 2 diabetes mellitus had statistically significantly more pronounced changes in arterial stiffness, capillary network density, as well as humoral markers levels of fibrosis and endothelial dysfunction. 

About the Authors

Yu. A. Danilogorskaya
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

MD, PhD, Assistant, Chair of Hospital Therapy №1

Trubetskaya ul. 8-2, Moscow, 119991 Russia



E. A. Zheleznykh
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

MD, PhD, Assistant, Chair of Hospital Therapy №1

Trubetskaya ul. 8-2, Moscow, 119991 Russia



E. A. Privalova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

MD, Cardiologist, Department of Cardiology №1, University Hospital №1

Trubetskaya ul. 8-2, Moscow, 119991 Russia



Yu. N. Belenkov
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

MD, PhD, Professor, Academician of the Russian Academy of Sciences, Head of Chair of Hospital Therapy №1

Trubetskaya ul. 8-2, Moscow, 119991 Russia



A. A. Shchendrigina
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

MD, PhD, Assistant, Chair of Hospital Therapy №1

Trubetskaya ul. 8-2, Moscow, 119991 Russia



M. V. Kozhevnikova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

MD, PhD, Assistant, Chair of Hospital Therapy №1

Trubetskaya ul. 8-2, Moscow, 119991 Russia



G. A. Shakaryants
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

MD, PhD, Assistant, Chair of Hospital Therapy №1

Trubetskaya ul. 8-2, Moscow, 119991 Russia



V. Y. Zektser
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

MD, PhD, Assistant, Chair of Hospital Therapy №1

Trubetskaya ul. 8-2, Moscow, 119991 Russia



A. S. Lishuta
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

MD, PhD, Associate Professor, Chair of Hospital Therapy №1

Trubetskaya ul. 8-2, Moscow, 119991 Russia



I. S. Ilgisonis
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

MD, PhD, Associate Professor, Chair of Hospital Therapy №1

Trubetskaya ul. 8-2, Moscow, 119991 Russia



References

1. Kearney P.M., Whelton M., Reynolds K., et al. Global burden of hypertension: analysis of worldwide data. Lancet.2005;365:217-23.19. DOI:10.1016/S0140-6736(05)17741-1.

2. Tarasenko N.A. Diabetes mellitus: reality, prognosis, prevention. Modern Problems of Science and Education. 2017;6 [cited by May 05, 2019]. Available from: http://www.science-education.ru/ru/article/view?id=27144 (In Russ.)

3. Kozakova M., Palombo C. Diabetes Mellitus, Arterial Wall, and Cardiovascular Risk Assessment. Int J Environ Res Public Health. 2016;13(2):201. DOI:10.3390/ijerph13020201.

4. 2013 ESH/ESC Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34;2159-219. DOI:10.1093/eurheartj/eht151.

5. Castorena-Gonzalez J.A., Staiculescu M.C., Foote C., Martinez-Lemus L.A. Mechanisms of the inward remodeling process in resistance vessels: Is the actin cytoskeleton involved ? Microcirculation. 2014;21(3):219-29. DOI:10.1111/micc.12105.

6. Yasmin, McEniery C.M., Wallace S., et al. Matrix metalloproteinase-9 (MMP-9), MMP-2, and serum elastase activity are associated with systolic hypertension and arterial stiffness. Arterioscler Thromb Vasc Biol. 2005;25(2):372. DOI:10.1016/j.amjcard.2005.03.072.

7. Tan J., Huan Q., Xing X., et al. Impact of the metalloproteinase-9/tissue inhibitor of metalloproteinase-1 system on large arterialstiffness in patients with essential hypertension. Hypertens Res. 2007;30(10):959-63. DOI:10/1291/hypres.30959.

8. Niemirska A., Litwin M., Trojanek J., et al. Altered matrix metalloproteinase 9 and tissue inhibitor of metalloproteinases 1 levels in children with primary hypertension. J Hypertens. 2016;34(9):1815-22. DOI:10.1097/HJH.0000000000001024.

9. Weigert K., Brodbeck K., Klopfer H.U., Häring E.D. Schleicher Angiotensin II induces human TGF-β1 promoter activation: similarity to hyperglycaemia. Diabetologia. 2002;45:890-8. DOI:10.1007/s00125-002-0843-4.

10. Pohlers D., Brenmoehl J., Löffler I., et al. TGF-βand fibrosis in different organs — molecular pathway. Biochimica et Biophysica Acta. 2009;1792:746-56. DOI:10.1016/j.bbadis.2009.06.004.

11. Harvey A., Montezano A.C., Lopes R.A., et al. Vascular Fibrosis in Aging and Hypertension: Molecular Mechanisms and Clinical Implications. Can J Cardiol. 2016;32(5):659-68. DOI:10.1016/j.cjca.2016.02.070.

12. Fels J., Jeggle P., Liashkovich I., et al. Nanomechanics of vascular endothelium. Cell Tissue Res. 2014;355:727-37. DOI:10.1007/s00441-014-1853-5.

13. Adeva-Andany M.M., Ameneiros-Rodríguez E., Fernández-Fernández C., et al. Insulin resistance is associated with subclinical vascular disease in humans. World J Diabetes. 2019;10(2):63-77. DOI:10.4239/wjd.v10.i2.63.

14. Cardoso C.R., Salles G.F. Aortic Stiffness as a Surrogate Endpoint to Microand Macrovascular Complications in Patients with Type 2 Diabetes. Int J Mol Sci. 2016;17:piiE2044. DOI:10.3390/ijms17122044.

15. Shah A.S., Urbina E.M. Vascular and Endothelial Function in Youth with Type 2 Diabetes Mellitus. Curr Diab Rep. 2017;17(6):36. DOI:10.1007/s11892-017-0869-0.

16. The patent of the Russian Federation №2012156011/14; Dec 24, 2012. Belenkov Y.N., Schendrygina A.A., Privalova E.V., et al. A method for assessing the state of the vascular bed in healthy individuals with risk factors for developing cardiovascular diseases and patients with cardiovascular diseases. The patent of Russia №2508900 С1.2014. Bulletin №7 (In Russ.)

17. Chen Q., Min J., Feng Y., et al. Matrix metalloproteinases: inflammatory regulators of cell behaviors in vascular formation and remodeling. Mediators Inflamm. 2013;2013:928315. DOI:10.1155/2013/928315.

18. Castro M.M., Tanus-Santos J.E. Inhibition of matrix metalloproteinases (MMPs) as a potential strategy to ameliorate hypertension-induced cardiovascular alterations. Curr Drug Targets. 2013;14(3):335-43. DOI:10.2174/1389450111314030005.

19. Sandstrom J., Vasan R..S Circulating biomarkers of extracellular matrix remodeling and risk of atherosclerotic events. Curr Opin Lipidol. 2006;17(1):45-53. DOI:10.1097/01.mol.0000203891.34890.b5.

20. Hlubocka Z., Umnerová V., Heller S.,et al.Circulating intercellular cell adhesion molecule-1, endothelin-1 and von Willebrand factor-markers of endothelial dysfunction in uncomplicated essential hypertension: the effect of treatment with ACE inhibitors. J Hum Hypertens. 2002;16(8):557-62. DOI:10/1038/sj.jhh.1001403.

21. Taqueti V.R., Di Carli M.F. Coronary microvascular disease Pathogenic Mechanism and Therapeutic options. J Am Coll Cardiol. 2018;72(21):2625-2641. DOI:10.1016/j.jacc.2018.09.042.

22. Belin de Chantemèle E.J., Vessières E., Guihot A.L., et al. Type 2 diabetes severely impairs structural and functional adaptation of rat resistance arteries to chronic changes in blood flow Cardiovasc Res. 2009;81(4):788-96. DOI:10.1093/cvr/cvn334.

23. Mulvany M.J. Small artery remodelling in hypertension: causes, consequences and therapeutic implications. Med Biol Eng Comput. 2008;46(5):461-7. DOI:10.1007/s11517-008-0305-3.

24. Sonoyama K., Greenstein A., Price A., et al. Vascular remodeling: implications for small artery function and target organ damage. Ther Adv Cardiovasc Dis. 2007;1(2):129-37. DOI:10.1177/1753944707086358.


For citation:


Danilogorskaya Y.A., Zheleznykh E.A., Privalova E.A., Belenkov Y.N., Shchendrigina A.A., Kozhevnikova M.V., Shakaryants G.A., Zektser V.Y., Lishuta A.S., Ilgisonis I.S. Vascular Remodeling Markers in Patients with Essential Arterial Hypertension Depending on Presence of Type 2 Diabetes Mellitus. Rational Pharmacotherapy in Cardiology. 2019;15(3):328-334. (In Russ.) https://doi.org/10.20996/1819-6446-2019-15-3-328-334

Views: 37


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)