SOVREMENNAYA PEDIATRIYA.2016.2(74):112-115; doi 10.15574/SP.2016.74.112 

The study of the functional state of the endothelium via a complex of markers with reactive hyperemia 

Berezhniy V., Romankevych I.       

P.L.Shupik National Medical Academy of Postgraduate Education, Kiev, Ukraine 

Diagnosis of endothelial dysfunction is a key point in the prevention and treatment of cardiovascular diseases. In scientific research the study of the state of the endothelium used test with reactive hyperemia of brachial artery wich present as the value of endothelium dependent and independent artery dilatation. However, the disadvantage of this marker is ignoring the size of arteries, well know that small arteries has a greater degree of dilation more than big arterias, this fact making difficult to compare results between different patients. 

The aim of our study was to examine the state of endothelium using a complex of markers, compare them informative in children with JRA who are at risk for the development of endothelial dysfunction. 

Materials and Methods. The study was included 40 children with juvenile rheumatoid arthritis who were treated at the department of children's cardiorheumatology Kyiv City Children's Hospital #1 and Kiev Regional Hospital m. Boyarka. 

Results. The study found a development of endothelial dysfunction changes in endothelium dependent vasodilation, reactive hyperemia and coefficient of vasodilation. Simultaneous marked change of endothelium vasodilation of the brachial artery and coefficient of vasodilatation. There were no pathological changes in endothelial shear stress in patients compared with healthy children. 

Conclusions. Evaluate the state of the endothelium is necessary with the help of a set of indicators (RH, EDVD, VC) that will help to avoid diagnostic mistakes during the test with the reactive hyperemia. 

Key words: endothelial dysfunction, reactive hyperemia, endothelium dependent vasodilation, tension shear, coefficient of vasodilation. 

REFERENCES

1. Beregnoi VV, Romankevych IV. 2014. Endothelial function status in chldren with juvenil rheumatoid arthritis. Sovremennaya pediatriya. 2(48): 70—76.

2. Beregnoi VV, Romankevych IV. 2011. Juvenile rheumatoid arthritis & atherosclerosis: new views on two diseases. Sovremennaya pediatriya. 5(39): 126—130.

3. Vinogradov A. 2006. Vasomotor form endothelial dysfunction at systemic vasculitis and systemic disorder connective tissue. Abstract. St-Peterburg.

4. Goncharenko N. 2010. Instrumental diagnostics early changes endothelial function in children. Zdorovya Ukrainy. 2(13): 50-51.

5. Klymenko M, Ataman Y. 2007. Atherosclerosis as inflammation/Experimental and clinical medicine. 4: 4-12.

6. Kavey Rae-Ellen W, Allada Vivek, Stephen R Daniels et al. 2006. A Scientific Statement From the American Heart Association Expert Panel on Population and Prevention Science; the Councils on Cardiovascular Disease in the Young, Epidemiology and Prevention, Nutrition, Physical Activity and Metabolism, High Blood Pressure Research, Cardiovascular Nursing, and the Kidney in Heart Disease; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research: Endorsed by the American Academy of Pediatrics. Circulation. 114: 2710—2738.

7. Urbina EM, Williams RV, Alpert BS et al. 2009. AHA Scientific Statement, Noninvasive Assessment of Subclinical Atherosclerosis in Children and Adolescents, Recommendations for Standard Assessment for Clinical Reserch: A Scientific Statement Froom the American Heart Association. Hypertension. 54: 919—950.

8. Hafstrom I, Rohani M, Deneberg S et al. 2007. Effects of Low-dose Prednisolone on Endothelial Function, Atherosclerosis, and Traditional Risk Factors for Atherosclerosis in Patients with Rheumatoid Arthritis — A Randomized Study. The Journal of Rheumatology. 34: 1810—1816.

9. Leeson P. 2007. Pediatric Prevention of Atherosclerosis: Targeting Early Variation in Vascular Biology. Pediatrics. 119: 1204—1206.

10. Huang Yu-Lin, Chung Hung-Tao, Chang Chee-Jen et al. 2009. Lymphopenia is a risk factor in the progression of carotid intima-media thickness in juvenile-onset systemic lupus erythematosus. Arthritis & Rheumatism. 60; Issue 12: 3766—3775.

11. Westerweel PE, Luyten R, Koomans HA et al. 2007. Premature atherosclerotic cardiovascular disease in systemic lupus erythematosus. Arthritis and Rheum. 56; Issue 5: 1384—1396.