Modificările decelabile în sistemul renin-angiotensin-aldosteron şi al vasopresinei la pacienţii cu valvulopatii mitrale asociate şi insuficienţă cardiacă cronică congestivă

Dănilă Aurelian

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2023-02-18 20:20

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DĂNILĂ, Aurelian. Modificările decelabile în sistemul renin-angiotensin-aldosteron şi al vasopresinei la pacienţii cu valvulopatii mitrale asociate şi insuficienţă cardiacă cronică congestivă . In: Buletinul Academiei de Ştiinţe a Moldovei. Ştiinţe Medicale, 2009, nr. 3(22), pp. 141-150. ISSN 1857-0011.

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Buletinul Academiei de Ştiinţe a Moldovei. Ştiinţe Medicale

Numărul 3(22) / 2009 / ISSN 1857-0011

Modificările decelabile în sistemul renin-angiotensin-aldosteron şi al vasopresinei la pacienţii cu valvulopatii mitrale asociate şi insuficienţă cardiacă cronică congestivă

Pag. 141-150

Dănilă Aurelian

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu“

Disponibil în IBN: 29 noiembrie 2013

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The study of 74 cases of patients with mitral valvular heart disease, aged between 35 and 75 years was performed with the determination of renin serum activity (RSA), angiotensin II (AII), aldosteron (ALD) and vasopressin (VP) in blood. The patients were divided in two groups – fi rst group the patients with middle age of 48 ± 1,3 years and second one with middle age of 64,2 ± 1,1 years. Mitral valvular heart disease with the prevalence of mitral stenosis (MV>S) was established at 49 patients and 25 subjects with mitral valvular heart disease the prevalence of mitral insuffi ciency (MV>I) was found. The values of RSA, AII, ALD, VP were compared at patients with different ages, type of mitral valvular heart disease, heart failure stage and initiated treatment. We concluded that the values of RSA, AII, ALD and VP at patients with mitral valvular heart disease at different ages do not differ veridical, except 60 – 75 old ages. With the progression of chronic heart failure, this neurohormonal parameters increase substantially, except patients with mitral disease with the prevalence of mitral stenosis (MV>S), at which RSA were authentically higher than subjects with MV > I. Dramatically increased renin serum activity can be fatal for patients with advanced heart failure. The administration of such drugs as B – blockers, calcium antagonists and IEC is clinically benefi cial.

У 74 больных с митральными пороками сердца в возрасте от 35 до 74 лет проведено изучение активности ренина плазмы, концентрации ангиотензина II, альдостерона и вазопрессина в зависимости от возраста больных, преобладанием стеноза или недостаточности митрального клапана, стадии недостаточности кровообращения и лечения. Установлено, что показатели РАА и ВП в базальных условиях у больных пожилого возраста не различаются достоверно от больных зрелого возраста. По мере прогрессирования ХНК эти показатели повышаются достоверно независимо от возраста больных. Однако, у больных с преобладанием митрального стеноза, секрециа ренина достоверно больше, чем у больных с преобладанием недостаточности. Применение изосорбида динитрата и коринфара в комплексной терапии больных способствуют повышению активности РАА системы.