Plastun M. Diagnosis and correction of cardiac complications in patients with chronic calculous cholecystitis and metabolic syndrome in pre-and postoperation periods

In the process of research it was revealed, that in patients with cronic calculous cholecystitis(CCC) without cardiac disorders and in patients with cholecysto-cardiac syndrome there was moderate decrease of activity of inhibitors of fibrinolysis and components of plasmin formation on the background of normal hemostasis. The patients with chronic calculous cholecystitis with accompanying diseases of cardiovascular system in perioperation period had decrease of anticoagulation activity of blood and functional activity of system of fibrinolysis presenting with increase of concentration of antiplasmins, activity of antiactivator in blood with parallel decrease of level of activator of plasminogen, plasminogen, and plasmin. The development of metabolic syndrome in patients with CCC leads to worsening of the mentioned above disorders of activity of hemostasis and fibrinolysis, which are associated with increased risk of development of thromboembolic complications, and the fast should be taken into account in the period of pre-operation management and for the choice of method of surgical treatment. The increase of differences between values of variability of systolic and diastolic blood pressure and high levels of blood pressure with disorder of 24-hour period variation before and after operative treatment sanity increased risk of cardiovascular complications in patients with chronic calculous cholecystitis and metabolic syndrome. The patients with CCC and accompanying MS have low tolerance to physical exertion. In the process of treadmill test in patients with CCC and metabolic disorders the formation of unfavourable hemodynamic type of circulation is observed due to low level of adaptive reactions of the cardiovascular system. The treatment with moxonidine for 4 weeks before planned operative treatment makes favourable effect on the 24-hour profile of systolic blood pressure in patients with CCC and metabolic disorders decreasing the number of patients with insufficient decrease of blood pressure at night-time (non-dipper), and increasing the number of patients with adequate decrease of blood pressure at night-time (dipper). Moxonidine decreases the magnitude and speed of the morning increase of blood pressure, which make it a perspective drug for prophylaxis of cerebral and cardiac complications of arterial hypertension in pre-oreration period.