Radzishevska Y. Oxidative mechanisms of magistral vessels and heart disorders in patients with hypertension in combination with type 2 diabetes mellitus and their correction.

The dissertation is devoted to developing the methods of optimizing the diagnosis and correction of cardiac and vascular remodelling in patients with essential hypertension and concomitant type 2 diabetes mellitus in the compensation and subcompensation stages by studying the oxidative mechanisms of the heart and blood vessels disorders. In the present work were proved the negative impacts of oxidative stress activation and decreased activity of antioxidant factors on the structural and functional state of the heart and magistral vessels in patients with essential hypertension and concomitant type 2 diabetes mellitus. Primarily these negative impacts result in increased arterial stiffness, the progression of heart diastolic dysfunction and reduction of endothelium-dependent vasodilatation of the brachial arteries. The selected 29 ultrasonic parameters have allowed us to establish a prognosis of the clinical status of patients. Using the values of the intima-media thickness of carotid arteries in the standard point and point of bifurcation, peak systolic blood flow velocity in the aorta, indexes of resistance and pulsation of arc intrarenal arteries we estimated the value of endothelium-dependent vasodilatation of brachial artery. This estimation allowed us to develop an additional method of assessment of the functional state of the vascular endothelium. Thus we proved the advantage of using the proposed four integral parameters - that we estimated from the set of heart and blood vessels ultrasound markers - to improve the diagnosis of cardiovascular disorders and the differential diagnosis of the clinical status of patients. We showed the positive effect of thiotriazoline, as additional to base treatment, on the oxidative stress and antioxidant defence systems, and demonstrated its advantage in the treatment of patients with essential hypertension and concomitant type 2 diabetes mellitus.