Bazyka O. Optimization of prognosis for the development of the most common diseases of circulatory system in the structure of the comorbid pathology in clean-up workers of the Chernobyl accident based on 30 years of medical follow-up.

The thesis is devoted to solving the scientific problem of modern medicine to optimize the prediction of the development of the most common diseases of the circulatory system in the structure of comorbid pathology based on a long dynamic study of the structural and functional state of the left ventricle in persons who participated in the aftermath of the Chernobyl accident, to determine the features of hypertensive heart disease (HHD) and coronary heart disease (CHD) development in the structure of comorbid pathology as diabetes mellitus (DM) type 2 and obesity, the impact of both radiation and non-radiation risk factors and the development of criteria for predicting the development of these diseases. New data have been obtained that radiation exposure is an independent and most significant risk factor for the development of HHD, CHD and DM that developed among the clean-up workers at an earlier date and at a younger age than non-irradiated persons. The development of HHD and CHD was significantly ahead of the clinical debut of DM type 2. The features of structural and functional changes in heart left ventricle during the 30-year period after irradiation was specified. It had a greater degree of pathological transformation and occurred in a larger number of clean-up workers compared with non-irradiated persons of the same age. Over 30 years after irradiation, an increase in myocardial mass and changes of left ventricular geometry were found to be primarily due to the gradual thickening of the left ventricle posterior wall and interventricular septum without significant dilatation of the left ventricular cavity. Concentric left ventricular hypertrophy, as an unfavorable factor for the development of CHD complications, was more often detected in exposed individuals compared with the corresponding non-irradiated control, especially in cases when cardiac pathology was combined with DM type 2. A method is proposed for predicting the development of HHD and CHD in persons exposed to radiation using the discriminant function equations. The accuracy of HHD prediction in clean-up workers is 81.7%, and CHD - 78.5%. The expediency of early prevention of cardiovascular diseases and diabetes mellitus in individuals exposed to ionizing radiation has been scientifically grounded.