Trishchynska M. Endothelium vasomotor function in the early stages of chronic cerebrovascular disease

The scientific research is devoted to theoretical generalization and clinical substantiation of prospects of increasing the efficiency of diagnosis. Prevention of chronic cerebral ischemia (CCI) early manifestations based of a comprehensive assessment of the pathogenic characteristics of their development, such as vasomotor endothelial function. Based on a comprehensive assessment of the significance and nature of the relationship between neuroimaging, clinical and neurological, neuropsychological data and features of cerebral and systemic hemodynamics, endothelium vasomotor function, immune-biochemical performance integrity of the cardiovascular system sets the basic characteristics of the CCI initial manifestations depending on the availability of vascular cerebral damage. Endothelial dysfunction is defined participate in pathogenic mechanisms of primary manifestations CCI against the background of normal blood pressure, uncomplicated hypertension (first and second grade and stage), idiopathic hypotension with assessment density relationships and mathematical modeling (prediction). Found that "early" (without structural brain damage) CCI initial manifestations accompanied by compensatory increased levels of nitrite on a background of unchanged levels of endotelin-1 (ET-1). While the increase in ET-1 accompanied by clinical and neurological manifestations and structural brain damage. Author proposed the concept of a comprehensive clinical and instrumental diagnosis of CCI primary manifestations due to the deepening of understanding of the features of the pathogenic perspective formation CCI initial manifestations, depending on the nature and degree of vasomotor endothelial function and cerebrovascular reactivity based on a comprehensive analysis of clinical and paraclinical indicators. Found degree and nature of the breach of vasomotor endothelial function at the initial manifestations CCI that justifies the use of endothelial-protective therapy and to predict the effectiveness of prevention, with the possibility of recourse ED. Proven effectiveness of nitric oxide precursor L-arginine in treating widespread and vasomotor ED in patients with CCI