FEATURES OF CENTRAL HEMODYNAMICS IN PATIENTS WITH BRONCHIAL ASTHMA

Аннотация

INTRODUCTION Fibroblasts play a key role in airway remodeling In the last decade, chronic nonspecific lung and inflammation. They produce collagen, diseases have taken third place in terms of reticular and elastic fibers, proteoglycans and prevalence, morbidity and mortality among other glycoproteins. Myofibroblasts promote tissue types of pathology. According to 2020–2023 World remodeling by releasing interstitial collagen, Health Organization (WHO) estimates, nearly 262 fibronectin and laminin, and producing growth million people worldwide suffered from bronchial factors for blood vessels, nerves and smooth asthma, resulting in 455,000 deaths [1]. muscle [3]. In bronchial asthma, the number of Bronchial asthma (BA) is a heterogeneous disease myofibroblasts increases and their number characterized by chronic inflammation of the correlates with the thickness of the reticular airways, the presence of respiratory symptoms basement membrane. Thus, as a result of the such as wheezing, shortness of breath, chest pathological process in bronchial asthma, the congestion and cough, which vary in time and reversible component of bronchial obstruction intensity, and occur together with variable airway predominates, which consists of contraction of obstruction [1,2]. Based on the pathogenesis of smooth muscles, edema of the mucous membrane, asthma, a number of cytokines and growth factors and obstruction of the bronchial lumen by mucus. relevant to the chronicity of airway inflammation However, with long-term inflammation in the are produced by normal resident cells of the bronchi, wall remodeling and proliferation of bronchial tree (fibroblasts, myofibroblasts, connective tissue (fibrosis) occurs, which is an epithelial cells and smooth muscle cells). irreversible part of bronchial obstruction. This in https://www.theamericanjournals.com/index.php/tajmspr 41 THE USA JOURNALS THE AMERICAN JOURNAL OF MEDICAL SCIENCES AND PHARMACEUTICAL RESEARCH (ISSN – 2689-1026) VOLUME 06 ISSUE09 turn will lead to multiple complications from the of bronchial lesions, as well as the phase of the cardiovascular system [3,4]. process. It is known that changes in the pulmonary circulation in patients with bronchial asthma can Frequent exacerbations of attacks in asthma are be associated with both disturbances of central most clearly demonstrated by the close anatomical hemodynamics and disorders of pulmonary and functional connection between the heart and microcirculation. lungs. As a result, the problem goes from pulmonary to cardiopulmonary. In patients with According to the observations of many authors, in asthma, changes in the cardiovascular system are patients with mild impairments in the function of often recorded with the development of external respiration, normal levels of oxygen pulmonary hypertension, damage predominantly tension in the arterial blood, pressure in the to the right side with the formation of chronic pulmonary artery and minute blood volume do not pulmonary heart disease, the development of exceed normal figures [3,9]. Against the myocardial ischemia and heart rhythm background of repeated exacerbations, with the disturbances. The issues of the combined course of progression of respiratory dysfunction, changes in cardiovascular diseases (CVD) and asthma are hemodynamics also become more pronounced. actively discussed in the literature. [5]. Cardiac Increasing disturbances in bronchial obstruction, remodeling, which occurs in response to damage, diffusion capacity and lung volume parameters, leading to a change in its geometry and impaired leading to chronic hypoxemia and hypercapnia, contractility, ultimately determines the prognosis can cause the development of moderate of life for patients with chronic obstructive pulmonary hypertension at rest and an increase in pulmonary pathology. Despite the fact that the right ventricular filling pressure [10]. Systolic and main function of the circulatory system is diastolic function of the right ventricle in patients transport, its participation in physiological and with asthma. Previous studies have revealed that pathological processes in the body is very diverse. the state of diastolic function of the right ventricle It should be noted that the clinical, functional and in asthma depends on the severity of the morphological changes that occur in the underlying disease, the formation of the level of cardiovascular system during inflammation, as a afterload, the values of pulmonary hypertension rule, represent a complex chain of cause-and-effect and the severity of enlargement and hypertrophy and closely related manifestations of pathology of the right ventricle. In various groups of patients [6,7]. Therefore, pathological changes that can be with asthma, pathological load against the objectively assessed are usually the result of the background of the lack of pharmacotherapeutic simultaneous influence of multiple factors such as control of asthma (increased resistance i