THE ROLE OF VASCULAR WALL RIGIDITY IN THE DEVELOPMENT OF CORONARY HEART DISEASE WITH COMORBID KIDNEY DYSFUNCTION

Аннотация

The article about the role of vascular wall stiffness in the development of coronary heart disease and renal dysfunction. At the beginning of the review, the definition of the stiffness of the vascular wall is given. Rigidity of the aorta and large vessels of the elastic type is being studied as an independent marker of the risk of developing coronary artery disease and how its measurement allows a more accurate assessment of the prognosis of the disease Methods for noninvasive determination of vascular stiffness by pulse wave propagation velocity, central pulse pressure level, and index of pulse pressure increase in the aorta allows to define formation of high- risk groups for the purpose of its further correction. Keywords: vascular wall stiffness, coronary artery disease, pulse wave propagation velocity, central pulse pressure, index of pulse pressure. РОЛЬ ЖЕСТКОСТИ СОСУДИСТОЙ СТЕНКИ В РАЗВИТИИ ИШЕМИЧЕСКОЙ БОЛЕЗНИ СЕРДЦА С СОПУТСТВУЮЩЕЙ ДИСФУНКЦИЕЙ ПОЧЕК Аннотация. Статья о роли жесткости сосудистой стенки в развитии ишемической болезни сердца и нарушениях функции почек. В начале обзора дается определение жесткости сосудистой стенки. Ригидность аорты и крупных сосудов эластического типа изучается как независимый маркер риска развития ИБС и как ее измерение позволяет более точно оценить прогноз заболевания Методы неинвазивного определения жесткости сосудов по пульсу скорость распространения волны, уровень центрального пульсового давления и индекс повышения пульсового давления в аорте позволяют определить формирование групп высокого риска с целью его дальнейшей коррекции. Ключевые слова: жесткость сосудистой стенки, ишемическая болезнь сердца, скорость распространения пульсовой волны, центральное пульсовое давление, индекс пульсового давления. Relevance: The development of the most socially significant cardiovascular diseases (CVD), which are based on the progression of atherosclerosis with the further occurrence of its 5 93 International scientific journal ISSN: 2181-3906 «MODERN SCIENCE АND RESEARCH» 2025 VOLUME 4 / ISSUE 3 / UIF:8.2 / MODERNSCIENCE.UZ complications, has been considered in recent decades from the standpoint of the "cardiovascular continuum". Currently, the search for new prognostic factors continues, the correction of which would allow to influence mortality from coronary artery disease [4]. Diagnosis and treatment of chronic coronary heart disease (CHD) is well developed, but in the management of patients with comorbid diseases, difficulties often arise. A very common chronic kidney disease (CKD) occupies a special place among comorbidities, which is considered a major risk factor for cardiovascular disease. The cause of death in patients with kidney dysfunction is significantly more often CHD than end-stage renal disease (ESRD) [14]. The urgency of this problem is increasing every year due to an increase in the number of elderly patients with coronary artery disease and severe kidney dysfunction. In this regard, one of the most important characteristics of the vascular system, arterial stiffness, is of great interest. Arterial stiffness is defined as the ability of the arterial wall to resist stretching under the influence of blood flow. Vascular stiffness depends on the ratio of the structural proteins of elastin and collagen, as well as the tone of the smooth muscle cells that make up the middle shell. The wall of the aorta and its large branches contains mainly elastin [6]. Such vessels are classified as elastic type. In peripheral arteries (muscle type), the predominant components are smooth muscle cells and collagen, which, when stretched, offers more resistance than elastin. The higher the blood pressure on the vessel wall, the greater the wall stress. This served as the basis for studying the role of vascular stiffness in the formation and progression of coronary artery disease. The main function of the aorta and large arteries is to buffer fluctuations in blood pressure (BP) resulting from intermittent ejection of blood from the cavity of the left ventricle. Highly elastic arterial system provides stable blood flow in most tissues of the body without the impact of peak systolic pressure; this mechanism is so effective that it practically prevents the decrease in diastolic pressure from the ascending aorta to the peripheral arteries. With the loss of distensibility, the aorta becomes more rigid and loses the ability to accommodate the volume of blood ejected from the left ventricle, which leads to an increase in systole pressure and an increase in pulse pressure. Purpose of the study: to study the magnitude of the stiffness of the aortic wall in patients with coronary artery disease and kidney dysfunction as an independent marker. Material and research methods. We examined 40 patients with coronary artery disease aged 40 to 70 years (mean age 61.5±6.5 years). 5 94 International scientific journal ISSN: 2181-3906 «MODERN SCIENCE АND RESEARCH» 2025 VOLUME 4 / ISSUE 3 / UIF:8.2 /