Vol. 7, Issue 8 (2018)

Author(s):
Olena M Kovalenko and Victoriya V Rodionova

Abstract:
Background: Cardiovascular diseases (CVD) are the most commonly associated ailment with patients with chronic obstructive pulmonary disease (COPD). Arterial hypertension (H) is an important and widespread risk factor for CVD and is recorded with high frequency in patients with COPD. Activation of vessel endothelium and platelet hemostasis is the most important factor in the development of CVD and their complications. Objective: To study the morphofunctional characteristics of platelets (pl) in patients with COPD and H and compare them to patients with H in the stable stage of diseases. Methods:Anthropometry, spirometry, questionnaires “The Modified Medical Risearch Council Dispnia Scale” (mMRC), “COPD Assessment Test” (CAT), defining of blood pressure, pl functional activity study by estimation of pl adhesion (Adh) degree, induced aggregation (Agr) of plwith adenosine diphosphate (ADP), collagen and thrombin (optical turbidimetric method),count of activated, degranulatedpl, packing density (PD) pl granules (transmission electron microscopy (TEM)). Clinical characteristics: The study included 87 persons. The I group (I gr.) included 39 patients with COPD A-D category with H stage I-II, II group (II gr.) – 38 patients with H stage I-II, control group (С gr.)-10 healthy personsage-matched category. When included in the study, the patients had a stable course of disease for at least the last 2 months. Results: Functional indices of platelet activity, namely, the degree of Adh pl, induced by ADP, collagen and thrombinpl Agr in patients ofboth I and II groups exceed those in C gr.In turn, a higher than in II gr. degree of pl Adh, induced by ADP rate of Agr, thrombin inuced degree of pl Agr, as well as the activity of the pl von Willebrand factor (vWf) was found in patients I gr. The total number of pl in I gr. is greater than in II gr. and C gr. Analysis of the TEM data in I gr. showed a greater number of activated and degranulated pl than in II gr. PD α- and λ-granules in I gr. was lower than in II gr. PD pl-granules in I and II are lower than in C. (p < 0.05). Conclusions: In patients with H and in comorbid patients with COPD and H the functional activity of pl is increased in comparison with healthy persons age - matched category. In patients with COPD and H the Adh degree, induced Agr of pl, ultra structural characteristic of pl intravascular activation, increases. In COPD patients and concomitant H these changes are more pronounced than in patients with H. Complex influence of factors which take part in the development and maintenance of increased activity of the vascular-thrombocyte part of hemostasis in comorbid patients with COPD and H, even in the absence of exacerbations, leads to increased thrombogenic potential and the risks associated cardiovascular events.