systhiperСистемные гипертензииSystemic Hypertension2075-082X2542-2189LLC «ИнтерМедсервис»10.38109/2075-082X-2024-3-31-39systhiper-826Research ArticleОРИГИНАЛЬНАЯ СТАТЬЯORIGINAL ARTICLEВлияние новой коронавирусной инфекции на уровень маркеров воспаления и гемостаза, показатели микроциркуляторного русла у больных артериальной гипертониейImpact of a new coronavirus infection on the level of inflammatory, haemostasis markers and microcirculatory parameters of patients with arterial hypertensionhttps://orcid.org/0000-0002-4269-4608КокаеваИ. О.KokaevaI. O.

Изольда Омаровна Кокаева, врач-кардиолог, аспирант

Институт клинической кардиологии им. А.Л. Мясникова; отдел гипертонии

121552; ул. Академика Чазова, д. 15 а; Москва

тел: +7 (925) 428-88-83

Izolda O. Kokaeva, cardiologist, graduate Student

A.L. Myasnikov Institute of Clinical Cardiology

121552; St. Academician Chazova, 15 a; Moscow

tel: +7 (925) 428-88-83

izolda.kokaeva@icloud.comhttps://orcid.org/0000-0001-7895-9068ЖернаковаЮ. В.ZhernakovaYu. V.

Юлия Валерьевна Жернакова, д. м. н., ученый секретарь

Институт клинической кардиологии им. А.Л. Мясникова

121552; ул. Академика Чазова, д. 15 а; Москва

 тел.: +7 (495) 414-63-00

Yuliya V. Zhernakova, Dr. of Sci. (Med.), Prof., Scientific Secretary

A.L. Myasnikov Institute of Clinical Cardiology

121552; St. Academician Chazova, 15 a; Moscow

tel.: +7 (495) 414-63-00

juli001@mail.ruhttps://orcid.org/0000-0001-5215-4894БлиноваН. В.BlinovaN. V.

Наталия Владимировна Блинова, к. м. н., с. н. с.

Институт клинической кардиологии им. А.Л. Мясникова; отдел гипертонии

121552; ул. Академика Чазова, д. 15 а; Москва

тел.: +7 (495) 414-61-86

Nataliya V. Blinova, Cand. of Sci. (Med.), Senior Researcher

A.L. Myasnikov Institute of Clinical Cardiology; Department of Hypertension

121552; St. Academician Chazova, 15 a; Moscow

tel.: +7 (495) 414-61-86;

nat-cardio1@yandex.ruФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр кардиологии имени академика Е.И. Чазова» Министерства здравоохранения Российской ФедерацииРоссияE.I. Chazov National Medical Research Center of cardiologyRussian Federation2024271020242133139Copyright © Кокаева И.О., Жернакова Ю.В., Блинова Н.В., 20242024Кокаева И.О., Жернакова Ю.В., Блинова Н.В.Kokaeva I.O., Zhernakova Y.V., Blinova N.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.syst-hypertension.ru/jour/article/view/826   Актуальность

   Актуальность. Пандемия COVID-19 и ее последствия значимо отразились на состоянии здоровья населения в целом. Отдельного внимания заслуживают лица, перенесшие коронавирусную инфекцию на фоне хронических сердечно-сосудистых заболеваний и ожирения.

   Цель

   Цель. Сравнить показатели углеводного, липидного обменов, уровень маркеров воспаления и гемостаза, а также состояние микроциркуляторного русла у больных АГ с ожирением и у больных АГ с нормальной массой тела через 1 мес. после перенесенной коронавирусной инфекции в среднетяжелой и тяжелой форме.

   Материалы и методы

   Материалы и методы. В исследование включены 87 пациентов обоего пола, в возрасте от 18 до 55 лет, из которых были сформированы три группы: в первую группу вошли лица с АГ и нормальной массой тела (ИМТ< 25 кг/м²) перенесшие COVID-19 в течении месяца, вторая группа включала лиц с АГ и ожирением (ИМТ ≥ 30 кг/м²) перенесших COVID-19 в течении месяца, контрольную группу составили 20 человек с АГ и ожирением без COVID-19 в анамнезе. Всем исследуемым проведена оценка параметров роста, веса, окружности талии, ИМТ. Определены показатели липидного профиля, уровня глюкозы, маркеры воспаления и параметры гемостаза. Всем пациентам проводилось офисное измерение систолического и диастолического АД. Показатели периферической микроциркуляции определялись методом лазерной доплеровской флоуметрии (ЛДФ) на портативном аппарате "ЛА ЗМА ПФ" (НПП «Лазма», Россия, г. Москва). Оценка состояния микроциркуляторного русла легочной ткани проводилась методом совмещенной с МСКТ перфузионной однофотонноэмиссионной сцинтиграфии легких.

   Результаты

   Результаты. Пациенты 1 и 2 групп закономерно отличались друг от друга по антропометрическим показателям. Показатели липидного и углеводного обменов также были достоверно выше у пациентов 2 группы по сравнению с пациентами 1 группы (р < 0,05). Уровень СРБ в группе лиц с АГ и ожирением, перенесших COVID-19, был достоверно более высоким, чем у лиц с АГ без ожирения (p < 0,001) и чем у лиц с АГ и ожирением без COVID-19 в анамнезе. При сравнении показателей микроциркуляции методом ЛДФ отмечено снижение показателей тканевой гемоперфузии (М), резерва кровотока (РК) во всех трех группах (p < 0,001), наиболее выраженная дисфункция нейрогенной и миогенной регуляции кровотока была выявлена в группе лиц с АГ и ожирением, перенесших COVID-19.

   Заключение

   Заключение. Изучение показателей микроциркуляции методом ЛДФ у лиц с АГ и ожирением после перенесенной коронавирусной инфекции свидетельствует о преобладании спастического типа микроциркуляции, что совместно с повышением уровней маркеров воспаления и говорит о более высоком риске тромбообразования и развития сердечно-сосудистых осложнений, требующем более тщательного наблюдения и лечения данной группы пациентов.

   Relevance

   Relevance. The COVID-19 pandemic and its consequences have significantly affected the health of the population as a whole. Persons who have undergone coronavirus infection against the background of chronic cardiovascular diseases and obesity deserve special attention.

   Aim

   Aim. To study and compare the main indicators of carbohydrate and lipid metabolism the level of inflammatory and haemostasis markers, microvascular changes in obesity AH patients and in AH patients with normal body weight 1 month after a new coronavirus infection in moderate to severe form.

   Materials and methods

   Materials and methods. The study included 87 patients of both sexes, aged from 18 to 55 years, from which three groups were formed: the first group included people with AH and normal body weight (BMI<25 kg/m²) who had undergone COVID-19 within a month, the second group included people with AH and obesity (BMI≥30 kg/m²) who had undergone COVID-19 within a month, the control group consisted of 20 people with AH and obesity without COVID-19. The parameters of height, weight, waist circumference, and BMI were assessed in all subjects. The parameters of lipid profile, glucose level were determined, inflammatory markers and haemostasis parameters. All participants underwent laser Doppler flowmetry (LDF) on the forearm with constrictor and dilator functional tests, and single-photon emission computed tomography (SPECT) in combination with x-ray computed tomography (SPECT/CT).

   Results

   Results. Patients of groups 1 and 2 naturally differed from each other in anthropometric indicators. Lipid and carbohydrate metabolism rates were also significantly higher in group 2 patients compared to group 1 patients (p < 0.05). The CRP level in the group of people with hypertension and obesity who underwent COVID-19 was significantly higher than in people with hypertension without obesity (p < 0.001) and than in people with hypertension and obesity without a history of COVID-19. When comparing microcirculation parameters by LDF, there was a decrease in tissue hemoperfusion (M), blood flow reserve (RK) in all three groups (p < 0.001), the most pronounced dysfunction of neurogenic and myogenic blood flow regulation was detected in the group of people with hypertension andobesity who underwent COVID-19.

   Conclusion

   Conclusion. The study of microcirculation indicators by LDF method in persons with hypertension and obesity after suffering a coronavirus infection indicates the predominance of the spastic type of microcirculation, which, together with an increase in the levels of inflammatory markers, indicates a higher risk of thrombosis and cardiovascular complications, requiring more careful monitoring and treatment of this group of patients.

COVID-19артериальная гипертониямикроциркуляциявоспалениеожирениеCOVID-19аrterial hypertensionmicrocirculationobesityinflammationИсследование проведено в рамках государственного задания Института клинической кардиологии им. А.Л. Мясникова, ФГБУ «НМИЦК им. ак. Е.И. Чазова» Минздрава России; ул. 3-я Черепковская, 15-а, Москва 121552, Российская ФедерацияThe study was carried out within the framework of the state assignment of the A.L. Myasnikov Institute of Clinical Cardiology, E.I. Chazov National Medical Research Center of Cardiology; St. Academician Chazova, 15 a, Moscow 121552, Russian FederationReferencesИнформационная панель ВОЗ по коронавирусу COVID-19 https://covid19.who.int/, февраль 2024 г. дата последнего обращения.WHO COVID-19 Coronavirus Dashboard, https://covid19.who.int/, February 2024, last accessedLiu, P. P., Blet, A., Smyth, D., & Li, H. (2020). The science underlying COVID-19: Implications for the cardiovascular system. Circulation, 2020 Jul 7;142(1):68-78. doi: 10.1161/circulationaha.120.047549Liu, P. P., Blet, A., Smyth, D., & Li, H. (2020). The science underlying COVID-19: Implications for the cardiovascular system. Circulation, 2020 Jul 7;142(1):68-78. doi: 10.1161/circulationaha.120.047549Yelin, D., Wirtheim, E., Vetter, P., Kalil, A. C., Bruchfeld, J., Runold, M., Guaraldi, G., Mussini, C., Gudiol, C., Pujol, M., Bandera, A., Scudeller, L., Paul, M., Kaiser, L., & Leibovici, L. (2020). Long-term consequences of COVID-19: Research needs. The Lancet Infectious Diseases. 2020 Oct;20(10):1115-1117. doi: 10.1016/s1473-3099(20)30701-5Yelin, D., Wirtheim, E., Vetter, P., Kalil, A. C., Bruchfeld, J., Runold, M., Guaraldi, G., Mussini, C., Gudiol, C., Pujol, M., Bandera, A., Scudeller, L., Paul, M., Kaiser, L., & Leibovici, L. (2020). Long-term consequences of COVID-19: Research needs. The Lancet Infectious Diseases. 2020 Oct;20(10):1115-1117. doi: 10.1016/s1473-3099(20)30701-5Ackermann, M., Verleden, S. E., Kuehnel, M., Haverich, A., Welte, T., Laenger, F., Vanstapel, A., Werlein, C., Stark, H., Tzankov, A., Li, W. W., Li, V. W., Mentzer, S. J., & Jonigk, D. (2020). Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in Covid-19. New England Journal of Medicine. 2020 Jul 9;383(2):120-128. doi: 10.1056/NEJMoa2015432Ackermann, M., Verleden, S. E., Kuehnel, M., Haverich, A., Welte, T., Laenger, F., Vanstapel, A., Werlein, C., Stark, H., Tzankov, A., Li, W. W., Li, V. W., Mentzer, S. J., & Jonigk, D. (2020). Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in Covid-19. New England Journal of Medicine. 2020 Jul 9;383(2):120-128. doi: 10.1056/NEJMoa2015432Lipowsky HH, Gao L, Lescanic A. Shedding of the endothelial glycocalyx in arterioles, capillaries, and venules and its effect on capillary hemodynamics during inflammation. Am J Physiol Heart Circ Physiol. 2011 Dec;301(6):H2235-45. doi: 10.1152/ajpheart.00803.2011Lipowsky HH, Gao L, Lescanic A. Shedding of the endothelial glycocalyx in arterioles, capillaries, and venules and its effect on capillary hemodynamics during inflammation. Am J Physiol Heart Circ Physiol. 2011 Dec;301(6):H2235-45. doi: 10.1152/ajpheart.00803.2011Teuwen LA, Geldhof V, Pasut A, Carmeliet P. COVID-19: the vasculature unleashed. Nat Rev Immunol. 2020 Jul;20(7):389-391. Erratum in: Nat Rev Immunol. 2020 Jul;20(7):448. doi: 10.1038/s41577-020-0343-0Teuwen LA, Geldhof V, Pasut A, Carmeliet P. COVID-19: the vasculature unleashed. Nat Rev Immunol. 2020 Jul;20(7):389-391. Erratum in: Nat Rev Immunol. 2020 Jul;20(7):448. doi: 10.1038/s41577-020-0343-0Fox SE, Li G, Akmatbekov A, Harbert JL, Lameira FS, Brown JQ, Vander Heide RS. Unexpected Features of Cardiac Pathology in COVID-19 Infection. Circulation. 2020 Sep 15;142(11):1123-1125. doi: 10.1161/circulationaha.120.049465Fox SE, Li G, Akmatbekov A, Harbert JL, Lameira FS, Brown JQ, Vander Heide RS. Unexpected Features of Cardiac Pathology in COVID-19 Infection. Circulation. 2020 Sep 15;142(11):1123-1125. doi: 10.1161/circulationaha.120.049465Varga, Z., Flammer, A. J., Steiger, P., Haberecker, M., Andermatt, R., Zinkernagel, A. S., Mehra, M. R., Schuepbach, R. A., Ruschitzka, F., & Moch, H. (2020). Endothelial cell infection and endotheliitis in COVID-19. The Lancet. 2020 May 2;395(10234):1417-1418. doi: 10.1016/s0140-6736(20)30937-5Varga, Z., Flammer, A. J., Steiger, P., Haberecker, M., Andermatt, R., Zinkernagel, A. S., Mehra, M. R., Schuepbach, R. A., Ruschitzka, F., & Moch, H. (2020). Endothelial cell infection and endotheliitis in COVID-19. The Lancet. 2020 May 2;395(10234):1417-1418. doi: 10.1016/s0140-6736(20)30937-5Armulik, A., Genove, G., & Betsholtz, C. (2011). Pericytes: Developmental, physiological, and pathological perspectives, problems, and promises. Developmental Cell. 2011 Aug 16;21(2):193-215. doi: 10.1016/j.devcel.2011.07.001Armulik, A., Genove, G., & Betsholtz, C. (2011). Pericytes: Developmental, physiological, and pathological perspectives, problems, and promises. Developmental Cell. 2011 Aug 16;21(2):193-215. doi: 10.1016/j.devcel.2011.07.001Eltzschig, H. K., & Carmeliet, P. (2011). Hypoxia and Inflammation. New England Journal of Medicine. 2011 Feb 17;364(7):656-65. doi: 10.1056/nejmra0910283Eltzschig, H. K., & Carmeliet, P. (2011). Hypoxia and Inflammation. New England Journal of Medicine. 2011 Feb 17;364(7):656-65. doi: 10.1056/nejmra0910283Ferrario CM, Jessup J, Chappell MC, Averill DB, Brosnihan KB, Tallant EA, Diz DI, Gallagher PE. Effect of angiotensin-converting enzyme inhibition and angiotensin II receptor blockers on cardiac angiotensin-converting enzyme 2. Circulation. 2005 May 24;111(20):2605-10. doi: 10.1161/circulationaha.104.510461Ferrario CM, Jessup J, Chappell MC, Averill DB, Brosnihan KB, Tallant EA, Diz DI, Gallagher PE. Effect of angiotensin-converting enzyme inhibition and angiotensin II receptor blockers on cardiac angiotensin-converting enzyme 2. Circulation. 2005 May 24;111(20):2605-10. doi: 10.1161/circulationaha.104.510461Capone, C., Faraco, G., Park, L., Cao, X., Davisson, R. L., & Iadecola, C. (2011). The cerebrovascular dysfunction induced by slow pressor doses of angiotensin II precedes the development of hypertension. American Journal of Physiology-Heart and Circulatory Physiology. 2011 Jan;300(1):H397-407. doi: 10.1152/ajpheart.00679.2010Capone, C., Faraco, G., Park, L., Cao, X., Davisson, R. L., & Iadecola, C. (2011). The cerebrovascular dysfunction induced by slow pressor doses of angiotensin II precedes the development of hypertension. American Journal of Physiology-Heart and Circulatory Physiology. 2011 Jan;300(1):H397-407. doi: 10.1152/ajpheart.00679.2010Kawamura H, Kobayashi M, Li Q, Yamanishi S, Katsumura K, Minami M, Wu DM, Puro DG. Effects of angiotensin II on the pericyte-containing microvasculature of the rat retina. The Journal of Physiology. 5 2004 Dec 15;561(Pt 3):671-683. doi: 10.1113/jphysiol.2004.073098Kawamura H, Kobayashi M, Li Q, Yamanishi S, Katsumura K, Minami M, Wu DM, Puro DG. Effects of angiotensin II on the pericyte-containing microvasculature of the rat retina. The Journal of Physiology. 5 2004 Dec 15;561(Pt 3):671-683. doi: 10.1113/jphysiol.2004.073098Burel-Vandenbos, F., Cardot-Leccia, N., & Passeron, T. (2020). Apoptosis and pericyte loss in alveolar capillaries in COVID-19 infection: Choice of markers matters. Author's reply. Intensive Care Medicine. 2020 Oct;46(10):1967-1968 doi: 10.1007/s00134-020-06220-1Burel-Vandenbos, F., Cardot-Leccia, N., & Passeron, T. (2020). Apoptosis and pericyte loss in alveolar capillaries in COVID-19 infection: Choice of markers matters. Author's reply. Intensive Care Medicine. 2020 Oct;46(10):1967-1968 doi: 10.1007/s00134-020-06220-1Kato, K., Diéguez-Hurtado, R., Park, D. Y., Hong, S. P., Kato-Azuma, S., Adams, S., Stehling, M., Trappmann, B., Wrana, J. L., Koh, G. Y., & Adams, R. H. (2018). Pulmonary pericytes regulate lung morphogenesis. Nature Communications. 2018 Jun 22;9(1):2448. doi: 10.1038/s41467-018-04913-2Kato, K., Diéguez-Hurtado, R., Park, D. Y., Hong, S. P., Kato-Azuma, S., Adams, S., Stehling, M., Trappmann, B., Wrana, J. L., Koh, G. Y., & Adams, R. H. (2018). Pulmonary pericytes regulate lung morphogenesis. Nature Communications. 2018 Jun 22;9(1):2448. doi: 10.1038/s41467-018-04913-2Ackermann M, Verleden SE, Kuehnel M, Haverich A, Welte T, Laenger F, Vanstapel A, Werlein C, Stark H, Tzankov A, Li WW, Li VW, Mentzer SJ, Jonigk D. Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19. New England Journal of Medicine. 2020 Jul 9;383(2):120-128. doi: 10.1056/NEJMoa2015432Ackermann M, Verleden SE, Kuehnel M, Haverich A, Welte T, Laenger F, Vanstapel A, Werlein C, Stark H, Tzankov A, Li WW, Li VW, Mentzer SJ, Jonigk D. Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19. New England Journal of Medicine. 2020 Jul 9;383(2):120-128. doi: 10.1056/NEJMoa2015432Fox, S. E., Li, G., Akmatbekov, A., Harbert, J. L., Lameira, F. S., Brown, J. Q., & Vander Heide, R. S. (2020). Unexpected features of cardiac pathology in COVID-19 infection. Circulation. 2020 Sep 15;142(11):1123-1125.. doi: 10.1161/circulationaha.120.049465Fox, S. E., Li, G., Akmatbekov, A., Harbert, J. L., Lameira, F. S., Brown, J. Q., & Vander Heide, R. S. (2020). Unexpected features of cardiac pathology in COVID-19 infection. Circulation. 2020 Sep 15;142(11):1123-1125.. doi: 10.1161/circulationaha.120.049465Isakson BE, Damon DN, Day KH, Liao Y, Duling BR. Connexin40 and connexin43 in mouse aortic endothelium: evidence for coordinated regulation. American Journal of Physiology-Heart and Circulatory Physiology. 2006 Mar;290(3):H1199-1205. doi: 10.1152/ajpheart.00945.2005Isakson BE, Damon DN, Day KH, Liao Y, Duling BR. Connexin40 and connexin43 in mouse aortic endothelium: evidence for coordinated regulation. American Journal of Physiology-Heart and Circulatory Physiology. 2006 Mar;290(3):H1199-1205. doi: 10.1152/ajpheart.00945.2005Segal SS. Regulation of blood flow in the microcirculation. Microcirculation. 2005 Jan-Feb;12(1):33-45. doi: 10.1080/10739680590895028Segal SS. Regulation of blood flow in the microcirculation. Microcirculation. 2005 Jan-Feb;12(1):33-45. doi: 10.1080/10739680590895028Pries AR, Höpfner M, le Noble F, Dewhirst MW, Secomb TW. The shunt problem: control of functional shunting in normal and tumour vasculature. Nat Rev Cancer. 2010 Aug;10(8):587-93. doi: 10.1038/nrc2895Pries AR, Höpfner M, le Noble F, Dewhirst MW, Secomb TW. The shunt problem: control of functional shunting in normal and tumour vasculature. Nat Rev Cancer. 2010 Aug;10(8):587-93. doi: 10.1038/nrc2895Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y, Li Y, Wang X, Peng Z. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020 Mar 17;323(11):1061-1069. doi: 10.1001/jama.2020.1585Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y, Li Y, Wang X, Peng Z. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020 Mar 17;323(11):1061-1069. doi: 10.1001/jama.2020.1585Carsana, L., Sonzogni, A., Nasr, A., Rossi, R. S., Pellegrinelli, A., Zerbi, P., Rech, R., Colombo, R., Antinori, S., Corbellino, M., Galli, M., Catena, E., Tosoni, A., Gianatti, A., & Nebuloni, M. (2020). Pulmonary postmortem findings in a series of COVID-19 cases from northern Italy: a two-centre descriptive study. The Lancet Infectious Diseases. 2020 Oct;20(10):1135-1140. doi: 10.1016/s1473-3099(20)30434-5Carsana, L., Sonzogni, A., Nasr, A., Rossi, R. S., Pellegrinelli, A., Zerbi, P., Rech, R., Colombo, R., Antinori, S., Corbellino, M., Galli, M., Catena, E., Tosoni, A., Gianatti, A., & Nebuloni, M. (2020). Pulmonary postmortem findings in a series of COVID-19 cases from northern Italy: a two-centre descriptive study. The Lancet Infectious Diseases. 2020 Oct;20(10):1135-1140. doi: 10.1016/s1473-3099(20)30434-5Hanley, B., Naresh, K. N., Roufosse, C., Nicholson, A. G., Weir, J., Cooke, G. S., Thursz, M., Manousou, P., Corbett, R., Goldin, R., Al-Sarraj, S., Abdolrasouli, A., Swann, O. C., Baillon, L., Penn, R., Barclay, W. S., Viola, P., & Osborn, M. (2020). Histopathological findings and viral tropism in UK patients with severe fatal COVID-19: a post-mortem study. The Lancet Microbe. 2020 Oct;1(6):e245-e253 doi: 10.1016/s2666-5247(20)30115-4Hanley, B., Naresh, K. N., Roufosse, C., Nicholson, A. G., Weir, J., Cooke, G. S., Thursz, M., Manousou, P., Corbett, R., Goldin, R., Al-Sarraj, S., Abdolrasouli, A., Swann, O. C., Baillon, L., Penn, R., Barclay, W. S., Viola, P., & Osborn, M. (2020). Histopathological findings and viral tropism in UK patients with severe fatal COVID-19: a post-mortem study. The Lancet Microbe. 2020 Oct;1(6):e245-e253 doi: 10.1016/s2666-5247(20)30115-4Wani K, AlHarthi H, Alghamdi A, Sabico S, Al-Daghri NM. Role of NLRP₃ inflammasome activation in obesity-mediated metabolic disorders. Int J Environ Res Public Health. 2021;18(2):511. doi: 10.3390/ijerph18020511Wani K, AlHarthi H, Alghamdi A, Sabico S, Al-Daghri NM. Role of NLRP₃ inflammasome activation in obesity-mediated metabolic disorders. Int J Environ Res Public Health. 2021;18(2):511. doi: 10.3390/ijerph18020511Mastrocola R, Penna C, Tullio F, et al. Pharmacological inhibition of NLRP₃ inflammasome attenuates myocardial ischemia/reperfusion injury by activation of RISK and mitochondrial pathways. Oxid Med Cell Longev. 2016;2016:1–11. doi: 10.1155/2016/5271251Mastrocola R, Penna C, Tullio F, et al. Pharmacological inhibition of NLRP₃ inflammasome attenuates myocardial ischemia/reperfusion injury by activation of RISK and mitochondrial pathways. Oxid Med Cell Longev. 2016;2016:1–11. doi: 10.1155/2016/5271251Hotamisligil GS. Inflammation, metaflammation and immunometabolic disorders. Nature. 2017;542(7640):177–185. doi: 10.1038/nature21363Hotamisligil GS. Inflammation, metaflammation and immunometabolic disorders. Nature. 2017;542(7640):177–185. doi: 10.1038/nature21363Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506. doi: 10.1016/S0140-6736(20)30183-5Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506. doi: 10.1016/S0140-6736(20)30183-5Hill JH, Solt C, Foster MT. Obesity associated disease risk: the role of inherent differences and location of adipose depots. Horm Mol Biol Clin Investig. 2018;33(2). doi: 10.1515/hmbci-2018-0012Hill JH, Solt C, Foster MT. Obesity associated disease risk: the role of inherent differences and location of adipose depots. Horm Mol Biol Clin Investig. 2018;33(2). doi: 10.1515/hmbci-2018-0012Virdis A, Masi S, Colucci R, et al. Microvascular endothelial dysfunction in patients with obesity. Curr Hypertens Rep. 2019;21(4). doi: 10.1007/s11906-019-0930-2Virdis A, Masi S, Colucci R, et al. Microvascular endothelial dysfunction in patients with obesity. Curr Hypertens Rep. 2019;21(4). doi: 10.1007/s11906-019-0930-2Varsamis P, Walther G, Share B, et al. Transient endothelial dysfunction induced by sugar-sweetened beverage consumption may be attenuated by a single bout of aerobic exercise. Microvasc Res. 2018;115:8–11. doi: 10.1016/j.mvr.2017.07.003Varsamis P, Walther G, Share B, et al. Transient endothelial dysfunction induced by sugar-sweetened beverage consumption may be attenuated by a single bout of aerobic exercise. Microvasc Res. 2018;115:8–11. doi: 10.1016/j.mvr.2017.07.003Hellmann M, Roustit M, Gaillard-Bigot F, Cracowski JL. Cutaneous iontophoresis of treprostinil, a prostacyclin analog, increases microvascular blood flux in diabetic malleolus area. Eur J Pharmacol. 2015;758:123–128. doi: 10.1016/j.ejphar.2015.03.066Hellmann M, Roustit M, Gaillard-Bigot F, Cracowski JL. Cutaneous iontophoresis of treprostinil, a prostacyclin analog, increases microvascular blood flux in diabetic malleolus area. Eur J Pharmacol. 2015;758:123–128. doi: 10.1016/j.ejphar.2015.03.066Cordovil I, Huguenin G, Rosa G, et al. Evaluation of systemic microvascular endothelial function using laser speckle contrast imaging. Microvasc Res. 2012;83(3):376–379. doi: 10.1016/j.mvr.2012.01.004Cordovil I, Huguenin G, Rosa G, et al. Evaluation of systemic microvascular endothelial function using laser speckle contrast imaging. Microvasc Res. 2012;83(3):376–379. doi: 10.1016/j.mvr.2012.01.004Cracowski JL, Roustit M. Current methods to assess human cutaneous blood flow: an updated focus on laser-based-techniques. Microcirculation. 2016;23(5):337–344. doi: 10.1111/micc.12257Cracowski JL, Roustit M. Current methods to assess human cutaneous blood flow: an updated focus on laser-based-techniques. Microcirculation. 2016;23(5):337–344. doi: 10.1111/micc.12257Holowatz LA, Thompson-Torgerson CS, Kenney WL. The human cutaneous circulation as a model of generalized microvascular function. J Appl Physiol. 2008;105(1):370–372. doi: 10.1152/japplphysiol.00858.2007Holowatz LA, Thompson-Torgerson CS, Kenney WL. The human cutaneous circulation as a model of generalized microvascular function. J Appl Physiol. 2008;105(1):370–372. doi: 10.1152/japplphysiol.00858.2007Iredahl F, Löfberg A, Sjöberg F, Farnebo S, Tesselaar E. Non-invasive measurement of skin microvascular response during pharmacological and physiological provocations. PLoS One. 2015;10(8):e0133760. doi: 10.1371/journal.pone.0133760Iredahl F, Löfberg A, Sjöberg F, Farnebo S, Tesselaar E. Non-invasive measurement of skin microvascular response during pharmacological and physiological provocations. PLoS One. 2015;10(8):e0133760. doi: 10.1371/journal.pone.0133760Tur E, Yosipovitch G, Bar-On Y. Skin reactive hyperemia in diabetic patients: a study by laser Doppler flowmetry. Diabetes Care. 1991;14(11):958–962. doi: 10.1046/j.1365-2362.2003.01179.xTur E, Yosipovitch G, Bar-On Y. Skin reactive hyperemia in diabetic patients: a study by laser Doppler flowmetry. Diabetes Care. 1991;14(11):958–962. doi: 10.1046/j.1365-2362.2003.01179.xIJzerman RG, De Jongh RT, Beijk MAM, et al. Individuals at increased coronary heart disease risk are characterized by an impaired microvascular function in skin. Eur J Clin Invest. 2003;33(7):536–542. doi: 10.1046/j.1365-2362.2003.01179.xIJzerman RG, De Jongh RT, Beijk MAM, et al. Individuals at increased coronary heart disease risk are characterized by an impaired microvascular function in skin. Eur J Clin Invest. 2003;33(7):536–542. doi: 10.1046/j.1365-2362.2003.01179.xYamamoto-Suganuma R, Aso Y. Relationship between post-occlusive forearm skin reactive hyperaemia and vascular disease in patients with Type 2 diabetes - A novel index for detecting micro- and macrovascular dysfunction using laser Doppler flowmetry. Diabet Med. 2009;26(1):83–88. doi: 10.1111/j.1464-5491.2008.02609.xYamamoto-Suganuma R, Aso Y. Relationship between post-occlusive forearm skin reactive hyperaemia and vascular disease in patients with Type 2 diabetes - A novel index for detecting micro- and macrovascular dysfunction using laser Doppler flowmetry. Diabet Med. 2009;26(1):83–88. doi: 10.1111/j.1464-5491.2008.02609.xIjzerman Rg, Serne EH, Van Weissenbruch MH, De Jongh RT, Stehouwer CDA. Cigarette smoking is associated with an acute impairment of microvascular function in humans. Clin Sci. 2003;104(3):247–252. doi: 10.1042/CS20020318Ijzerman Rg, Serne EH, Van Weissenbruch MH, De Jongh RT, Stehouwer CDA. Cigarette smoking is associated with an acute impairment of microvascular function in humans. Clin Sci. 2003;104(3):247–252. doi: 10.1042/CS20020318Halcox JPJ, Schenke WH, Zalos G, et al. Prognostic value of coronary vascular endothelial dysfunction. Circulation. 2002;106(6):653–658. doi: 10.1161/01.cir.0000025404.78001.d8Halcox JPJ, Schenke WH, Zalos G, et al. Prognostic value of coronary vascular endothelial dysfunction. Circulation. 2002;106(6):653–658. doi: 10.1161/01.cir.0000025404.78001.d8Francischetti EA, Tibirica E, Da Silva Eg, Rodrigues E, Celoria BM, De Abreu Vg. Skin capillary density and microvascular reactivity in obese subjects with and without metabolic syndrome. Microvasc Res. 2011;81(3):325–330. doi: 10.1016/j.mvr.2011.01.002Francischetti EA, Tibirica E, Da Silva Eg, Rodrigues E, Celoria BM, De Abreu Vg. Skin capillary density and microvascular reactivity in obese subjects with and without metabolic syndrome. Microvasc Res. 2011;81(3):325–330. doi: 10.1016/j.mvr.2011.01.002Баланова Ю.А., Шальнова С.А., Имаева А.Э., Капустина А.В., Муромцева Г.А., Евстифеева С.Е., Тарасов В.И., Редько А.Н., Викторова И.А., Прищепа Н.Н., Якушин С.C., Бойцов С.А., Драпкина О.М. Распространенность артериальной гипертонии, охват лечением и его эффективность в Российской Федерации (данные наблюдательного исследования ЭССЕ-РФ-2). Рациональная Фармакотерапия в Кардиологии. 2019;15(4):450-466. doi: 10.20996/1819-6446-2019-15-4-450-466Balanova Yu.A., Shalnova S.A., Imaeva A.E., Kapustina а.V., Muromtseva G.A., Evstifeeva S.V., Tarasov V.I., Redko A.N., Viktorova I.A., Prishchepa N.N., Yakushin S.S., Boytsov S.A., Drapkina O.M. Prevalence, Awareness, Treatment and Control of Hypertension in Russian Federation (Data of Observational ESSERF-2 Study). Rational Pharmacotherapy in Cardiology. 2019;15(4):450-466. (In Russ.). doi: 10.20996/1819-6446-2019-15-4-450-466Levy BI, Ambrosio G, Pries AR, Struijker-Boudier HA. Microcirculation in hypertension: a new target for treatment? Circulation. 2001 Aug 7;104(6):735-40. PMID: 11489784. doi: 10.1161/hc3101.091158Levy BI, Ambrosio G, Pries AR, Struijker-Boudier HA. Microcirculation in hypertension: a new target for treatment? Circulation. 2001 Aug 7;104(6):735-40. PMID: 11489784. doi: 10.1161/hc3101.091158Лазерная допплеровская флоуметрия микроциркуляции крови : рук. для врачей / под ред. А. И. Крупаткина, В. В. Сидорова. – Москва: Медицина: Шико, 2005. – 254 с.: ил., табл.; 22 см.; ISBN 5-225-04221-X: 1000Laser Doppler flowmetry of blood microcirculation: Manual for physicians / edited by A. I. Krupatkin, V. V. Sidorov. – Moscow: Medicine: Shiko, 2005. – 254 p.: ill., table; 22 cm; ISBN 5-225-04221-X: 1000 (In Russ.)Lai YJ, Liu SH, Manachevakul S, Lee TA, Kuo CT, Bello D. Biomarkers in long COVID-19 : A systematic review. Front Med (Lausanne). 2023 Jan 20;10:1085988. PMID: 36744129; PMCID: PMC9895110. doi: 10.3389/fmed.2023.1085988Lai YJ, Liu SH, Manachevakul S, Lee TA, Kuo CT, Bello D. Biomarkers in long COVID-19 : A systematic review. Front Med (Lausanne). 2023 Jan 20;10:1085988. PMID: 36744129; PMCID: PMC9895110. doi: 10.3389/fmed.2023.1085988Петелина Т.И. , Гаранина В.Д. , Авдеева К.С., Валеева Л.Л., Жмуров Д.В., Жмуров В.А., Гапон Л.И., Капустина А.А. Динамика лабораторных параметров у пациентов с артериальной гипертонией, перенесших COVID-19- ассоциированную пневмонию. Клиническая лабораторная диагностика. 2024;69(4):108-116. doi: 10.51620/0869-2084-2024-69-4-108-116Petelina T.I., Garanina V.D., Avdeeva K.S. , Valeeva K.S. , Zhmurov D.V., Zhmurov V.A., Gapon L.I., Kapustina A.A. Dynamics of laboratory parameters in patients with arterial hypertension who underwent COVID-19-associated pneumonia. Klinicheskaya Laboratornaya Diagnostika (Russian Clinical Laboratory Diagnostics). 2024;69(4):108-116 (in Russ.). doi: 10.51620/0869-2084-2024-69-4-108-116Kowalik M, Myśliński W, Mosiewicz J. Cutaneous microcirculation reactivity in patients with arterial hypertension, taking into account intake of anti-hypertensive drugs. Ann Agric Environ Med. 2022 Dec 27;29(4):582-587. Epub 2022 Dec 19. PMID: 36583327. doi: 10.26444/aaem/157146Kowalik M, Myśliński W, Mosiewicz J. Cutaneous microcirculation reactivity in patients with arterial hypertension, taking into account intake of anti-hypertensive drugs. Ann Agric Environ Med. 2022 Dec 27;29(4):582-587. Epub 2022 Dec 19. PMID: 36583327. doi: 10.26444/aaem/157146Jung F, Pindur g, Ohlmann P. Microcirculation in hypertensive patients. Biorheology. 2013;50(5–6):241–55. doi: 10.3233/BIR-130645Jung F, Pindur g, Ohlmann P. Microcirculation in hypertensive patients. Biorheology. 2013;50(5–6):241–55. doi: 10.3233/BIR-130645Scalia R. The microcirculation in adipose tissue inflammation. Rev Endocr Metab Disord. 2013;14(1):69-76. doi: 10.1007/s11154-013-9236-xScalia R. The microcirculation in adipose tissue inflammation. Rev Endocr Metab Disord. 2013;14(1):69-76. doi: 10.1007/s11154-013-9236-xMuris DM, Houben AJ, Schram MT, Stehouwer CD. Microvascular dysfunction: an emerging pathway in the pathogenesis of obesity-related insulin resistance. Rev Endocr Metab Disord. 2013;14(1):29-38. doi: 10.1007/s11154-012-9231-7Muris DM, Houben AJ, Schram MT, Stehouwer CD. Microvascular dysfunction: an emerging pathway in the pathogenesis of obesity-related insulin resistance. Rev Endocr Metab Disord. 2013;14(1):29-38. doi: 10.1007/s11154-012-9231-7Scalia R. The microcirculation in adipose tissue inflammation. Rev Endocr Metab Disord. 2013;14(1):69-76. doi: 10.1007/s11154-013-9236-xScalia R. The microcirculation in adipose tissue inflammation. Rev Endocr Metab Disord. 2013;14(1):69-76. doi: 10.1007/s11154-013-9236-xMuris DM, Houben AJ, Schram MT, Stehouwer CD. Microvascular dysfunction: an emerging pathway in the pathogenesis of obesity-related insulin resistance. Rev Endocr Metab Disord. 2013;14(1):29-38. doi: 10.1007/s11154-012-9231-7Muris DM, Houben AJ, Schram MT, Stehouwer CD. Microvascular dysfunction: an emerging pathway in the pathogenesis of obesity-related insulin resistance. Rev Endocr Metab Disord. 2013;14(1):29-38. doi: 10.1007/s11154-012-9231-7Celik T., Balta S., Karaman M., Ahmet Ay S., Demirkol S., Ozturk C., Dinc M., Unal H.U., Yilmaz M.I., Kilic S., et al. Endocan, a novel marker of endothelial dysfunction in patients with essential hypertension: Comparative effects of amlodipine and valsartan. Blood Press. 2015;24:55–60. PMID: 25390761. doi: 10.3109/08037051.2014.972816Celik T., Balta S., Karaman M., Ahmet Ay S., Demirkol S., Ozturk C., Dinc M., Unal H.U., Yilmaz M.I., Kilic S., et al. Endocan, a novel marker of endothelial dysfunction in patients with essential hypertension: Comparative effects of amlodipine and valsartan. Blood Press. 2015;24:55–60. PMID: 25390761. doi: 10.3109/08037051.2014.972816Savoia C., grassi g. Exercise activity and endothelial function: The uprising role of endothelial progenitor cells in vascular protection. J. Hypertens. 2012;30:2083–2084. PMID: 23052045. doi: 10.1097/HJH.0b013e32835a0d31Savoia C., grassi g. Exercise activity and endothelial function: The uprising role of endothelial progenitor cells in vascular protection. J. Hypertens. 2012;30:2083–2084. PMID: 23052045. doi: 10.1097/HJH.0b013e32835a0d31Королев А.И., Федорович А.А., Горшков А.Ю., Михайлова М.А., Дадаева В.А., Васильев Д.К., Акашева Д.У., Драпкина О.М. Особенности микроциркуляции в коже в зависимости от индекса массы тела у мужчин с нормальным артериальным давлением. Профилактическая медицина. 2020;23(5):144-151. doi: 10.17116/profmed202023051144Korolev AI, Fedorovich AA, gorshkov AYu, et al. Skin microvascular change in men with normal arterial pressure depending on body mass index. Russian Journal of Preventive Medicine. 2020;23(5):144-151. (In Russ.) doi: 10.17116/profmed202023051144

The authors declare that there are no conflicts of interest present.