#1972 Changes in vegetative hemodynamic relationship in the comorbid state of patients with respiratory pathology
Authors: Alimovna Dilorom , Rasulev Yorkin , Alyavi Anis , Mavjuda Aliakhunova 
Published: May 2024

Abstract

Background and Aims
The parameters of the vegetative nervous system (VNS) and its relationship with the function of the central and renal vessels in patients with bronchial asthma (BA) in comorbidity with glomerular filtration dysfunction of the kidneys were studied and the above-mentioned indicators of complex treatment regimens were determined.
Since the tension of neuropsychiatric predictors negatively affects the state of hemodynamics and internal organs directly of the VNS. The constant hyperactivity of this system due to chronic inflammatory processes is the starting point of vegetative imbalance.

Method
68 patients with comorbidity with glomerular filtration dysfunction of the kidneys and 30 healthy individuals were examined.
Studies were conducted in 36 patients with BA grade II-III (group 1, in which the level of glomerular filtration rate of the kidneys was determined by eGFRCKD-EPI ≥6 ml/min/1.73 m2) and 32 patients with BA grade IV (group 2, they were determined by eGFRCKD-EPI ≥60 ml/min/1,73m2). The functional state of the peripheral VNS was studied by cardiointervalography (CIG) using methods of mathematical analysis of indicators: Mode (Mo, sec.) and mode amplitude (AMo, %); Vasodilation of dependent endothelium (VDE) was determined by hyperreactive brachial artery Dopplerography test: maximum systolic velocity (Vmax) and vascular resistance index (IR).

Results
On the first day of admission to the hospital, patients were examined by the VNS meth, where eitonia and vagotonia were detected in practically healthy people, and hypersympathicotonia was determined in patients with BA with disorders of central and renal hemodynamics. A significant decrease in Mo parameters and an increase in AMo levels were analyzed when compared with the reference parameters of healthy individuals. This reflects the tension of the sympathetic department, and parasympathicotonia, on the contrary, decreased. There is a decrease in the ability of PA vessels to actively vasodilate due to an imbalance in the tone of the VNS. In the results of the hyperemic test, it was analyzed that in patients with BA in comorbidity with glomerular filtration dysfunction of the kidneys, the Vmax of blood flow decreases, and IR increases in parallel with the severity of the disease.
All patients underwent complex therapy with halotherapy for 20 minutes daily and resonance therapy for the area of both kidneys for 5 minutes of exposure, once a day, for 10 days. After the course of treatment, there was a positive dynamics in the functional parameters of the state of the VNS. The indicators of CIG were analyzed, where hypaticotonia decreased by 6.7%, and the parameters of the parasympathetic system improved to 5.3%.

Conclusion
At the heart of the elevation of maladaptive processes of chronic respiratory inflammation, hypoxia of brain structures and dysfunctions of glomerular filtration of the kidneys, vegetovisceral imbalance develops. The regimens of complex therapy have a positive effect, both anti-inflammatory at the visceral level and a calming effect on the VNS.