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CNAA / Theses / 2017 / May /

Central, pulmonary, hepatic and renal hemodynamics in patients with liver cirrhosis


Author: Tcaciuc Eugen
Degree:doctor habilitat of medicine
Speciality: 14.00.05 - Internal Diseases (with specification: Pulmonology, Gastroenterology, Hepatology, Nephrology, Functional Diagnostics and Endoscopy)
Year:2017
Scientific adviser: Sergiu Matcovschi
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 15 May, 2017
Approved by NCAA on the 31 May, 2017

Abstract

Adobe PDF document – 2.32 Mb / in romanian

Thesis

CZU 616.36-004-02:616.9+616.12-008

Adobe PDF document 9.43 Mb / in romanian
230 pages

Keywords

liver cirrhosis, hemodynamic changes, portal hypertension, β-blockers, angiotensin II receptor blockers, treatment.

Summary

Study domain: Internal Medicine, hepatology.

The purpose of the study: the research of central, pulmonary, hepatic and renal hemodynamics particularities in patients with liver cirrhosis and the pharmacological treatment methods of circulatory disorders associated with liver cirrhosis.

The objectives of the study: the elucidation of central and regional hemodynamics particularities in patients with liver cirrhosis, the evaluation of the electrophysiological activity of the heart and the exercise tolerance, the determination of the role of vasodilator and vasoconstrictor substances in the development of hemodynamic changes in liver cirrhosis, the evaluation of the comparative treatment effectiveness with non-selective β-blockers and angiotensin II receptor blockers on the main hemodynamic parameters in patients with liver cirrhosis.

Scientific novelty and originality of the study has elucidated the hemodynamics particularities in patients with liver cirrhosis, the role of vasodilator and vasoconstrictor substances in the development of progressive hemodynamic changes in liver cirrhosis, the evaluation of the effectiveness of non-selective β-blockers and angiotensin II receptor blockers on central and hepatic hemodynamics disturbances in liver cirrhosis.

The fundamentally new results for science and practice obtained from the latest research have been determined creation of a new scientific direction of major importance in the domain of hemodynamic complications in liver cirrhosis and their pharmacological correction with diverse schemes of treatment.

The theoretical significance: it was demonstrated that cirrhosis leads to significant hemodynamic changes, which are progressing as cirrhosis advances. The treatment with propranolol and carvedilol improves central and hepatic hemodynamics, especially in decompensated cirrhosis, and the treatment with losartan – in compensated liver cirrhosis.

Practical value of the work: research results argues about the necessity of early detection of the hemodynamics changes in liver cirrhosis and their correction by pharmacological methods. The implementation of the scientific results: the results of the study have been implemented in the department of Gastroenterology, The Internal Diseases No 1 and No 2 in CMH “Saint Trinity”, department of Hepatology in Republic Clinical Hospital of Republic of Moldova and Department of Internal Medicine of the State University of Medicine and Pharmacy “Nicolae Testemitanu”.