ASSESSMENT OF PROGNOSTIC FACTORS FOR THE DEVELOPMENT OF PULMONARY HYPERTENSION IN CHILDREN WITH CONGENITAL HEART DEFECTS

Abstract

Pulmonary hypertension in congenital heart defects (CHD) is a condition based on changes in the functional state and hyperplasia of endotheliocytes, hypertrophy of the smooth muscles of the middle layer and fibrous restructuring of the adventitia of the vessels of the small circle of blood circulation, accompanied by remodeling of the right heart. This process is a complex symptom complex with specific pathomorphological and hemodynamic features that define a wide range of tasks for clinical practice. This condition is a serious complication in a significant number of patients with a natural course of congenital heart failure. Despite the growing scientific interest in the problem of endothelial dysfunction in the microcirculatory system, the totality of the main participants in the process — from early markers (endothelin-1 level) to progression indicators (levels of soluble platelet adhesion factor to the endothelium, interleukin-1) and endothelial repair (vascular endothelial growth factor) — in combination with coagulation and hemodynamics in diseases of the small circle of blood circulation in children with varying degrees of severity of chronic heart failure has not been studied.