Assessing risks of developing myeloproliferative diseases complications with laser doppler flowmetry

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UDC: 
616.155.191-072/.074
DOI: 
10.21668/health.risk/2020.3.19.eng
Authors: 

A.I. Bogomolov1, I.L. Davydkin2, E.A. Savinov 1, N.S. Popel'nyuk2, K.V. Naumova2

Organization: 

1Financial University under the Government of the Russian Federation, 49 Leningradskii Ave., 125993, Moscow, Russian Federation
2Samara State Medical University, 89 Chapaevskaya Str., Samara, 443099, Russian Federation

Abstract: 

Public healthcare in Russia faces many challenges; meeting them requires non-standard and innovative approaches. The set tasks are being solved within the «Public healthcare development» State program. A sub-program within it is called «Development and implementation of innovative diagnostics, prevention, and treatment procedures as well as basics of personified medicine». This sub-program involves wide use of information and digital technologies. Personified medicine envisages developing such methods that would allow early detection of a probable disease even at a preliminary stage in examining a patient; this detection is to be based on a simple and relatively cheap diagnostic technology and to provide a medical center with reliable data on detected signs of a disease for a further diagnosis. Mass use of such technologies also requires truly reliable mathematic procedures and models for putting a preliminary diagnosis. At present cardiovascular diseases are still the leading cause of death all over the world; they
develop due to variable factors including influence exerted by malignant neoplasms and also due to chemotherapy.
The paper contains data collected by contemporary medical experts on case histories and complications of myeloproliferative diseases caused by vascular system pathology that holds the first rank place as per mortality worldwide. It was detected that both pathological cellular mass and medications applied to treat myeloproliferative neoplasms could produce adverse effects on vascular endothelium damage to which plays the leading role in cardiovascular continuum. To assess risks of myeloproliferative diseases complications, we examined patients using Laser Doppler Flowmetry (LDF). The results were processed with a logistic regression model. As per ROC-analysis results the obtained diagnostic criterion has sensitivity (1 – β) and specificity, (1 – α) that are equal to 0.87 and 0.96 accordingly, and it means diagnostics is high-quality. The procedure and the mode can be applied in digital medicine.

Keywords: 
digital medicine, diagnostics, myeloproliferative diseases, vascular endothelium dysfunctions, Laser Doppler Flowmetry, mathematical model, logistic regression, risk assessment.
Bogomolov A.I., Davydkin I.L., E.A. Savinov, Popel'nyuk N.S., Naumova K.V Assessing risks of developing myeloproliferative diseases complications with laser doppler flowmetry. Health Risk Analysis, 2020, no. 3, pp. 160–168. DOI: 10.21668/health.risk/2020.3.19.eng
References: 
  1. Taddei S., Ghiadoni L., Virdis A., Versari D., Salvetti A. Mechanisms of endothelial dysfunction: clinical significance and preventive non-pharmacological therapeutic strategies. Curr. Pharm. Des, 2003, vol. 9, no. 29, pp. 2385–2402. DOI: 10.2174/1381612033453866
  2. Aleksandrova T.N., Yadrikhinskaya V.N., Mulina I.I., Solov'eva I.E., Terekhova L.D., Pavlova N.I., Zhozhikov L.R., Kurtanov Kh.A. Cardiovascular risk factors in patients with chronic myeloproliferative diseases. Vestnik severo-vostochnogo federal'nogo universiteta imeni M.K. Ammosova. Seriya «Meditsinskie nauki», 2018, vol. 13, no. 4, pp. 28–32 (in Russian). DOI: 10.25587/SVFU.2018.4(13).20741
  3. Melikyan A.L., Sukhanova G.A., Vakhrusheva M.V., Subortseva I.N., Orel E.B. Experience in treating portal thromboses in patients with chronic myeloproliferative diseases. Ter Arkh, 2016, vol. 88, no. 1, pp. 89–95. DOI: 10.17116/terarkh201688189-95\
  4. Tanashyan M.M., Kuznetsova P.I., Raskurazhev A.A., Lagoda O.V. Nekotorye aspekty profilaktiki narushenii mozgovogo krovoobrashcheniya u patsientov s mieloproliferativnymi zabolevaniyami [Certain aspects in preventing brain circulation disorders in patients with myeloproliferative diseases]. Medicamente. Lechim s umom, 2017, vol. 3, no. 1, pp. 41–44 (in Russian).
  5. Melikyan A.L., Turkina A.G., Abdulkadyrov K.M., Zaritskii A.Yu., Afanas'ev B.V., Shuvaev V.A., Lomaia E.G., Morozova E.V. [et al.]. Clinical recommendations for diagnosis and therapy of Ph-negative myeloproliferative diseases (polycythemia vera, essential thrombocythemia, primary myelofibrosis). Gematologiya i transfuziologiya, 2014, vol. 59, no. 4, pp. 31–56 (in Russian).
  6. Disfunktsiya endoteliya i arterial'naya gipertenziya [Endothelium dysfunction and arterial hypertension]. In: P.A. Lebedeva ed. Samara, OFORT Publ., 2010, 192 p. (in Russian).
  7. Fudashkin A.A. Endothelial disfunction in patients with hypertension and history of ischemic stroke. Vestnik Kyrgyzsko-Rossiiskogo Slavyanskogo universiteta, 2015, vol. 15, no. 4, pp. 173–175 (in Russian).
  8. Clark C.E., Taylor R.S., Shore A.C., Ukoumunne O.C., Campbell J.L. Association of a difference in systolic blood pressure between arms with vascular disease and mortality: a systematic review and meta-analysis. Lancet, 2012, vol. 379, no. 9819, pp. 905–916. DOI: 10.1016/S0140-6736(11)61710-8
  9. Vlachopoulos C., Aznaouridis K., O’Rourke M.F., Safar M.E., Baou K., Stefanadis C. Prediction of cardiovascular events and allcause mortality with central haemodynamics: a systematic review and meta-analysis. Eur. Heart. J., 2010, vol. 31, no. 15, pp. 1865–1871. DOI: 10.1093/eurheartj/ehq024
  10. Duangnapasatit D., Rattarittamrong E., Rattanathammethee T., Hantrakool S., Chai-Adisaksopha C., Tantiworawit A., Norasetthada L. Clinical Manifestations and Risk Factors for Complications of Philadelphia Chromosome-Negative Myeloproliferative Neoplasms. Asian. Pac. J. Cancer Prev., 2015, vol. 16, no. 12, pp. 5013–5018. DOI: 10.7314/apjcp.2015.16.12.5013
  11. Steegmann J.L., Baccarani M., Breccia M., Casado L.F., García-Gutiérrez V., Hochhaus A., Kim D.-W., Kim T.D. [et al.]. European Leukemia Net recommendations for the management and avoidance of adverse events of treatment in chronic myeloid leukaemia. Leukemia, 2016, vol. 30, no. 8, pp. 1648–1671. DOI: 10.1038/leu.2016.104
  12. Popova A.A., Berezikova E.N., Mayanskaya S.D. Mechanism of endothelial dysfunction development. Sibirskoe meditsinskoe obozrenie, 2010, vol. 64, no. 4, pp. 7–11 (in Russian).
  13. Orphanos G.S., Ioannidis G.N., Ardavanis A.G. Cardiotoxity induced by tyrosine kinase inhibitors. Acta Oncologica, 2009, vol. 48, no. 7, pp. 964–970. DOI: 10.1080/02841860903229124
  14. Bulaeva N.I., Golukhova E.Z. Endothelial dysfunction and oxidant stress: the role in cardiovascular pathology. Kreativnaya kardiologiya, 2013, no. 1, pp. 14–22 (in Russian).
  15. Ivanov A.N., Grechikhin A.A., Norkin I.A., Puchin'yan D.M. Methods of endothelial dysfunction diagnosis. Regionarnoe krovoobrashchenie i mikrotsirkulyatsiya, 2014, vol. 52, no. 4, pp. 4–11 (in Russian).
  16. Kanishcheva E.M., Fedorovich A.A. Possibilities for evaluating the condition of miscrovasculature and walls of large blood vessels. Serdtse: zhurnal dlya praktikuyushchikh vrachei, 2010, vol. 9, no. 1 (51), pp. 65–70 (in Russian).
  17. Khalepo O.V., Molotkov O.V., Eshkina S.L. Otsenka sostoyaniya sistemy mikrotsirkulyatsii i mekhanizmov regulyatsii tkanevogo krovotoka u bol'nykh pri razlichnykh variantakh IBS metodom funktsional'nykh nagruzochnykh prob [Assessing microcirculation functioning and mechanisms of tissue circulation regulation in patients suffering from various types of IHD via functional tests under loads]. Regionarnoe krovoobrashchenie i mikrotsirkulyatsiya, 2007, vol. 6, no. 3 (23), pp. 43–46 (in Russian).
  18. Bogoyavlenskii V.F., Bogoyavlenskaya O.V. Clinical aspects of microcirculation research: achievements and perspectives. Kazanskii meditsinskii zhurnal, 2011, vol. 92, no. 2, pp. 145–151 (in Russian).
  19. Favorskii A.P., Abakumov M.V., Esikova N.B., Mukhin S.I., Sosnin N.V. Matematicheskaya model' serdechnososudistoi sistemy. Preprint [A mathematical model for the cardiovascular system. Pre-print]. Moscow, MGU Publ., 1998, 16 p. (in Russian).
  20. Abakumov M.V., Ashmetkov I.V., Esikova N.B., Koshelev V.B., Mukhin S.I., Sosnin N.V., Tishkin V.F., Favorskii A.P., Khrulenko A.B. Metodika matematicheskogo modelirovaniya serdechno-sosudistoi sistemy [Mathematical techniques for cardiovascular system modeling]. Matematicheskoe modelirovanie, 2000, vol. 12, no. 2, pp. 106–117 (in Russian).
  21. Ashmetkov I.V., Mukhin S.I., Sosnin N.V., Favorskii A.P., Khrulenko A.B. Chastnye resheniya uravnenii gemodinamiki. Preprint [Particular solutions to hemodynamics equations. Pre-print]. Moscow, Dialog-MGU Publ., 1999, 43 p. (in Russian).
  22. Bunicheva A.Ya., Mukhin S.I., Sosnin N.V., Favorskii A.P. Osrednennaya nelineinaya model' gemodinamiki v odnom sosude. Preprint [Averaged non-linear model showing hemodynamics in one vessel. Pre-print]. Moscow, Dialog-MGU Publ., 2000, 21 p. (in Russian).
  23. Gusev A.V., Kuznetsova T.Yu., Korsakov I.N. Iskusstvennyi intellect v otsenke riskov razvitiya serdechnososudistykh zabolevanii [Artificial intellect in assessing risks of cardiovascular diseases development]. Zhurnal telemeditsiny i elektronnogo zdravookhraneniya, 2018, no. 3, pp. 18–32 (in Russian).
  24. Turkina A.G., Zaritskii A.Yu., Shuvaev V.A., Chelysheva E.Yu., Lomaia E.G., Morozova E.V., Golenkov A.K., Pospelova T.I. [et al.]. Clinical Recommendations for the Diagnosis and Treatment of Chronic Myeloid Leukemia. Klinicheskaya onkogematologiya, 2017, vol. 10, no. 3, pp. 294–316 (in Russian).
  25. Melikyan A.L., Kovrigina A.M., Subortseva I.N., Shuvaev V.A., Ageeva T.A., Baikov V.V., Vinogradova O.Y., Golenkov A.K. [et al.]. National clinical recommendations for diagnosis and therapy of PH-negative myeloproliferative neoplasms (polycythemia vera, essential thrombocythemia, primary myelofibrosis) (edition 2018). Gematologiya i transfuziologiya, 2018, vol. 63, no. 3, pp. 275–315 (in Russian).
  26. Hosmer D.W., Lemeshow S., Sturdivant R.X. Applied logistic regression. USA, John Wiley & Sons, Inc. Publ., 2013, 527 p.
Received: 
05.06.2020
Accepted: 
18.09.2020
Published: 
30.09.2020

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