Home – Home – Jornals – The journal "Ateroskleroz" 2017 number 4

Purpose: to study associations of homozygous allelic variants of VEGFR2*C/*C and CYP2C19*17/*17 genes with atherosclerotic lesion of coronary arteries in patients with acute coronary syndrome (ACS) in the North (Surgut) and in large cities of the Siberian Federal District of Russia (Irkutsk and Kemerovo). 257 consecutive patients with ACS upon admission to the cardiological hospitals of Surgut, Irkutsk and Kemerovo has been included in the study. All examined patients underwent coronarography and determination of allelic variants of VEGFR2*C/*C and CYP2C19*17 /*17 genes. In patients from Surgut has been determened the direct associations of the combination of allelic variants of VEGFR2*C/*C + CYP2C19*17/*17 with indicators of severe coronary atherosclerosis (lesion of the left coronary artery trunk (LCA), LCA stenosis more than 50 %, proximal or medial lesion of the three major arteries more than 70 % (PLA) and the presence of PLA or stenosis of the LCA trunk more than 50 %). Such associations were not found in patients from Kemerovo and Irkutsk. The multivariate analysis determined the direct effect of combination of allelic variants of the VEGFR2*C/*C and CYP2C19*17/*17 genes on the presence of PTA or stenosis of the LCA trunk more than 50 % in patients with ACS from Surgut regardless of males gender, ages and smoking (Exp B) = 21.065, 95 % CI (2.003; 221.524), p = 0.011). Thus, the combination of allelic variants of VEGFR2*C/*C and CYP2C19*17/*17 genes directly affects the presence of severe coronary atherosclerosis in patients with ACS from Surgut.

Aim of the study. The relationships and connections of atherosclerotic damage of carotid arterial wall concomitant with atherosclerosis of thoracic aorta have been studied here, as from data of contrast-enhanced magnetic resonance imaging (MRI), and also bearing in mind the results of blood lipids biochemistry. Material and methods. The study patients group comprised seventeen persons (of which 12 males and five females, as old as 62.3 ± 6.2 years) with extensive atherosclerosis verified from data of complex radiologic and biochemical study. In everybody extensive MRI study with contrast enhancement has been carried out imaging both carotid, cerebral and aortic arch regions, and also blood spectrum of lipids was studied. Everybody used to be a in-patient of departments of cardiovascular surgery or of urgent cardiology, with multiple ischemic attacks in cerebral and coronary vascular areas (all seventeen) and also lower limb vascular arterial disorders (in twelve). Diabetes mellitus of type 2 with need of antidiabetic peroral treatment was present in eight of seventeen included. Carotid arterial stenotic atherosclerosis involved common carotid artery bifurcation and internal carotid artery (with bilateral critical stenosis in ten patients and with essentially monolateral one in seven patients) and was concomitant with stenosis over 50 % in one or more segment of syphone and/or intracranial part of internal carotid artery or of anterior or middle cerebral arteries. MRI study of aorta and carotid arteries has been carried out in everybody using MRI scanner with Toshiba Titan Vantage with field induction 1.5 T. Pearson’s parametric coefficient of correlation was employed for analysis of group relationships, with calculation of correlation coefficient r . Results. In all patients with atherosclerosis statistically significantly higher values of paramagnetic contrast enhancement of T1WI- SE scans of carotid artery’s wall as compared to the control group were observed. Age-matched control persons demonstrated the indices as low as 1.04 ± 0.02. In particular the index of enhancement of T1-WI of carotid arteries and aorta in patients with advanced atherosclerosis were as follows: over carotid arteries - 1.24 ± 0.17, over r aorta - 1.22 ± 0.17. When assessing the relationship between the indices of enhancement of T1-WI of aorta and of carotid arteries, a positive linear correlation was found ( r = 0.672, p < 0.05). There were no evidence for aortic dissection or aneurysm; the diameter of aorta in patients with atherosclerosis was as narrow as 2.5 ± 0.31 cm. The index of enhancement of T1-WI of carotid arteries atherosclerotic lesion and the total cholesterol level did correlate significantly ( r = 0.584, p < 0.05). There was also positive correlation between index of enhancement of T1-Scans of carotid plaque and blood triglycerides ( r = 0.667; p <0.05). Conclusion. Uptake of paramagnetic contrast agents as visual expression of pathologic neoangiogenesis in the media layers of wall of aorta and carotid arteries is seen over all extent of aortic arch and carotid vessels in patients with extensive atherosclerosis. When observing the uptake of paramagnetic contrast to the arterial wall concomitant with carotid stenosis it is recommended to carry out the MRI of aorta as well.

The goal was to study clinical features, NTproBNP and ST-2 indices in patients with acute myocardial infarction with ST segment elevation (STEMI) complicated by heart failure. Materials and methods. Included 150 patients with STEMI in the first 24 hours from the onset of the disease, with arterial hypertension, acute heart failure (AHF), Killip I-IV degree. All patients underwent clinical, laboratory and instrumental examinations: on admission to the hospital (first visit) and discharge (second visit). Results. The average age of the patients was 61.70 ± 2.96 years. In the dynamics of treatment of STEMI patients in the general group, a decrease in the level of ST-2 was observed against a background of high concentration of NTproBNP. With the progression of the degree of AHF Killip II-IV, the level of ST-2 and NTproBNP increases. At the first visit in the ST-2 ≥ 35 ng/mL group, the ST-2 and NTproBNP levels were statistically higher than those in the ST-2 group <35 ng/ml. At the second visit in ST-2 ≥ 35 ng/ml group, ST-2 level was decreased, and NTproBNP values remained high in the studied groups. A statistically significant reduction in the ejection fraction in patients with ST-2 ≥ 35 ng/ml was found to be statistically significant compared to the ST-2 group <35 ng/ml. The conclusion. In STEMI patients, ST-2 and NTproBNP are prognostic markers for the progression of acute heart failure. In the dynamics of inpatient treatment, the level of ST-2 persisted more than 35 ng/ml, in the ST-2 group of 35 ng/ml has the most unfavorable prognosis of heart failure.

Aim: to evaluate association between the nutrition habits and abdominal obesity in cross-sectional population study among women 45-69 years in Novosibirsk. Materials and methods. The present analysis included 5074 women examined in the frame of international project HAPIEE. Data on nutrition were obtained in the population survey using a questionnaire on the frequency of food consumption (FFQ). Abdominal obesity (AO) was determined by waist circumference, using two criteria - ≥ 88 cm (AHA, 2005) and ≥ 80 cm (IDF, 2005). Statistical analysis was performed using package SPSS. Results. Significant negative association between intake of carbohydrates in the diet and obesity in women was found. The chance of abdominal obesity defined by both criteria was 2 times lower in the highest quartile of distribution of carbohydrate intake in comparison with the lowest quartile ( p < 0.001). The chance of abdominal obesity increased 1.5 times in the highest quartile of distribution of fat intake ( p < 0.001). The chance of AO in the highest quartile of protein was 1.8 times higher than in the lowest quartile for AHA 2005 criterion and 1.7 times for IDF 2005 criterion of AO. Conclusion. In studied population sample of women aged 45-69 high consumption of carbohydrates in the diet was associated with reduced frequency of metabolic disorders, probably due to contribution of high intake of fiber and low intake of saturated fatty acids and cholesterol. High consumption of fats and proteins increases the risk of AO in female population ages 45-69 years. In the group with the highest intake of carbohydrates the ratio of nutrients in the diet (carbs / fat / protein) was close to the recommended by WHO.

The review systematizes the results of studies on the effect of consumption of polyphenolic compounds on serum lipids. Data on the effect of polyphenol content in various products, consumption in different regions are given. The results of the effect on the lipid profile of phenolic acids cocoa, resveratrol, polyphenols olive oil. The mechanisms of the effect of polyphenols on lipids are given.

The review provides an analysis of the literature data on the Klotho protein. The discovery and in-depth study of the Klotho gene and its protein broadened the notion of natural aging. The levels of Klotho protein in serum decrease with age and with certain diseases associated with aging, in particular, such as osteoporosis, arterial hypertension, diabetes mellitus, malignant neoplasms, and certain kidney diseases. A number of experimental publications have suggested that the Klotho protein may affect the functional state of the vascular endothelium by suppressing inflammation and oxidative stress. According to some data a decrease the Klotho protein in blood is observed in cardiovascular diseases, but such data are scarce. Further studies are needed in this direction to determine possible relationships of the Klotho protein content in the blood serum with atherogenesis. New knowledge in understanding these processes can be used to find a more effective approach in the treatment and diagnostic tactics of cardiovascular diseases.

The described clinical case illustrates the fifteen years’ advance of the man on classical stages of a cardiovascular continuum caused by extremely low commitment to therapy with a debut of risk factors at 35-year age and the final at a stage of a systolic heart failure after a Q-positive myocardial infarction at the age of 50 years when, even in the conditions of a high compliance, therapeutic opportunities of tertiary prophylaxis of coronary heart disease are extremely limited.