Home – Home – Jornals – The journal "Ateroskleroz" 2018 number 1

Objective: to determine the clinical significance of markers of myocardial remodeling (NT-proBNP, galectin-3, sST2, MMP-1, 2, 3 and TIMP-1) in patients with ST segment elevation myocardial infarction and preserved left ventricular function. Materials and methods. 100 consecutive patients diagnosed with ST segment elevation myocardial infarction (STEMI) and LV ejection fraction ≥40 % were included. All patients underwent revascularization of the culprit artery. Echocardiography was performed in all the patients on days 1 day, 10-12 and in a year after hospitalization. In all the patients on admission, days 10-12 and in a year after STEMI serum concentrations of the following markers were assessed: matrix metalloproteinases-1, 2 and 3 (MMP), tissue inhibitor of matrix metalloproteinase-1 (TIMP-1), galectin-3; N-terminal brain natriuretic propeptide (NT-proBNP); soluble protein of the IL-1 receptor family (sST2). Results. The concentration of MMP-3, determined on days 10-12 of the MI, was 1.62 times higher than the values measured on the first day. While the concentration of soluble ST2 receptor, on the contrary, is almost twice as low on days 10-12 as measured on the 1st day. Also statistically significant dynamics in the period of hospitalization was determined for galectin-3 ( p = 0.0001), MMP-2 ( p = 0.0003), NT-proBNP ( p = 0.0361). Analyzing the differences in the concentrations of the markers under study, taking into account the presence / absence of signs of DD, draws attention to the fact of large median values in the group of patients with DD ( n = 38): galectin-3 at each of the observation points, NT-proBNP by the 10-12th day and in a year, MMP-1 - on the 1st and 10-12th day of observation, MMP-2 - at the annual observation stage, MMP-3 - on the 1st and 10-12th days from the MI, TIMP-1 - on the contrary, in the group of patients with DD the concentrations were lower in comparison with patients without DD ( n = 62) both on the 1st day and a year later. For sST2 no significant differences were found. Conclusions. It was determined that in the group of patients with ST segment elevation myocardial infarction and preserved LV function in the hospital period and a year later, a statistically significant dynamics of the majority of studied markers was registered, which indicates the regular processes of structural and functional remodeling of myocardium of the LV at different stages of observation. Significant differences in the levels of studied markers were determined between the groups, taking into account the presence / absence of diastolic dysfunction in patients with preserved and middle fraction of LV ejection.

Aim. To study flow-mediated dilation (FMD) in patients with coronary artery disease (CAD), depending on the presence of diabetes mellitus (DM) type 2. Materials and Methods. The study included 137 patients (77 men and 60 women) with CAD. The average age of patients was 62.0 (57.0-66.0) years. The first group included 67 patients with CAD and DM type 2 and the second group included 70 patients with CAD. All patients underwent duplex scanning of the carotid and lower limb arteries. FMD was evaluated in a test with reactive hyperemia according to D.S. Celermajer in the modification of O.V. Ivanova. Results. The dilated response of the brachial artery was statistically significantly less in the first group of patients - 5.20 % (3.57-7.14) vs. 9.30 % (4.61-12.0) in the second group ( p = 0.0001). In the group of patients with DM, the proportion of patients with a dilated response less than 10 % was 61 (91.0 %), which was significantly less in comparison with the second group - 40 (57.1 %) patients ( p = 0.0001) . A decrease in the dilatational response of the brachial artery was associated with an increase in the degree of stenosis of the left CCA ( r = -0.286, p = 0.001), overall carotid stenosis ( r = -0.186; p = 0.029), plaque score (r = -0.279; p = 0.001), total carotid plaque area ( r = -0.256; p = 0.003); increase in femoral IMT ( r = -0.246; p = 0.004). The magnitude of the dilated response of the brachial artery during reactive hyperemia was inversely correlated with the duration of DM type 2 ( r = -0.349, p = 0.0001) and glycated hemoglobin ( r = -0.308; p = 0.0001). Conclusion. Patients with CAD and DM type 2 showed statistically significantly lower values of FMD compared with patients with CAD without DM. Decrease in FMD was associated with the severity of the DM type 2 and the severity of subclinical atherosclerosis of peripheral arteries.

The study objective is evaluate atherosclerosis burden on atorvastatin protective effect in patients with chronic total occlusion recanalization. Methods. 38 patients underwent recanalization of chronic total occlusions. All patients received a loading dose of atorvastatin 80 mg before surgery. Further patients were divided into high and low risk group according to SYNTAX score. In both groups, troponin I, CF fraction of creatine phosphokinase, functional parameters of the myocardium were measured 1 day prior to surgery, 24 hours and 1 month after the surgery. Results. In the high risk group there was discovered more significant troponin I rising compared with low risk group. In the low risk group troponin I level was significantly lower. CF fraction of creatine phosphokinase in both groups was similar. There were no statistically significant changes in echocardiography parameters. Conclusion. Atorvastatin loading dose has a protective effect and prevents periprocedural myocardial ischemia. At the same time this effect appears only in patients with low atherosclerosis burden - SYNTAX score less than 19.5. At the same time it doesn’t influence on central hemodynamics in short-term period.

Background: The literature data about the frequency of cardiovascular risk factors in old age patients from social protection institutions at the present time remains controversial. Objective: To examine the frequency of cardiovascular risk factors in persons of both sexes aged over 60 years who lives at infirmaries and social service centers of the Novosibirsk region. Methods: Questioning of infirmaries and social service centers of the Novosibirsk region was applied. Data from 2676 people of both sexes aged over 60 years who were residents of the Novosibirsk Region were obtained. A unified database of questioning data results was created. The material in the statistical package «R» for Windows was analyzed. Results: In aged 60 years people who lives at infirmaries and social service centers of the Novosibirsk region the frequency of major cardiovascular risk factors is rather high (in particular, arterial hypertension and overweight). Conclusion: The analysis of such risk factors may be of great interest in the detailed development of preventive measures. In conditions of social protection institutions, it is important to adhere to a balanced diet, both to correct hyperglycemia in diabetes and to reduce excess body weight.

In the review, modern views on the significant role of hypercholesterolemia (HCH), especially familial HCH, hypertriglyceridemia and hyperglycemia in the onset and development of coronary heart disease (CHD) and its complications (myocardial infarction) in young people 25-45 years are systematized. According to prospective studies of CHD, about 8-10 % of young men are ill. For the purpose of effective prevention of the disease, it is necessary to conduct screening examinations of the young population, which necessarily include the determination of blood levels of total cholesterol, low-density lipoprotein cholesterol and glucose.

Elevated lipoprotein(a) plasma concentration - [Lp(a)] is considered a risk factor for cardiovascular disease (CVD). In African Americans (AA) have 2-3 times above [Lp(a)] than in Europeans and Asians, for example, in Chinese - 7.0 mg/dl, in black Sudanese - 46 mg/dl. Some authors believe that the apo(a) gene is the main determinant of the [Lp(a)] variation in AA, while others recognize the role of variant factors. The relationship between [Lp(a)] and the risk of CVD in AA is unclear: in meta-analysis under the Collaboration Emerging Risk Factors, at Europeans [Lp(a)] is associated with coronary artery disease, in AA - no. In Novosibirsk, from 96 men with confirmed surgically expressed coronary atherosclerosis [Lp(a)] is raised only in 16 %, and the high-atherogenous phenotype of apo(a) was detected in 20 %; but in the presence of unstable plaques (UP) in coronary arteries [Lp(a)] is 1.8 times higher than in persons without UP. Average [Lp(a)]+ ([Лп(а)]>0) at Chukchi male made 28,1 mg/dl, Chukchi female have 28,4 mg/dl, at Eskimos with [Lp(a)]+ the median of the [Lp(a)] - 22,4 mg/dl, and the mode - 15,5 mg/dl. In the aboriginals of Chukotka with AH, apo(a) S1, S2 occurred a little more frequently than among those without AH. Along with lipoprotein apheresis and niacin, apolipoprotein-(B-100)-antisense mipomersen, inhibitor of PCSK9 and apolipoprotein-(a)-antisense (oligonucleotide), showed promising results in reducing [Lp(a)]. In Russia, ehvolocumab and alirocoumab have been approved.

Colorectal cancer is the second cause of death among all deaths, caused by malignant tumors in the world. Understanding its pathophysiology is important for developing effective strategies for treating this disease. Lipidome, a combination of total lipids, lipid-linked enzymes, receptors and signaling pathways play an important role in numerous cellular processes such as metabolism, energy storage, proliferation and apoptosis. The disturbances in the regulation of lipid metabolism and their functions contribute to the development and progression of colorectal cancer and can be used to assess the prognosis. For a whole range of directions, the dysregulation of lipid metabolism in colorectal cancer is similar to that in the development of cardiovascular pathology. Strategies aimed at lipidome have been used in clinical studies and have shown promising results. This review presents recent advances in the study of impaired lipid metabolism in colorectal cancer, the mechanisms by which lipid metabolites regulate carcinogenesis and tumor progression, and potential therapeutic targets for future clinical trials.