Home – Home – Jornals – The journal "Ateroskleroz" 2018 number 4

Aim. To study the expression of scavenger-receptor genes SCARF1 , MSR1 , CD36 , LDLR , VLDLR and cell adhesion genes VCAM1 , ICAM1 , PECAM1 , SELE , SELP , CDH5 potentially responsible for endothelial toxicity of mineral-organic nanoparticles (bions) in cultures of endothelial cells exposed to magnesium phosphate (MPB) and calcium phosphate bions (CPB). Materials and methods. In this study we used the culture of human immortalized venous endothelial cells (EA.hy 926 line), as well as commercial cultures of primary human coronary (HCAEC) and internal thoracic artery endothelial cells (HITAEC). Cells were cultured in the presence of synthesized MPB and CPB and pure phosphate-saline buffer (control). Immediately after cultivation, total RNA was isolated from samples of the cell lines. Based on the isolated RNA, a single-stranded cDNA was synthesized using a reverse transcription reaction. Evaluation of gene expression in cell cultures was carried out using Real-Time quantitative PCR with a SYBR Green fluorescent dye. Statistical analysis of the results was performed in GraphPad Prism 6 software. Results. Exposure of EA.hy 926 cells by MPB did not lead to significant changes in the expression of the studied genes except SELP and SELE compared with non-exposed control. Two-fold change in gene expression was shown for the SCARF1 and CD36 genes in culture exposed to spherical CPB (SCPB), as well as for the ICAM1 gene in culture exposed to needle-like CPB (NCPB). CPB exposure to HCAEC and HITAECcultures resulted in a pronounced decrease of expression of the CD36 and SELP genes and an increase of expression of the ICAM1 gene both in HCAEC and HITAEC.Expression of the VCAM1 and SELE genes was 2.5-fold higher in HCAEC exposed to NCPB and 2-fold increase of expression of the VLDLR gene HITAEC exposed to both types of CPB and the PECAM1 exposed to SCPB. MPB had practically no effect on the expression of the studied genes in the EA.hy 926 and HCAEC cultures, but at the same time they increased the expression of the PECAM1 gene and reduced the expression of the SELP and CDH5 genes in HITAEC. Conclusion.The chemical composition and morphology of bions, as well as the physiological characteristics of vessels can affect to gene expression signature in cultures of endothelial cells.

Aim. To evaluate the impact of age and gender on in-hospital outcomes of coronary artery bypass grafting (CABG) in patients with coronary artery disease. Methods. 538 (79.10 %) men and 142 (20.90 %) women ( n = = 680) in the CABG registry of the Research Institute for Complex Issues of Cardiovascular who were referred to CABG in the period from 2011 to 2012 were retrospectively reviewed to assess the prevalence of comorbidities and estimate the in-hospital outcomes. The mean age of patients was 59.12 ± 7.98 (33 to 78 years). All patients were assigned to 4 age groups: Group 1 - <50 years, Group 2 - 51-60 years, Group 3 - 61-70 years, Group 4 - >70 years. The statistical analysis was performed using the software package SPSS 20.0.1. A p value of <0.05 was considered statistically significant. Results. Women were commonly older than men and had a positive history of hypertension, chronic heart failure and higher angina class, obesity, type 2 diabetes, impaired glucose tolerance, non-ulcerative lesions of the gastrointestinal (GI) tract (gastritis, cholecystitis and / or pancreatitis). The male group was superior to the female group in the number of smokers and prior myocardial infarction. The incidence of first detected atrial fibrillation, atrial flutter, as well as ischemic strokes, congestive pneumonia increased with aging in both men and women within the in-hospital period. However, women, particularly from the younger age group (<50 years), more frequently suffered from ischemic strokes, GI bleedings, exacerbation of erosive gastritis, compared with men. Women from the older age group commonly had hydrothorax requiring pleural puncture, surgical wound healing complications, and exacerbation or / the first detected duodenal and / or stomach ulcers, compared to men. Conclusion: Female gender is associated with a significantly higher rate of the in-hospital complications compared to men. However, the impact of gender is mediated by age differences between men and women undergoing CABG.

Retrospective analysis enrolled 124 patients (90 males and 34 females, mean age 67.2 ± 7.4 years) with stable coronary artery disease (CAD) and non-valvular atrial fibrillation (AF) who underwent inpatient treatment in 2016 and 2017. All patients had planned percutaneous coronary intervention (PCI) performed. As a part of combined antithrombotic therapy 104 patients received peroral anticoagulants after planned PCI. It was demonstrated that the majority of AF patients after planned PCI got triple or double antithrombotic therapy including oral anticoagulants in actual clinical practice. Significant decrease of using antiaggregants combination only in patients of this category was stated. According to clinical observation a patient with high risk of thromboembolic complications, hemorrhage, macrohematuria and planned surgical intervention due to comorbidity after PCI received double antithrombotic therapy including clopidogrel and dabigatran 110 mg twice per 24 hours. No thrombotic complications of coronary atherosclerosis, cardioembolic complications, clinically relevant bleeding were noticed in long-term postsurgical period. Modern evidential basis of advantages of double antithrombotic therapy with direct oral anticoagulants was presented. It is crucially important for patients with high risk of hemorrhagic complications.

Objective. To analyze the protective effect of atorvastatin loading dose on the reduction of myocardial injury associated with percutaneous coronary intervention, left ventricular systolic functionand exercise tolerancein patients with endovascular recanalization of chronic atherosclerotic total occlusions. Methods. 82 patients underwent recanalization. The patients in the main group ( n = 38) received a loading dose of atorvastatin 80 mg before surgery. Patients in control group ( n = 44) received 20 mg of atorvastatin. In both groups Troponin I, CF fraction of creatine phosphokinaseweremeasured, echocardiographyand veloergometer test were performed prior to surgery, 24 hours, 1 month, 1 year after the surgery. Results. There was no difference in Troponin I and CF fraction of creatine phosphokinase initial levels. In 24 hours in the main group in 3 patients (7,9 %) there was discovered moderate troponin I rising. In the control group there were 11 (25 %) patients with increasing in troponin I level in 5 and more times. CF fraction of creatine phosphokinase in control group was increased in 3 (7,9 %) patients, in the control group this parameter was increased in 16 (36,4 %) patients. In 1 month and 1 year Troponin Iand CF fraction of creatine phosphokinaselevel was normal in the both groups.There were no statistically significant changes in echocardiography parametersor exercise tolerance during the all follow-up period. Conclusion. Atorvastatin loading dose has a protective effect and prevents periprocedural myocardial injury. At the same time it doesn’t influence on central hemodynamics parameters measured by echocardiography.

The possible mechanisms for the development of aspirin resistance, platelet involvement in thrombus formation, inflammation and atherogenesisare presented. The presence of associations between aspirin resistance and the risk of thrombotic complications in people not using aspirin and the possibility of using aspirin resistance to assess the individual risk of thromboembolic complications in 492 patients (mean age 56.2 ± 0.9 years) with arterial hypertension I - Stage II and without ithas been researched. The parameters of platelet aggregation were studied in subgroups of patients different in the risk of developing venous thrombo-embolic complications by reaction to the cyclooxygenase blocker. It has been revealed that the conducted antiplatelet therapy is effective in 50-60 % of persons with cardiovascular diseases; ~ 40 % of patients show signs of relative resistance to antiplatelet agents. Resistance to therapeutic doses of antiplatelet agents is multifactorial, however, the presence of a shunt between thromboxane synthetase and lipoxygenase plays a role in it. It is likely that the influence of inflammation on the development of aspirin resistance through an increase in the synthesis of 12-NETU, thromboxane and leukotrienes. Aspirin resistance is a risk factor for the development of venous thrombotic complications, regardless of the use of antiaggregant therapy. It was established that the most accurate prediction of the result according to the severity of hemorheological disorders (distinguishing between moderate and severe disorders from the lungs) is provided by such indicators of platelet aggregation as the coefficient K ((ADF5 % - ADP 5 % + Asp) - 100 / ADF 5 %) (AUC 0.995) and ADP 5 % (AUC 0.713). Changes in platelet aggregation in response to aspirin in an in vitro test can be used to identify individuals with a high risk of thrombotic complications, and to assess individual risk (specificity 92.9-98.2 %, sensitivity 83.7-93 %).

Purpose: This study aimed to develop a method for detection of nonsignificant coronary lesions using clinical and functional parameters in suspected CAD men without obstructive coronary atherosclerosis by CAG. Methods. From 17.784 consecutive patients from the local CAG database we selected men with non-significant coronary lesions (Ј30 % of lumen) and with smooth coronary arteries by CAG with suspected CAD without acute coronary syndrome, unstable angina, myocardial infarction. Selected 1.957 patients were divided into two groups in a random way (1.389 - studied group and 568 - test group). We divided studied group in two subgroups: with nonsignificant coronary lesions (1.085 patients) and with smooth coronary arteries (304 patients). Results: Patients with nonsignificant coronary lesions compared to patient without were older, arterial hypertension, and II-III NYHA classes and angina pectoris were observed more often in these patients. Atherogenic index, echocardiographic indexes of aortic root diameter and left ventricular (LV) mass were higher in patients with nonsignificant coronary lesions, and echocardiographic signs of ascending aorta atherosclerosis were more frequent in these patients. For selection of scoring variables, we used the values of the Cramer coefficient and the information value index - IV. All quantitative variables were converted into categorical using the binning procedure. Based on the values of WoE, the model of logistic regression was constructed using stepwise variable selection. The model includes independent variables with an average and high prognostic ability: age, atherogenic index, arterial hypertension, echocardiographic signs of atherosclerosis of the ascending aorta. By converting the coefficients of the logistic regression equation obtained into scores, a scoring model was developed to assess the probability of non-obstructive coronary atherosclerosis in men. Based on ROC analysis, in studied group the specificity of the model for detection of nonsignificant coronary atherosclerosis was 67 %, the sensitivity was 65 %, the area under the ROC curve - 0.711. For patients of test group sensitivity was 68 % and specificity 63 %, the area under the ROC curve - 0.687. Conclusion. Nonsignificant coronary atherosclerosis can be predicted in men with suspected CAD before CAG by screening test based on age, atherogenic index, arterial hypertension and echocardiographic signs of aortic atherosclerosis.

Objective: to study the association of prolactin with indicators of carbohydrate and lipid metabolism in women of reproductive age 25-45 years. Materials and methods: Clinical and laboratory examination of a random representative sample of women 25-45 years old. The random number method formed a sample of 416 women, who determined the level of PRL. The average age of the examined women was 36.0 ± 6.2 years. Formed a group of women who have an elevated level of PRL (prolactin> 19.5 ng/ml ( n = 95)). Statistical evaluations included a descriptive analysis of the numerical characteristics of the features (mean value, standard deviation). The studied parameters are divided into quartiles by the level of prolactin. The analysis of variance was performed using the multiple comparison method. Results: There is a decrease in the average values of fasting plasma glucose, TC, LDL in women from 1 to 4 quartile of PRL. The mean values of cholesterol-HDL increase from 1 to 3 quartile of PRL, not reaching statistical significance. BMI has minor changes between quartiles. In the group of women with a normal level of PRL with a flat analysis of the data of biochemical blood analysis, indicators of blood pressure, BMI, and waist circumference, lower levels of total cholesterol and LDL were obtained in 4 prolactin. When analyzing the studied parameters in women with a PRL level of more than 19.5 ng/ml, there is an increase in TG, BMI and waist circumference values from 1 to 4 quartile of PRL. Fasting plasma glucose TC, LDL, HDL increase from 1 to 4, however, the difference does not reach statistical significance. Conclusion: Analyzing our own and literature data, we can conclude that hyperprolactinemia can increase the risk of atherosclerotic lesions of the cardiovascular system, both through direct effects on lipids and atherosclerotic plaques, and indirectly, affecting metabolic disorders leading to obesity, development insulin resistance and changes in glucose metabolism, which in turn can affect the development of atherosclerotic lesions. The features and mechanisms of PRL effects on metabolism are very complex and need further study.

Objectives. The alterations of structure and function of the heart are intermediate phenotypes in the pathway of cardiovascular diseases. The relationship between alcohol consumption and echocardiographic parameters is understudied with inconsistent estimates. We aimed to perform a systematic literature review of studies which assessed the associations between alcohol consumption and Echocardiography parameters. Material and methods. This review analyzes the literature data focused on this topic published during the last 17 years (2001-2017) using PubMed (https://www.ncbi.nlm.nih.gov/pubmed), Google Scholar (https://scholar.google.ru) and main national cardiological journals. Results. The literature review showed that high alcohol consumption is associated with increased myocardial mass of left ventricle (LV) or an increase in the thickness of LV walls;decreased diastolic function and systolic strain of LV,increase in dimension of left atrium and decreased function of left atrium. The relationship between a number of echocardiographic characteristics (LV ejection fraction, the parameters of right ventricle) and alcohol consumption are estimated contradictory. In exited literature there is a shortage of long-term studies on the issue. The integrative assessment of relationship between variety of indicators and patterns of alcohol consumption and structural and functional heart phenotypes is required, as well as application of modern echocardiographic modalities. Taking into account the population specificity, the studies based on different epidemiological context of various populations are needed. Conclusion.The analysis of structural and functional changes of the heart in respect to alcohol consumption remains relevant for understanding the mechanisms by which alcohol effects on the cardiovascular system.