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The journal "Ateroskleroz"

2020 year, number 3

1.
PREDICTORS OF PROGRESSION OF CORONARY CALCIFICATION IN PATIENTS AFTER CORONARY ARTERY BYPASS GRAFTING

O.L. Barbarash, D.Yu. Sedykh, V.V. Kashtalap, O.N. Khryachkova, A.N. Kokov, I.A. Shibanova
Research Institute for Complex Issues of Cardiovascular Diseases, 650002, Kemerovo, Sosnoviy Blvd, 6
Keywords: коронарное шунтирование, коронарный кальциноз, прогноз, костный метаболизм, coronary artery bypass graft surgery, coronary calcification, prognosis, bone metabolism

Abstract >>
Aim: To assess predictors of progression of coronary artery calcification (CAC) in men with stable coronary heart disease (CHD) after coronary artery bypass graft surgery (CABG) based on long-term (5 years) follow-up. Materials and methods. The prospective study included 111 men who were hospitalized for planned CABG using cardiopulmonary bypass. All patients in the preoperative period underwent the following procedures: color duplex scanning (CDS) of the brachiocephalic arteries (BCA), multi-slice computed tomography (MSCT) coronary angiography to assess the degree of CAC using the Agatson method (calculation of the coronary artery calcium score - CAC) and estimation of femoral neck bone mineral density with the T-score calculation. The vital status of patients was ascertained after 3-5 years of follow-up after CABG, CDS of the BCA and MSCT-coronary angiography were repeated. To identify the most significant clinical and anamnestic risk factors and form a model of predictors of CAC progression, patients were divided into two groups depending on the high increase in CAC score (an increase in the score of more than 100 Agatston units (AU). Results. 16 (14.4 %) out of 111 patients failed to establish contact for the next stage of the study. In 4 (3.6%) cases death was registered (3 - fatal myocardial infarction, 1 - fatal stroke). The CAC progression was assessed in 91 patients (81.9 %). Patients who showed signs of CAC progression comprised a group of 60 (65.9 %) patients; without CAC progression - 31 (34.1 %) patients. The “end points” in the groups were comparable and were detected in 18 cases (19.7 %): recurrent angina in 16 patients ( p = 0.368), non-fatal myocardial infarction in 1 ( p = 0.162) and 1 emergency stenting ( р = 0,162) of the coronary artery that was not subjected to CABG. The five-year risk model for CAC progression included an initial decrease in femoral neck bone mineral density and nonadherence to statins for 5 years after CABG ( p = 0.001). Conclusions. 65.9 % of men with stable CHD showed the signs of CAC progression for 5 years after CABG, according to MSCT. The main predictors were: nonadherence to statins after CABG and initial low femoral neck bone mineral density.
																								



2.
FEATURES OF THE SUBPOPULATION COMPOSITION OF CIRCULATING NK AND NKT CELLS IN PATIENTS WITH SUBCLINICAL ATHEROSCLEROSIS OF LOWER LIMB ARTERIES

V.V. Genkel, I.I. Dolgushin, I.L. Baturina, I.V. Emelyanov, A.Yu. Savochkina, I.I. Shaposhnik
South-Ural State Medical University of Minzdrav of Russia, 454092, Chelyabinsk, Vorovskogo str., 64
Keywords: атеросклероз, артерии нижних конечностей, NK-клетки, NKT-клетки, atherosclerosis, lower limb arteries, natural killer cells, natural killer T cells

Abstract >>
Aim of the study was to investigate the features of the subpopulation composition of circulating NK and NKT cells and their diagnostic value in middle-aged patients, depending on the presence of subclinical atherosclerosis of lower limb arteries. Material and methods. The study included 80 patients (44 men (55.0 %) and 36 women (45.0 %)), whose age was 49.0 (44.0; 56.0) years. All patients underwent duplex ultrasound scanning (DUS) of the arteries of the lower extremities. Lymphocyte immunophenotyping was performed on a Navios 6/2 flow cytometer (Beckman Coulter, USA) using labeled mouse monoclonal antibodies CD45-PC7.0, CD16-PE, CD11b-FITC, CD4-APC, CD8-PC5.5, CD3-ECD manufactured by Beckman Coulter, USA. Results. According to the results of the DUS of the arteries of the lower extremities, the patients were divided into two groups: the first group included 46 (57.5 %) patients with lower extremity artery atherosclerosis, the second group included 34 (42.5 %) patients without plaques in lower extremity artery. Patients of first group had significantly higher, than patients of second group, number of circulating NK cells and lower number of CD4+CD11b+ NK cells. The decrease in the CD4+CD11b+ NK cell number ≤16.5 cells/μl allowed to diagnose lower extremity artery atherosclerosis with a sensitivity of 80.0 % and a specificity of 58.8 %. According to logistic regression analysis, a decrease in the number of CD4+CD11b+ NK cells ≤16.5 cells/μl was associated with a odds ratio of lower extremity artery atherosclerosis 5.71 (95 % confidence interval (CI) 1.44-22.6; p = 0.013). Conclusion. Compared with the control group, patients with lower extremity artery atherosclerosis differed in a statistically significantly larger number of circulating NK cells and a smaller number of CD4+CD11b+ NK cells. The decrease in the number of latter ≤16.5 cells/μl allowed to diagnose lower extremity artery atherosclerosis with a sensitivity of 80.0% and a specificity of 58.8 %.
																								



3.
BLOOD LIPID PROFILE IN PATIENTS WITH CORONARY ARTERY DISEASE AND SARCOPENIA

I.I. Grigorieva1, T.A. Raskina1, K.E. Krivoshapova2, O.S. Malyshenko1, M.V. Letaeva1, V.L. Masenko2, O.L. Barbarash2
1Kemerovo State Medical University of Minzdrav of Russia, 650029, Kemerovo, Voroshilova str., 22
2Research Institute for Complex Issues of Cardiovascular Diseases, 650002, Kemerovo, Sosnovyy blvd., 6
Keywords: атеросклероз, липиды, саркопения, ишемическая болезнь сердца, atherosclerosis, lipids, sarcopenia, coronary artery disease

Abstract >>
Objective of the study was to investigate the characteristics of lipid metabolism in male patients with coronary artery disease (CAD) depending on the state of muscle mass, strength and function. Material and methods. The investigation enrolled 79 male patients with a reliable diagnosis of CAD, verified by coronary angiography (median age 63 (57; 66) years). Diagnosis of sarcopenia was based on the recommendations of the European Working Group on Sarcopenia in Older People (EWGSOP, 2010) with the examining of muscle strength, muscle mass and muscle function. Total cholesterol, triglycerides (TG), high-density lipoproteins (HDL) and low-density lipoproteins (LDL) content was determined in fasting blood serum by spectrophotometric method. Patients were divided into 3 groups (according to the definition of EWGSOP, 2010): 1st-31 patients without sarcopenia, 2nd-21 patients with presarcopenia, and 3rd-27 patients with sarcopenia. Results and discussion. There was an inverse correlation between the level of total cholesterol in patients and the musculoskeletal index ( r = -0.315; p = 0.005) and the total skeletal muscle area at level LIII ( r = -0.277; p = 0.013). Comparative analysis in the group of patients with coronary artery disease and sarcopenia showed significant higher levels of total cholesterol compared with those in patients with coronary artery disease without sarcopenia (5.20 (3.75; 6.00) mmol/l vs 3.90 (3.40; 4.60) mmol/l; p = 0.03). According to the results of regression analysis, a direct relationship was found between the value of total cholesterol and the risk of decreasing of the musculoskeletal index (odds ratio 1.914, 95 % confidence interval 1.166-3.141). The receiver operating characteristic (ROC) curve analysis provided the critical value of total cholesterol as 4.7 mmol/l. Conclusion. The presence of sarcopenia in patients with CAD was associated with severe proatherogenic disorders of the lipid profile of the blood. Hypercholesterolemia is an additional predictive factor in reducing muscle mass.
																								



4.
ATHEROCALCINOSIS OF THE ARTERIAL WALL AND ITS ASSOCIATION WITH DISORDER OF BLOOD LIPOPROTEIN PROFILE, MINERAL EXCHANGE AND STRUCTURAL CHANGES OF ACHILLES TENDON (ACCORDING TO COMPUTER TOMOGRAPHY DATA)

A.V. Anikina1,2, Yu.P. Nikitin1,2, M.E. Amelin3
1Research Institute of Internal and Preventive Medicine, 630089, Novosibirsk, Boris Bogatkov str., 175/1
2Institute of Cytology and Genetics of SB RAS, Novosibirsk, Russia
3Federal Center of Neurosurgery of Minzdrav of Russia, 630108, Novosibirsk, Nemirovich-Danchenko, 130/1
Keywords: атеросклероз, гиперхолестеринемия, сухожилие трехглавой мышцы голени, atherosclerosis, hypercholesterolemia, tendon of leg triceps muscle

Abstract >>
The purpose of the study was to study the possible association of hyperlipidemia, atherosclerosis and calcification of the arterial wall with the structural features of Achilles tendons. Material and methods. The group of examined patients was 148 people hospitalized in the vascular department of the Federal Center for Neurosurgery with the aim of stenting the internal carotid artery. All patients underwent a complete physical, instrumental examination and a biochemical blood test. Results. It was found that in individuals with a total cholesterol level higher than 5.0 mmol / L, the tendon cross-sectional area was larger than in subjects with cholesterol level less than 5.0 mmol / L ( p = 0.05), in patients with increased low density cholesterol (LDL-C) content the of the tendon cross-sectional area was 1.5 times larger in people with low LDL-C concentration. Further, all patients were divided into 2 groups depending on atherosclerotic plaque density. In patients with a low or medium atherosclerotic plaque density, the average tendon cross-sectional area was 335 mm2, the tendon density was 59HU, calcium deposition in the Achilles tendon was detected in 38 % cases, in the group with atherosclerotic plaque density - 441 mm2, 66 HU, 52 %, respectively. Conclusions. In individuals with high levels of fractions of atherogenic cholesterol, an increase in the cross-sectional area of the Achilles tendon is noted. There is also a tendency towards an increase in the incidence of calcinosis of the achilles tendons in patients with atherocalcinosis.
																								



5.
DYNAMICS OF BLOOD LIPID PROFILE INDICATORS IN A PERSPECTIVE SAMPLE OF YOUNG PEOPLE AGING 19-22 YEARS IN NOVOSIBIRSK FOR THE FIFTH YEAR PERIOD (2014-2019)

E.V. Stryukova1,2, M.S. Troshina1,2, D.V. Denisova1,2, A.V. Sukhanov1,2
1Research Institute of Internal and Preventive Medicine, 630089, Novosibirsk, Boris Bogatkov str., 175/1
2Institute of Cytology and Genetics of SB RAS, Novosibirsk, Russia
Keywords: дислипидемии, липидный профиль, подростки, молодежь, динамика липидного профиля, dyslipidemia, lipid profile, adolescents, youth, dynamics of the lipid profile

Abstract >>
Lipid levels in children correlate with adult lipid levels, and dyslipidemia is a major risk factor for developing of cardiovascular diseases. We aimed to study the dynamic levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL cholesterol), high-density lipoprotein cholesterol (HDL cholesterol) and triglycerides (TG) in young people from 2014 to 2019. Material and methods. In 2014 a cohort of 105 people was formed based on the cross-sectional population survey of schoolchildren, in which the lipid profile was analyzed. In 2019, a second analysis was conducted. Blood TC, HDL cholesterol, TG were measured by enzymatic methods. LDL cholesterol was calculated with Friedwald’s formula. Results. From 2014 to 2019 TC levels increased from 154.5 to 163.0 mg/dl ( p = 0.005), due to the subgroup of men. HDL cholesterol also increased from 44.5 to 62.5 mg/dl ( p < 0.001) in both men and women. A general downward trend in LDL cholesterol is noticeable from 2014 to 2019. However, a significant difference was obtained only in the female subgroup (96.8 and 86.3 mg/dl, p = 0.038). TG levels increased from 2014 to 2019 (from 61.0 to 64.0 mg/dl), due to the subgroup of men. TC levels were higher in the female subgroup in 2014 ( p = 0.014), HDL cholesterol levels were higher in the female subgroup in 2014 ( p = 0.022) and 2019 ( p <0.001), TG levels were higher in the male subgroup in 2019 ( p = 0.021). Levels of LDL cholesterol were not significantly different between men and women in both years. Conclusions. Our results demonstrate the regular dynamics of the lipid profile over a five-year period, with an increase in the levels of TG and TC and a decrease in the level of LDL cholesterol, in young people.
																								



6.
RECEPTORS AND PROTEINS BINDING HIGH DENSITY LIPOPROTEINS

L.M. Polyakov1, R.A. Knyazev1, N.V. Trifonova1, M.V. Kotova1, E.I. Solovyova1, A.V. Ryabchenko1
Institute of Biochemistry of Federal Research Center for Fundamental and Translation Medicine, 630117, Novosibirsk, Timakov str., 2
Keywords: липопротеины высокой плотности, cкэвенджер-рецептор SR-BI, кассетный транспортер ABC, экто-F1-АТФаза, кубилин-мегалиновый рецептор, high-density lipoproteins, scavenger receptor SR-BI, ABC-cassette transporters, ecto-F1-ATPase, cubiline-megaline receptor

Abstract >>
Interest in the study of high density lipoproteins (HDL) is associated with the functional activity of these particles, which, first of all, determines their antiatherogenic properties. The main biological role of HDL is the «reverse» transport of cholesterol from peripheral tissues to the liver. However, it must be borne in mind that the mechanism of antiatherogenic action of HDL is not limited only to the «reverse» transport of cholesterol from peripheral tissues to the liver, it is determined by many other factors, each of which is important not only in the context of protecting the body from atherosclerosis, but also in the protective role HDL in a wider aspect. It turned out that HDL has an important antiinflammatory effect, have antioxidant and antiapoptotic properties, regulate vascular tone and anticoagulant activity, and act as antimicrobial and antiviral agents. According to modern concepts, in connection with the development of proteomics, data have appeared that indicate the participation in these processes of the protein components of the plasma membrane of cells and specific receptor proteins embedded in it. The purpose of this review is to summarize the existing body of knowledge about events and molecules related to the regulation of HDL metabolism with the participation of the scavenger receptor (SR-BI), ATP-linked cassette transporters ABCA1 and ABCG1, ecto-F1-ATPase, and cubiline-megaline receptor.
																								



7.
GENES OF APOA5 AND APOH APOLIPROTEINS AS REGULATORS OF LIPOPROTEIN METABOLISM

N.S. Shirokova1, S.V. Mikhailova2, D.E. Ivanoshchuk2,3, E.V. Shachtshneider2,3
1Novosibirsk State University, 630090, Novosibirsk, Pirogov str., 1
2Federal Research Center Institute of Cytology and Genetics of SB RAS, 630090, Novosibirsk, Academician Lavrentiev av., 10
3Research Institute of Internal and Preventive Medicine, 630089, Novosibirsk, Boris Bogatkov str., 175/1
Keywords: аполипопротеины, атеросклероз, триглицериды, ген APOA5, ген APOH, apolipoproteins, atherosclerosis, triglycerides, APOA5 gene, APOH gene

Abstract >>
Atherosclerosis is main cause of cardiovascular disease leading to disability and death worldwide. Many factors can affect atherogenesis, including hypertension, smoking, diabetes mellitus and inflammatory processes. It is known that disorders of cholesterol and triglycerides It is known, that violation in cholesterol and triglyceride metabolism caused by substitutions in the structure of apolipoproteins are associated with a predisposition to hyperlipidemia and atherosclerosis. Despite the increased interest in the atherogenesis mechanisms, many participants in this process are not fully understood. In this review, we examined the structure and functions of two proteins - apolipoprotein A5 and apolipoprotein H in connection with their association with impaired lipid metabolism.
																								



8.
2019 ESC / EAS RECOMMENDATIONS FOR THE TREATMENT OF DYSLIPIDEMIA: LIPID MODIFICATION TO REDUCE CARDIOVASCULAR RISK