THE RISK FACTORS AND EVALUATION CRITERIA FOR PROGRESSION OF ATHEROSCLEROSIS IN ONE YEAR POST CORONARY BYPASS

Aim. To assess risk factors and to compare evaluation criteria of non-coronary atherosclerosis progression in coronary heart disease patients in 1 year post coronary bypass surgery (CBG).Material and methods. Of 732 consequtive patients (586 males, 146 females, median age 59 y.o.) underwent CBG, 504 were investigated second time in 1 year after operation. Patients underwent ultrasound study (US) of carotid and peripheral arteries with measurement of intima-media thickness. Ankle-brachial index (ABI) was measured automatically with sphygmomanometer VaSeraVS-1000 (Fukuda Denshi,Japan). In blood, lipids were tested. Based on the stenosis indexes NASCET and ECST, the groups were selected: <30% (minor stenosis); 30-49% (moderate stenosis); 50-69% (severe stenosis); 70-99% (critical stenosis); occlusion; absence of stenoses. Criteria for progression of atherosclerosis was existence of at least one sign: transition of non-coronary stenosis from one group to another by US; decrease of ABI during 1 year below0,9 in normal baseline;  decrease of ABI >10% if the baseline ABI lower than 0,9. For analysis, two groups were selected: group 1 (n=375) without progression, and group 2 (n=129) with progression of atherosclerosis. The relation of possible factors to probaility of  on-coronary atherosclerosis progression was evaluated in logistic regression model.Results. Levels of the total cholesterol (TC) and low density lipoproteides cholesterol (LDL-C) were higher in patients with progression of atherosclerosis. In dynamics, significantly in both groups the level of high density lipoproteides cholestrol (HDL-C) increased (p<0,001), and triglycerides decreased (p<0,05). In intergroup analysis, ABI values were higher in the group with no progression of atherosclerosis (p<0,001). In dynamics, in the group of atherosclerosis progression there was significant ABI decrease (p<0,05). In non-progression group ABI, remaning in reference range, significantly decreased during a year after CBG (p<0,05). Thickness of CIM in the non-progression group significantly decreased during a year post-surgery, but in progression group the difference was non-significant. In monofactorial logistic regression, probability of atherosclerosis progression increased with the increase of age, in smoking anamnesis before surgery, in increase of TC and LDL-C, as with GFR decline and in baseline multifocal atherosclerosis presence. Multifactorial analysis showed remaining statistical significance for the several arterial regions, and adverse lipid profile.Conclusion. In one year post-CBG, progression of non-coronary atheroslerosis is marked in 25,6% of patients. In one year post-CBG, ABI decreases independently from the presence of non-coronary atherosclerosis. Factors associated with atherosclerosis progression, were multifocality, level of TC and LDL-C

POLYMORPHISMS WITHIN INNATE IMMUNE RESPONSE, CALCIUM METABOLISM AND LIPID METABOLISM ARE PREDICTORS OF INFECTIVE ENDOCARDITIS

Infective endocarditis (IE) is a septic inflammation of the endocardium generally caused by bacteria. Despite certain advances in treatment, case fatality rate and mortality of IE are still relatively high, particularly in high-risk groups. This requires the development of novel efficient preventive approaches; one of them is a personalized medicine. Recognition of microbial patterns, cytokine and acute phase responses, hemostasis features and alterations in plasma lipid and calcium profile all have been reported to affect pathogenesis and clinical course of IE. We hypothesized that inherited genomic variation in the abovementioned pathways may determine individual susceptibility to IE. Having recruited 124 patients with IE and 300 age-, sex-, and ethnicity-matched healthy controls, we profiled their genomic DNA for 35 functionally significant polymorphisms within the 22 selected genes involved in pathways mentioned above, with the further genetic association analysis. Genotyping was performed using TaqMan allelic discrimination assay while statistical analysis was carried out utilizing SNPStats, a web tool for genetic association analysis. We found that the G/A genotype of the rs1143634 polymorphism within the IL1B gene, the G/T genotype of the rs3212227 polymorphism within the IL12B gene, the A/G genotype of the rs1130864 polymorphism within the CRP gene, and the G allele of the rs1801197 polymorphism within the CALCR gene are associated with a decreased risk of IE whereas the T/T genotype of the rs1205 polymorphism within the CRP gene is associated with a higher risk of IE. Furthermore, heterozygous genotypes of the rs1143634 and rs3212227 polymorphisms were associated with the higher plasma levels of IL-1β and IL-12, respectively, suggesting their possible importance for IE development. Our results indicate that inherited variation in the cytokine, acute phase response, and calcium metabolism pathways may be linked to IE. However, further molecular epidemiology studies are needed to thoroughly uncover the genetic basis of IE

Dynamics of parameters of oxidative stress in blood of ischemic heart disease patients before and after coronary bypass surgery

Study the dynamics of oxidative stress in the blood of patients with ischemic heart disease before and after on-pump coronary bypass surgery. 27 ischemic heart disease patients were examined. Serum lipid peroxidation product concentrations, total antioxidant activity and α-tocopherol levels were measured. It has been found that lipid peroxidation product concentrations in the blood of ischemic heart disease patients increased significantly along with the decreased activity of antioxidant system. After coronary artery bypass surgery lipid peroxidation — antioxidant system imbalance worsens. The severity of the found impairments is closely related to the functional class of ischemic heart disease

Polymorphism of the apolipoprotein E gene in the population of the indigenous inhabitants of the Mountain Shoria and its association with the parameters of carbohydrate metabolism

Objective: we investigated apolipoprotein E gene polymorphism and its influence on a carbohydrate metabolism in native population of Mountain Shoria (West Siberia). Methods: The study included 40 men and 80 women aged 25-64. The apolipoprotein E polymorphism was analyzed by original method using Hixson’s approach. The serum glucose levels were determined by standard enzymatic assays. Results: The frequencies of ε2, ε3, ε4 alleles in men were 6.5 %, 80.4 %, 13.1 % and in women – 7.6 %, 72.6 %, 19.8 % respectively. The frequencies of genotypes ε2/ε4, ε2/ε3, ε3/ε3, ε3/ε4, ε4/ε4 in men and women together were 1.8 %, 12.4 %, 51.8 %, 31.2 % and 2.9 %. Mean fasting serum glucose levels in case of genotypes ε2/ε4, ε2/ε3, ε3/ε3, ε3/ε4 and ε4/ε4 were 4.6±0.3mg/dl, 4.6±0.1mg/dl, 4.0±0.1mg/dl, 4.7±0.1mg/dl, 5.8±0.3mg/dl (рGLM=0,000) in man and 4.7±0.3mg/dl, 4.7±0.1mg/dl, 4.1±0.1mg/dl, 4.9±0.1mg/dl, 5.9±0.2mg/dl in women (рGLM=0,000). After glucose tolerance test mean serum glucose levels in case of genotypes ε2/ε4, ε2/ε3, ε3/ε3, ε3/ε4 and ε4/ε4 were 6.0±0.6mg/dl, 6.1±0.3mg/dl, 5.2±0.2mg/dl, 6.4±0.2mg/dl, 8.4±0.5mg/dl (рGLM=0,000) in man and 6.2±0.6mg/dl, 6.1±0.2mg/dl, 5.5±0.1mg/dl, 6.7±0.1mg/dl, 8.6±0.5mg/dl (рGLM=0,000) in women. Conclusions: The native population of Mountain Shoria is characterized by relatively high frequencies of ε4 alleles. The allele ε4 prevails in women. The genotype ε4/ε4 has been associated with higher serum glucose level

Russian Science Foundation grant No. 20-14-00140 supported this study. The authors are thankful to the multi-access Center “Bioinformatics” for the use of computational resources as supported by Russian government project FWNR-2022-0020 and the Russian Federal Science and Technology Program for the Development of Genetic Technologies.

It is generally accepted that during the domestication of food plants, selection was focused on their productivity, the ease of their technological processing into food, and resistance to pathogens and environmental stressors. Besides, the palatability of plant foods and their health benefits could also be subjected to selection by humans in the past. Nonetheless, it is unclear whether in antiquity, aside from positive selection for beneficial properties of plants, humans simultaneously selected against such detrimental properties as allergenicity. This topic is becoming increasingly relevant as the allergization of the population grows, being a major challenge for modern medicine. That is why intensive research by breeders is already underway for creating hypoallergenic forms of food plants. Accordingly, in this paper, albumin, globulin, and β­amylase of common wheat Triticum aestivum L. (1753) are analyzed, which have been identified earlier as targets for attacks by human class E immunoglobulins. At the genomic level, we wanted to find signs of past negative selection against the allergenicity of these three proteins (albumin, globulin, and β­amylase) during the domestication of ancestral forms of modern food plants. We focused the search on the TATA­binding protein (TBP)­binding site because it is located within a narrow region (between positions –70 and –20 relative to the corresponding transcription start sites), is the most conserved, necessary for primary transcription initiation, and is the best­studied regulatory genomic signal in eukaryotes. Our previous studies presented our publicly available Web service Plant_SNP_TATA_Z­tester, which makes it possible to estimate the equilibrium dissociation constant (KD) of TBP complexes with plant proximal promoters (as output data) using 90 bp of their DNA sequences (as input data). In this work, by means of this bioinformatics tool, 363 gene promoter DNA sequences representing 43 plant species were analyzed. It was found that compared with non­food plants, food plants are characterized by significantly weaker affinity of TBP for proximal promoters of their genes homologous to the genes of commonwheat globulin, albumin, and β­amylase (food allergens) (p< 0.01, Fisher’s Z­test). This evidence suggests that in the past humans carried out selective breeding to reduce the expression of food plant genes encoding these allergenic proteins

ПУТИ ОПТИМИЗАЦИИ РЕЗУЛЬТАТОВ РЕВАСКУЛЯРИЗАЦИИ У ПАЦИЕНТОВ С МУЛЬТИФОКАЛЬНЫМ АТЕРОСКЛЕРОЗОМ

Purpose. To perform a comparative assessment of diagnostic tools and strategies of myocardial revascularization in patients with and without polyvascular disease (PolyVD) based on the findings of perioperative analysis.Materials and methods. The medical records of 2 828 patients, aged 32–84, consecutively admitted to the clinic of the Research Institute for Complex Issues of Cardiovascular Diseases between January, 2006, and July, 2010, for coronary artery bypass surgery, were retrospectively reviewed. All the patients were divided into two groups: Group 1 included 448 (15,48 %) PolyVD patients with clinically manifested or angiographically confirmed obliterating (≥ 60 %) non-cardiac artery lesions. Group 2 (the control group) included 1691(59,79 %) patients without any clinical symptoms of non-coronary atherosclerosis. The incidence rate, structure and causes of in-hospital mortality and type I neurological disorders (i.e. strokes and transient ischemic attacks) were assessed in both groups.Results. The incidence rate of significant non-cardiac occlusive stenotic lesions in patients with coronary artery disease (CAD), who had to undergo CABG, was 15,84 %. Simultaneous revascularization of coronary and non-coronary arteries was performed in 2,46 % of patients with CAD and PolyVD and multi-stage surgical procedures were chosen in other cases.Conclusions. The outcomes of CAD surgical treatment were improved in this group of patients due to the implementation of a multidisciplinary team approach, which ensured a proper diagnosis of polyvascular disease.Цель. Провести сравнительную оценку диагностических и тактических аспектов хирургической реваскуляризации миокарда среди пациентов с наличием и отсутствием мультифокального атеросклероза (МФА) на основе анализа периоперационных результатов.Материалы и методы. В основе работы – ретроспективное изучение сплошной выборки историй болезни 2 828 больных в возрасте от 32 до 84 лет, которым в период с января 2006 по июль 2010 года в клинике НИИ КПССЗ проводили коронарное шунтирование (КШ). Пациенты были разделены на две группы: I группа из 448 (15,84 %) пациентов с МФА, с клинически манифестирующими либо ангиографически подтвержденными облитерирующими (≥ 60 %) поражениями некардиальных артерий. II группа (контроля) из 1 691 (59,79 %) пациента без клинических признаков внекардиального атеросклероза. У пациентов обеих групп оценивали частоту, структуру и причины госпитальной летальности и неврологических нарушений первого типа (т. е. инсульты и транзиторные ишемические атаки). 695 пациентов с незначительными стенозами были исключены из исследования.Результаты. Распространенность значимых окклюзионно-стенотических поражений некардиальных артерий среди пациентов с ишемической болезнью сердца (ИБС), требующих КШ, составила 15,84 %. Лишь в 2,46 % случаев больным с ИБС и МФА проводили симультанные реконструкции коронарных и некардиальных артерий, в остальных случаях использовали этапные хирургические вмешательства.Заключение. В рамках работы мультидисциплинарной бригады и за счет более активного подхода, направленного на диагностику мультифокального поражения, удалось добиться улучшения результатов оперативного лечения ИБС у данной категории больных