Platelet aggregation activity and beta-adrenoblocker therapy in patients with dilated cardiomyopathy

Aim. To investigate the specifics of ischemic and idiopathic dilated cardiomyopathy (DCMP), platelet aggregation activity, and the reaction of the latter to the beta-adrenoblocker (β-AB) therapy with atenolol or bisoprolol. Results. In DCMP patients, a significant increase in velocity and maximal amplitude of ADP-induced platelet aggregation, as well as a significant reduction in the time to the maximal aggregation amplitude, was observed. In both therapy groups, all parameters of platelet aggregation activity were significantly higher in ischemic vs. idiopathic DCMP patients. Long-term bisoprolol therapy provided a more manifested antiaggregant effect of the basis treatment, compared to atenolol therapy. Conclusion. DCMP patients, especially ones with ischemic DCMP, demonstrated an increase in platelet aggregation activity. Long-term bisoprolol therapy facilitated a more pronounced anti-aggregant effect of the basis treatment, compared to atenolol treatment

Left ventricular remodelling in patients with reversible ischemic dysfunction before and after myocardial revascularization

Aim. To study the dynamics of left ventricular (LV) remodelling in patients with myocardial infarction (MI) and reversible ischemic dysfunction, before and after myocardial revascularization. Material and methods. The study included 69 patients after MI. All participants underwent two-dimensional echocardiography (EchoCG), within 24 hours after hospital admission and one month after revascularization. After three-four days of treatment and clinical stabilization, the patients underwent stress EchoCG with dobutamine, to assess myocardial viability. Results. Complete or partial recovery of all asynergic myocardial segments was observed in 22 (Group I) and 19 (Group II) patients, respectively, while in 28 (Group III), LV aneurysm was detected. In most patients from each group, transluminal balloon angioplasty (TLBAP) with stent implantation was performed. The proportion of conservatively treated patients was maximal in Group III. Despite revascularization, in coronary patients with impaired myocardial viability (Group III), the increase in ejection fraction and reduction in end-systolic volume was significantly lower than in patients with viable myocardium. Sphericity index, relative wall thickness index, and myocardial stress parameters were increased in each group, although this increase was non-significant in Group III. After revascularization, a significant reduction in end-systolic volume, and a tendency towards enddiastolic LV volume reduction were observed in each group, being maximal in Group I. Conclusion. In MI patients with viable myocardium in dyskineticLV zones, revascularization surgery should be considered

Phospholipid metabolism and effectiveness of a glycoprotein IIb/IIIa receptor blocker tirofiban in patients with acute coronary syndrome without ST segment elevation

Aim. To study the effects of tirofiban, a glycoprotein IIb/IIIa receptor blocker, on platelet (PL) phospholipids (PhL) in patients with acute coronary syndrome (ACS).Material and methods. The study included 55 ACS patients without ST segment elevation (↓ST), receiving standard therapy; 26 participants were administered tirofiban. The control group included 23 healthy volunteers, with­out any cardiovascular disease. In all participants, PL PhL characteristics were assessed at baseline, at Day 3 and Days 7-10.Results. In ACS patients, both qualitative and quantitative changes in PL PhL metabolism were observed, which could result in disturbed PL hemostasis. The main manifestation of these disturbances was increased lysophosphatidyl choline (LFS) level in PL membranes. Disturbed PL PhL metabolism was observed in all ACS patients, being maximally manifested at baseline.Conclusion. Tirofiban therapy, as a part of standard ACS↓ST treatment, improved PhL composition of PL membranes and beneficially affected PL hemostasis

PAECILOMYCOTIC TOXIC CARDIOMYOPATHY AND MYOCARDITES IN CHILDREN

Paecilomycosis is a new mycosis, included in the WHO classification. For the first time, paecilomycotic heart pathology was studied in animals and humans. In particular, 218 children were examined, using various bacteriological, clinical, cardiological, biochemical, and immunological methods. In 150 white mice, an experiment paecilomycosis model was used to confirm the diagnosis and investigate the potential of various registered medications, identifying the most effective and the least toxic ones. According to evidence-based medicine principles, the clinical diagnoses of paecilomycotic cardiomyopathy and myocardites were specified. Aetiopathogenetic therapy with nizoral and immunomodulin improved clinical course of pecylomycotic heart disease, due to prevention of complications, chronisation, and long hospitalization time. The best treatment effectiveness in 4-7-year-old children with pecylomycotic cardiomyopathy and myocardites was observed for the combination of diflucan, mycosyst, cardiac glycosides from medicinal plants, and polyoxydonium