Clinical and prognostic value of determining the level of neopterin in patients with chronic heart failure with preserved ejection fraction

Objective: to analyze the level of neopterin in patients with chronic heart failure (CHF) with a preserved fraction ejection fraction depending on the stage of the disease. Materials and methods: were examined 148 patients with CHF with preserved ejection fraction (50% and >) and 30 as a control group. Patients with CHF were divided into groups depending on the stage of CHF (from I to III). The level of neopterine was determined by the method of enzyme immunoassay in blood plasma. Results: in patients with CHF with preserved ejection fraction there was a tendency to increase the level of neopterin from stage I to stage III compared to the control group. In the group of patients with CHF IIB+III the level of neoplasm was statistically slightly lower compared to patients of stage I and IIA, but statistically signifi cantly higher than in the control group. Conclusion: it was revealed the change in the level of neopterin in patients with CHS with retained ejection fraction depending on the stage of the disease

Dynamics of Stroke Incidence and Mortality Indicators over Eight-Year Period in the Territories Included into the Federal Program of Reorganization of Care for Patients with Stroke

Background. Stroke is a severe medical, social and economic burden for all countries of the world. The leading indicators characterizing the “epidemiological picture” of stroke are the incidence and mortality rates from stroke.Aims. Analyze the dynamics of stroke incidence and mortality rates in the regions of Russia that were included in the federal program for reorganizing care for patients with stroke for the period from 2009 to 2016.Material and methods. The study was based on the data of the territorial-population register for seven study areas in the regions of Russia that were included in the federal program for reorganizing care for patients with stroke (Republic of Bashkortostan, Sverdlovsk region, Republic of Tatarstan, Sakhalin region, Stavropol Territory, Ivanovo Region and Irkutsk Region). The age of the examined persons was 25 years and older.Results. In the period from 2009 to 2016, in the studied territories, there was a consistent stable decrease in the value of the stroke incidence rate. Stroke mortality rates fluctuated with a single increase in 2012. When comparing the average incidence of stroke and mortality from it between 2009 and 2016, we discovered a statistically significant decrease in the incidence of stroke – by 1.4 times and in the rate of mortality from stroke – by 2.3 times. According to the results of the cluster analysis, we revealed a significant conformity (similarity) of mortality rates between regions by 2016 and the absence of monotony (stability) of the rate of stroke incidence.Conclusion. In all the regions under study, an almost systematic annual decrease in the incidence and mortality rates from stroke among the adult population was revealed in seven studied territories. The results of cluster analysis of the “picture” of stroke incidence and mortality from it also demonstrate a positive trend by 2016 in all studied territories. Only one of the studied territories – the Republic of Tatarstan – despite the presence of a positive dynamics of stroke incidence over an eight-year period, in 2016 belonged to the rank with a high integral incidence rate

Prognostic value of molecules of average mass in patients with chronic obstructive pulmonary disease

Background. Chronic obstructive pulmonary disease is a socially significant disease affecting patient’s quality of life. Assessment of endogenous intoxication in patients with chronic obstructive pulmonary disease will allow to understand pathogenetic features of different phenotypes of this disease, which can be taken into account when predicting its course.The aim of the study. To determine the prognostic value of levels of mediumand low-molecular-weight substances and oligopeptides in patients with chronic obstructive pulmonary disease.Materials and methods. One hundred and four patients with chronic obstructive pulmonary disease (COPD) and 110 somatically healthy individuals were examined. Molecular weight medium and low molecular weight substances (LMWSM) and oligopeptides (OP) were determined in blood plasma, erythrocytes and urine. Based on these indicators mathematically calculated indices of endogenous intoxication and coefficient of elimination were defined. Statistical processing of the data was performed using the SPSS 26.0 software package (IBM Corp., USA).Results. In all biological fluids, the levels of average molecules and calculated indices in the COPD patients’ group were statistically significantly different from those in the control group. The indices characterizing endotoxin accumulation were statistically significantly higher, while those characterizing toxin elimination were lower. The level of endotoxemia was correlated with the frequency of exacerbations, clinical manifestations severity, quality of life, COPD group and phenotype.Conclusions. Frequent exacerbations, groups C and D, bronchitic and mixed COPD phenotypes are characterized by more severe endotoxicosis manifested by high levels of LMWSM, OP and calculated indices

Clinical and diagnostic significance of apoptosis markers in myocardial infarction in the setting of chronic obstructive pulmonary disease

Objective: To study the levels of heat shock protein 70 (HSP70) and annexin V-dependent apoptosis of cells in myocardial infarction (MI) with a different course of the disease and in the setting of chronic obstructive pulmonary disease (COPD).Materials and Methods: Sixty-five patients with MI were examined; 37 of them developed MI in the setting of COPD, and 28 patient had MI without COPD. The subjects were divided into subgroups depending on the presence of ST segment elevation. The control group included 30 somatically healthy individuals.Results: In all examined patients with MI and in patients with MI with COPD, the number of annexin V-associated apoptotic cells and the level of HSP70 was statistically significantly higher than in healthy individuals. The value of the studied biomarkers was statistically significantly higher than in patients without COPD. In patients with MI with ST segment elevation, the values of the studied biomarkers were statistically significantly higher in patients without ST segment elevation in all the examined patients.Conclusions: Higher values of the studied biomarkers in the group of comorbid patients compared with those with MI without COPD may be associated with intensified apoptosis in the setting of chronic systemic inflammation, which worsens the clinical course of both diseases. The greater significance of the levels of HSP70 and annexin V-dependent cell apoptosis in patients with MI with ST segment elevation compared with patients without ST segment elevation is due to the volume of myocardial lesion

Proinflammatory cytokines in patients with acute myocardial infarction against the background of chronic obstructive pulmonary disease

Objective: To study and analyze serum levels of interleukins (IL): IL-1β, IL-2 and IL-6 in patients with myocardial infarction and chronic obstructive pulmonary disease.Materials and methods: In 85 people were examined: 28 patients with myocardial infarction, 37 patients with comorbid pathology (myocardial infarction and chronic obstructive pulmonary disease) and 20 somatically healthy volunteers as a control group. Determination of IL-1β, IL-2 and IL-6 levels was basing on enzyme immunoassay.Results: The median and inter-percentile range of IL-1β, IL-2 and IL-6 in the donors did not differ significantly from the data of the manufacturer. In the group of patients with myocardial infarction and in patients with comorbid pathology a statistically significant increase in the level of median and inter-percentile range of cytokines was revealing compared with the control group. The highest levels of IL-1β, IL-2 and IL-6 were detecting in the group of patients with comorbid pathology. IL-6 was found to be an independent marker of increased risk of STEMI and an increase in its concentration later than 12 hours after hospitalization is associated with the risk of future cardiovascular death or new myocardial infarction.Conclusion: Analysis of the dynamics of the level of IL-1β, IL-2 and IL-6 has a high prognostic value in patients with myocardial infarction and in patients with comorbid pathology

Analysis of the links between endothelium-dependent vasodilation indicators and the levels of high-sensitivity C-reactive protein and fractalkine/CX3CL1 in patients with acute coronary syndrome

Objective: to study and analyze the links between endothelium-dependent vasodilation (EDV) indicators and the levels of fractalkine (FN/CX3CL1) and high sensitivity C-reactive protein (hs-CRP) in patients with acute coronary syndrome (ACS).Materials and methods: among the examined individuals with ACS, 63 patients had acute myocardial infarction (MI); 41 patients had unstable angina (UA), represented by first – time angina in 15 people and 26 people had progressive angina. Control group included 20 healthy control individuals. Pharmacological test with 5% acetylcholine (AcH) was used to assess the functional state of the vascular endothelium. Enzyme-linked immunosorbent assay was used to determine the levels of FN/CX3CL1 and hs-CRP.Results: all the examined patients with ACS showed statistically significant changes in EDV indicators compared to the control group, as well as an increase in the level of FN/CX3CL1 and hs-CRP. The most pronounced changes of the values of EDV indicators and the levels of FN/CX3CL1 and hs-CRP, from the examined patients, were detected among patients with acute MI. Th e presence of correlations between the studied indicators was revealed. Th e strength of the identified links was greater among patients with acute MI, compared to patients with UA. Th e strength of the links found in patients with both UA and acute MI was greater between EDV indicators and FN/CX3CL1 levels, than between EDV indicators and hs-CRP levels.Conclusions:all the examined patients with ACS had the EDV disorders associated with the severity of systemic infl ammation. In the group of patients with acute MI, the severity of EDV disorders was greater than in patients with UA, which was apparently due to the infl uence of the resorption-necrotic syndrome, which potentiates increased systemic infl ammation and damage to the endothelium of microvessels with EDV disorders, which was confirmed by the results of correlation analysis. A positive link was found between the levels of FN/CX3CL1 hs-CRP

THE PROGNOSIS OF DEVELOPMENT OF THE PAROXYSM OF ATRIAL FIBRILLATION IN PATIENTS WITH POST-INFARCTION CARDIOSCLEROSIS

Aim. Create an algorithm predicting the risk of development of paroxysmal atrial fibrillation in patients with coronary heart disease on the background of post-infarction cardiosclerosis (PICS).Material and Methods. There was conducted the deep analysis of a number of laboratory and functional indicators (indicators of peroxidation of proteins, lipids, antioxidant protection and skin microcirculation) at 85 patients with atrial fibrillation (AF). All patients were divided into 4 groups: patients with paroxysmal and chronic AF without PICS (27 people), patients with paroxysmal and chronic AF with PICS (12), patients with permanent AF without PICS (26) and patients with permanent form of AF with PICS (20). Results. There was created the mathematical model to predict the development of atrial fibrillation in patients with PICS with calculation of the odds ratio of atrial fibrillation. Methods of correlation and factor analysis revealed the greatest value for the prognosis of paroxysmal atrial fibrillation in patients with PICS two factors: the total level of deep oxidation products of protein and an indicator of microcirculation by laser Doppler flowmetry. The diagnostic sensitivity of the developed prognostic model was 86%, specificity of the test – 94%, the diagnostic efficiency of the test – 90%.Conclusion. The study has been proven clinical diagnostic and prognostic value of a comprehensive study of indicators of oxidation-reduction reactions, and the microcirculation indices in combination with standard laboratory and instrumental investigations in patients with AF. The developed mathematical model allows to predict the development of atrial fibrillation in patients with PICS

The efficiency of tear substitute therapy at dysfunction tear basic secretion

Purpose: to evaluate the efficiency and tolerance of drops replacing tear with hyaluronic acid 0.15% (Hylabak, thea, France) for the treatment of tear film diseases, in particular blepharoconjunctival form of dry eye syndrome.Methods: 32 patients (range 38 to 72 years) with blepharoconjunctival form of dry eye syndrome were treated lubricant Hylabak 2-4 times a day during 7-30 days.Results: After treatment was detected the elimination of complaints in 30 of 32 people, increasing the stability of the tear film (increasing values of the samples Norn test from 7.3 ±0.5 to 10.1±0.6 seconds), as well as normalization of Schirmer test (from 8.8±0.4 to 15.2±0.5 mm).Conclusion: the study was showed high efficacy of lubricant Hylabak and subjective tolerability at blepharoconjunctival form of dry eye syndrome