Evaluation of structural-functional changes of the left ventricular myocardium in patients with arterial hypertension and obesity by the level of irisin

The aim was to evaluate the structural and functional changes of the left ventricular myocardium according to the data of echocardiography in patients with arterial hypertension combined with obesity by the level of irisin. Materials and methods. 105 patients were divided into 2 groups for participation in the study: the 1 group consisted of patients with arterial hypertension with concomitant obesity with concomitant obesity (n = 70), the group 2 – patients with arterial hypertension and normal body weight (n = 35). The control group consisted of 25 practically healthy persons. All participants of the study underwent irisin level measurement by an enzyme-linked immuno-sorbent assay and an echocardiographic examination with subsequent computer processing of the results using the software package “Statistica 6.0” (StatSoft Inc.,USA). Results. In patients with arterial hypertension and obesity, hypoirisinemia (irisin level <1.19 ± 0.03 ng/ml) was associated with an increase in the end-diastolic and systolic volumes by 31.57 % (r = -0.44; Р < 0. 05) and 20.70 % (r = -0.53; P <0.05), sizes – by 43.54 % (r = -0.36; P < 0.05) and 40.44 % (r = -0.62; P < 0.05) and decrease in the ejection fraction by 16.59 % (r = 0.41; P < 0.05) (P < 0.05). Conclusions. Decrease in the content of serum irisin leads to structural and functional changes in the left ventricular myocardium in the form of myocardial contractility reduction and increase in both the cavity and size of the left ventricle, and can play a role in the pathogenesis of obesity in patients with arterial hypertension

Prognostic Value of Polymorphism of G-308A Gene of the Tumor Necrosis Factor-α in the Progression of Chronic Heart Failure in Patients with Ischemic Heart Disease and Obesity

One of the widespread and prognostically unfavorable complications of cardiovascular diseases is chronic heart failure, where an important role is given to proinflammatory cytokines in the pathogenesis of the disease. Polymorphic variants of the gene of tumor necrosis factor-α are determinants of increased risk in the development of chronic heart failure in patients with ischemic heart disease. Presence of allelic gene A and genotype A/A of polymorphic locus G-308A, the gene of tumor necrosis factor-α in patients with ischemic heart disease and concomitant obesity was associated with chronic heart failure progressing and development of systolic dysfunction of the left ventricle

FEATURES OF CORONARY ARTERIES CHANGES IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION DEPENDING ON THE PRESENCE OR ABSENCE OF CONCOMITANT DIABETES MELLITUS TYPE 2

The article analyzes the features of coronary arteries changes in patients with acute myocardial infarction (AMI) depending on the presence or absence of concomitant diabetes mellitus (DM) type 2. 60 patients with AMI and concomitant DM type 2 who were treated at the infarctional department of Kharkiv City Clinical Hospital No. 27 (Kharkiv, Ukraine) and cardiology department of the Kharkiv Clinical Hospital on Railway Transport №1 (Kharkiv, Ukraine) were investigated. In order to assess the status of the coronary flow, all patients in both groups underwent coronary angiography. The proportion of cases with multi-vessel lesions of coronary arteries exceeded the proportion of cases with one and twovessel lesions of coronary arteries in patients with acute myocardial infarction and type 2 diabetes.The article analyzes the features of coronary arteries changes in patients with acute myocardial infarction (AMI) depending on the presence or absence of concomitant diabetes mellitus (DM) type 2. 60 patients with AMI and concomitant DM type 2 who were treated at the infarctional department of Kharkiv City Clinical Hospital No. 27 (Kharkiv, Ukraine) and cardiology department of the Kharkiv Clinical Hospital on Railway Transport №1 (Kharkiv, Ukraine) were investigated. In order to assess the status of the coronary flow, all patients in both groups underwent coronary angiography. The proportion of cases with multi-vessel lesions of coronary arteries exceeded the proportion of cases with one and twovessel lesions of coronary arteries in patients with acute myocardial infarction and type 2 diabetes

The relationship between indicators of cardiac hemodynamics and types of dyslipidemia in patients with coronary heart disease and type 2 diabetes mellitus

The purpose of this study was to evaluate the relationship between indicators of cardiac hemodynamics and types of dyslipidemia in patients with coronary heart disease and type 2 diabetes mellitus. Materials and Methods. A comprehensive examination of 85 patients with CHD and type 2 diabetes mellitus who were treated in the Cardiology Department of the Kharkiv City Clinical Hospital № 27 as a basic medical institution of the Department of Internal Medicine № 2 and Clinical Smmunology and Allergology of Kharkiv National Medical University MOH of Ukraine was made. Types of dyslipidemia were determined using the hyperlipidemia classification by WHO, based on the classification by Fredrickson (D. Fredrickson). The echocardiography study was performed according to standard methods (H. Feigenbaum, 1999) by the ultrasound unit RADMIR (Ultima PRO 30) (Kharkiv,Ukraine). Results. As a result of our research it has been found a significant increase in such indicators of cardiac hemodynamics as EDV by 29.32%, CSR by 35,39%, ESV by 13.79%, EDS by 16.17% in the group of patients with coronary heart disease and type 2 diabetes mellitus with type IIb dyslipidemia compared with patients with coronary heart disease and type 2 diabetes mellitus with type IIa dyslipidemia. We have determined the cardio hemodynamics indexes in patients with coronary heart disease and type 2 diabetes mellitus with type I and type IV dyslipidemia and detected a significant increase in such indices as DBP by 15.49%, EDV by 26.99%, EDS by 13.49%, ESV by 16.57% and the diameter of the aorta by 9.85% compared with patients with coronary artery disease and type 2 diabetes mellitus with I type dyslipidemia. Conclusions. According to the results of our study significant changes in the indices of cardiac hemodynamics occurred more often in patients with IIb and type IV dyslipidemia, suggesting a more adverse impact of these types on left ventricular remodeling in patients with coronary heart disease and type 2 diabetes mellitus

Changes in the system of asymmetric dimethylarginine - endothelial NO-synthase in patients with acute myocardial infarction and type 2 diabetes mellitus

The purpose of this study was the assessment of asymmetric dimethylarginine (ADMA) and its links with carbohydrate and lipid metabolism parameters in patients with acute myocardial infarction (AMI) and type 2 diabetes mellitus following determination of asymmetric dimethylarginine and NO synthase plasma levels. Materials and methods. The study included examination of 73 patients with acute myocardial infarction and type 2 diabetes mellitus, 57 patients with AMI without type 2 diabetes and 20 conditionally healthy individuals. The content of ADMA and NO synthase was measured by using an enzyme-linked immunosorbent assay kit (ADMA Xpress ELISA kit;Immundiagnostik,Austria) and Bender MedSystem (Austria), respectively. The parameters of carbohydrate and lipid metabolism were determined by a standard biochemical method. Results. A significant 2.64 times increased level of ADMA (1.24 ± 0.04 μmol/L) was found in the patients with AMI and type 2 diabetes compared to the practically healthy persons (control group) (0.47 ± 0.05 μmol/L), and 2.53 times increased (P < 0.05) in comparison with the patients without type 2 diabetes. In the presence of type 2 diabetes the 40.1 % (P < 0.05) decrease in NOs level was noted compared to the control group (3.12 ± 0.11ng / ml and 5.21 ± 0.19 ng/ml, respectively) and the 26.1 % (P < 0.05) decrease compared to the patients with AMI without type 2 diabetes. The study provided a possibility to determine a direct correlation between ADMA and total cholesterol (r = 0.47; P < 0.05); LDL cholesterol (r = 0.28; P < 0.05), HDL cholesterol (r = -0.39; P < 0.05), triglycerides (P = 0.35; P < 0.05), glucose (P = 0.46; P < 0.05), insulin = 0.49; P < 0.05), glycosylated hemoglobin (r = 0.39; P < 0.05). Correlation analysis showed an inverse correlation between ADMA and NO synthase levels (r = -0.67; P < 0.05). Conclusions. The association between asymmetric dimethylarginine high levels and pathological changes in the parameters of carbohydrate, lipid metabolism and endothelial dysfunction has been established, which increases ischemia in the vessel wall and adversely affects the course and prognosis of acute myocardial infarction in patients with type 2 diabetes mellitus

The assessment of the depressive states severity and their relationship with concomitant type 2 diabetes and obesity in patients with chronic heart failure of ischemic origin

The aim is to assess the prevalence and expressiveness of depressive disorders in patients with chronic heart failure (CHF) of the ischemic origin, depending on the presence of concomitant type 2 diabetes mellitus (T2DM), obesity and their combined course, as well as to assess the influence of existing metabolic disorders on the development of depression in individuals of this cohort. Materials and methods. The study included 154 patients with CHF of ischemic origin. Group 1 included patients with CHF with coronary heart disease (CHD), T2DM and obesity (n = 42). The second group consisted of patients with CHF on the background of CHD with concomitant T2DM (n = 46), and the third group – with concomitant obesity (n = 36). The comparison group was formed from patients who had signs of CHF of ischemic origin without metabolic disorders (n = 30). The Beck Depression Inventory (BDI) was used to assess the presence and nature of depressive disorders. Results. In patients with isolated CHF of ischemic origin, depression was found in 60 % of cases, according to BDI. In the second group depression was manifested in 80.6 % of cases, and in the third group – in 91.3 % of cases. 95.2 % of patients of the first group had depressive disorders. The average value of scores in patients of the first group significantly exceeded that of the patients of the fourth group by almost two times. Comparing the scores of patients of the second and third groups with the fourth group determined their increase by 57 % and 36 %, respectively. It was established that in patients with CHF of ischemic origin against the background of the combined course of T2DM, mild depression was found in 1/3 of patients, a quarter of patients had manifestations of moderate depression, 9.5 % of patients had severe depression and 4.8 % of people in this group had symptoms of mild depression. Conclusions. The presence of type 2 diabetes mellitus is associated with the development of depression in patients with chronic heart failure of ischemic origin. The combined course of type 2 diabetes mellitus and obesity is a risk factor for the development of depression and its progression to a marked/severe form

Galectin-3 and its relationship with the state of coronary arteries in patients with acute myocardial infarction and concomitant obesity

The aim of the study - to evaluate the condition of the coronary arteries according to quartile of galectin-3 serum level in patients with acute myocardial infarction and obesity. Materials and methods. A total of 31 patients with acute myocardial infarction and I and II degree of obesity were examined. A coronaroventriculography was performed with stenting of the infarct-dependent coronary artery within 12 hours from the pain syndrome onset. Galectin-3 was determined using a Human Galectin-3 ELISA kit (China). The degree of coronary atherosclerosis severity was assessed by coronaroventriculography (CVG) using the Gensini score. Results. The most common atherosclerotic lesion was found in the right interventricular artery – 89 % of cases followed by the right coronary artery (59.3 %), about half of patients (48.1 %) had a lesion of the circumflex artery. The greatest vulnerability of the right interventricular artery was accompanied by the highest mean stenosis values – 77.3 % followed by the right coronary artery, the mean stenosis value of which was 68.2 %. The development of acute myocardial infarction predominantly (57.1 %) was due to occlusion of the right interventricular artery. The increase in the level of galectin-3 to 23.48–41.42 ng/ml, which corresponds to 3–4 quartiles of galectin-3 level, was associated with an increase in the number of affected vessels and segments with high Gensini scores. Conclusions. The right interventricular and right coronary arteries are the most vulnerable according to the angiographic findings, both in terms of frequency and degree of lesion, and frequency of hemodynamically significant stenoses in patients with acute myocardial infarction and obesity. An increase in galectin-3 level up to 3 and 4 quartiles is accompanied by a parallel increase in parameters characterizing the progression of atherosclerotic lesion of the coronary arteries. Galectin-3 can be considered as a marker of atherosclerotic process in patients with acute myocardial infarction and obesity due to the association between galectin-3 level and the degree of coronary artery lesion severity

Revealing weak A and B antigens in patients with knee and hip joint arthroplasty

АНТИГЕНЫКРОВЬАНТИТЕЛА АНТИИДИОТИПИЧЕСКИЕАНТИ-АНТИТЕЛААНТИГАММА-ГЛОБУЛИНОВЫЕ АНТИТЕЛААНТИГЛОБУЛИНЫАНТИИДИОТИПНЫЕ АНТИТЕЛАКОМПЛЕМЕНТКОМПЛЕМЕНТБЕЛКИ КОМПЛЕМЕНТАРНЫЕКОМПЛЕМЕНТА БЕЛКИЭРИТРОЦИТЫЦель. Провести анализ методов выявления слабых А и В антигенов на эритроцитах в системе АВ0. Материал и методы. Проведено обследование пациентов с эндопротезированием коленного и тазобедренного суставов с целью определения группоспецифической принадлежности с выявлением слабых А и В антигенов на эритроцитах. Использованы методы абсорбции, реакция агглютинации, агглютинация в присутствии комплемента и антиглобулиновый тест. Результаты. Антиглобулиновый тест с использованием как поликлональной сыворотки, так и сыворотки, содержащей только IgG антитела, позволил выявить слабые A и B подгруппы на эритроцитах при 37{o}С. В реакции абсорбции с анти-А, анти-В поликлональными сыворотками у некоторых пациентов на эритроцитах выявлены А и В антигены, также проявившиеся в реакции агглютинации при 37{o}С, но не обнаруженные при инкубации при комнатной температуре. Агглютинационный тест с использованием комплемента и сыворотки с IgG антителами также способствовал проявлению слабых антигенов. Присутствие IgG антител было определено после обработки сыворотки унитиолом в антиглобулиновом тесте. Наличие в сыворотке только IgG антител, соответствующих антигенам, при участии комплемента приводило к более выраженным изменениям эритроцитов по сравнению с присутствием обоих классов антител – IgM и IgG. Появление гемолиза ассоциировалось с увеличением размеров эритроцитов и гипохромией. Присутствие слабых подгрупп в большинстве случаев было ассоциировано с гемолизирующими, а не агглютинирующими свойствами сыворотки пациента, а также наличием комплементсвязывающих IgG антител. Заключение. Применение абсорбции, агглютинация при 37{o}С, антиглобулиновый тест при 37{o}С с сывороткой, как подвергшейся, так и не подвергшейся обработке унитиолом, а также реакция агглютинации с использованием комплемента способствовали определению слабых антигенов в системе АВ0.Objective. To analyze the methods of revealing weak A and B antigens on the erythrocytes in AB0 system. Methods. Patients after knee and joint arthroplasty were examined on group-specific characteristics with revealing weak A and B antigens on the erythrocytes. Methods of absorption, agglutination, agglutination with complement and antiglobulin test were used. Results. Antiglobulin test with the use of polyclonal serum as well as serum containing the only IgG allowed revealing weak A and B subgroups on erythrocytes at 37{o}С. In some patients A and B antigens on erythrocytes were found while absorption with anti-A, anti-B polyclonal sera and also revealed in agglutination at 37{o}С, but were not revealed while incubation at the room temperature. Agglutination test with the use of complement and IgG was also helpful in determining the weak antigens. Presence of IgG antibodies was revealed by the treatment of the serum with unithiol in antiglobulin test. Presence of complement and only IgG antibodies corresponding to the antigens led to the more expressed changes of erythrocytes as compared to the presence of both types of antibodies – IgM and IgG. Appearance of hemolysis was associated with the increased sizes of erythrocytes and hypochromia. Presence of weak subgroups was mostly associated with hemolytic rather than agglutinating abilities of the patient’s serum, as well as with the presence of complement binding IgG antibodies. Conclusions. Absorption, agglutination at 37{o}С, antiglobulin test at 37{o}C with serum both treated and non-treated with unithiol and agglutination with use of the complement helped to define weak antigens in AB0 system

The impact of irisin level on the thickness of the left ventricle posterior wall according to the echocardiography data in patients with arterial hypertention and obesity

Адипоцити продукують низку факторів, що відіграють важливу роль у регуляції енергетичного балансу, чутливості тканин до дії інсуліну, імунологічної відповіді, стану кровоносних судин і міокарду лівого шлуночка. Вплив рівня ірисину на товщину задньої стінки лівого шлуночка за даними ехокардіографії у хврих на АГ у поєднанні з ожирінням

The ishemic genesis mitral regurgitation severity underestimation at ultrasonography

Причиною появи мітральної недостатності (МН) ішемічного генезу можуть служити функціональні порушення лівого шлуночка (ЛШ) внаслідок ремоделюванняйого порожнини і зниження насосної функції, а також органічна патологія клапанного апарату, пов'язана з розривом хорди або папілярного м'язу