IMMUNOPATHOGENESIS OF HEART FAILURE IN PATIENTS WITH INFECTIVE-IMMUNE MYOCARDITIS

Aim. To study quantitative parameters, specifics of functional state of the main subpopulations of peripheral blood lymphocytes of the infective-immune myocarditis patients (IIM) and postmyocarditis cardiosclerosis (PMC), and specifics of cytokine profile.Material and methods. Totally, 35 IIM patients included, and 39 with PMC. In 17 patients with IIM there was significant heart failure (HF) — III functional class (FC) by New-York Heart Association (NYHA), in 18 patients with IIM there were no signs of HF, or mild signs (0-II FC by NYHA). In 18 patients with PMC there were no signs of HF, and in 21 — there was I FC by NYHA. The controls were 10 formally healthy persons. Study of population and subpopulation contents, and lymphocytes activation markers of peripheral blood, was done with four-color laser flow cytometry using FACSCalibur equipment and relevant monoclonal antibodies (Beckton Dickinson, USA). We studied the mean cytokines concentrations characterizing Th1-, Th2- and Th17- subpopulations of the helper lymphocytes. Measurement of serum cytokines was done with the method solid-phase immune-enzyme assay with LLC “Vectro-Best” (Russia) media. Statistics was done with software PASW Statistics 18.Results. Inflammatory diseases of myocardium show the deviations of native, as acquired immunity. In IIM and PMC there was significant decrease of NKTlymphocytes, not related to the severity of HF signs and durations of the disease. Immunity activation signs in IIM group showed the increase of the early activator marker CD25 expression activation, that was marked during the first 2 weeks from the disease onset. Following, by the end of the 1st month and on the 2nd month from the disease onset, the increase of T- and non-T-lymphocytes was found with the signs of delayed activation, revealed by HLA-DR antigen expression. The activator marker patterns were differ in patients with different grade of HF severity. Concentration of interferon-γ (IFN-γ) and interleukine (IL)-4 was more than 3 times higher in IIM patients comparing to controls. There was more than 7-times higher increase of IL-17A, and concentrations of effectory cytokines of Th17-subpopulation — IL-8 and granulocyte-macrophagal colony-stimulating factor (GM CSF). The level of IFN-γ reached maximal levels during the first 2 weeks from the disease onset. Later, IFN-γ concentration declined. Opposite, serum level of IL-4 was significantly increased by the end of the 1st and on the 2nd month from disease onset. Concentrations of IL-17A, IL-8 and GM CSF in blood serum were increased during the whole 2nd week, by the end of the 1st month and on the 2nd month. Th17-cytokines concentrations were significantly increased in PMC patients. Level of IL-17A was higher than in controls almost two times, IL8 — by 51%, GM CSF — by 50%. Serum levels of IL-4, and IL-17A, IL-8 and GM CSF were higher in subgroup of PMC patients with the disease duration less than 6 months. Conclusion. Disorders of anti-infection immunity and mechanisms of selfrestriction of immune reactions do play important role in development of myocardium damage of inflammatory origin

Electromagnons in multiferroic RMn2O5 compounds and their microscopic origin

We summarize the existing experimental data on electromagnons in multiferroic RMn2O5 compounds, where R denotes a rare earth ion, Y or Bi, and discuss a realistic microscopic model of these materials based on assumption that the microscopic mechanism of magnetically-induced ferroelectricity and electromagnon absorption relies entirely on the isotropic Heisenberg exchange and magnetostrictive coupling of spins to a polar lattice mode and does not involve relativistic effects. This model explains many magnetic and optical properties of RMn2O5 manganites, such as the spin re-orientation transition, magnetically-induced polarisation, appearance of the electromagnon peak in the non-collinear spin state and the polarisation of light for which this peak is observed. We compare experimental and theoretical results on electromagnons in RMn2O5 and RMnO3 compounds.Comment: 20 pages, 9 figures, to be published in J. Phys.: Condens. Matter, special issue on multiferroic

Cause of Death and Predictors of All-Cause Mortality in Anticoagulated Patients With Nonvalvular Atrial Fibrillation : Data From ROCKET AF

M. Kaste on työryhmän ROCKET AF Steering Comm jäsen.Background-Atrial fibrillation is associated with higher mortality. Identification of causes of death and contemporary risk factors for all-cause mortality may guide interventions. Methods and Results-In the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) study, patients with nonvalvular atrial fibrillation were randomized to rivaroxaban or dose-adjusted warfarin. Cox proportional hazards regression with backward elimination identified factors at randomization that were independently associated with all-cause mortality in the 14 171 participants in the intention-to-treat population. The median age was 73 years, and the mean CHADS(2) score was 3.5. Over 1.9 years of median follow-up, 1214 (8.6%) patients died. Kaplan-Meier mortality rates were 4.2% at 1 year and 8.9% at 2 years. The majority of classified deaths (1081) were cardiovascular (72%), whereas only 6% were nonhemorrhagic stroke or systemic embolism. No significant difference in all-cause mortality was observed between the rivaroxaban and warfarin arms (P=0.15). Heart failure (hazard ratio 1.51, 95% CI 1.33-1.70, P= 75 years (hazard ratio 1.69, 95% CI 1.51-1.90, P Conclusions-In a large population of patients anticoagulated for nonvalvular atrial fibrillation, approximate to 7 in 10 deaths were cardiovascular, whereasPeer reviewe

On the shape and likelihood of oceanic rogue waves

We consider the observation and analysis of oceanic rogue waves collected within spatio-Temporal (ST) records of 3D wave fields. This class of records, allowing a sea surface region to be retrieved, is appropriate for the observation of rogue waves, which come up as a random phenomenon that can occur at any time and location of the sea surface. To verify this aspect, we used three stereo wave imaging systems to gather ST records of the sea surface elevation, which were collected in different sea conditions. The wave with the ST maximum elevation (happening to be larger than the rogue threshold 1.25H s) was then isolated within each record, along with its temporal profile. The rogue waves show similar profiles, in agreement with the theory of extreme wave groups. We analyze the rogue wave probability of occurrence, also in the context of ST extreme value distributions, and we conclude that rogue waves are more likely than previously reported; the key point is coming across them, in space as well as in time. The dependence of the rogue wave profile and likelihood on the sea state conditions is also investigated. Results may prove useful in predicting extreme wave occurrence probability and strength during oceanic storms

USAGE OF CARDIOPROTECTION PRINCIPLES IN TREATING CHRONIC HEART FAILURE

Usage of cardioprotection principles in treating chronic heart failure

EVALUATING THE CLINICAL AND HEMODYNAMICAL ACTION OF NEBIVOLOL IN CHRONIC HEART FAILURE

A task of this research was to study the influence of nebivolol on hemodynamic parameters, clinical sympthoms and life quality in patients II-IV FK HD by NYHA. 24 patients of main group have taken nebivolol in daily dose of 2,5-5 mg per os. Patients were treated with the drug in a course of 3 months.A control group(15 people) was treated traditional therapy (by heart glicozides, metabolic preparations, diurethics, if necessary). We have found that new β-adrenoblocker with additional vasodilatatorial qualities- nebivolol (NEBILET) kindly influences main hemodinamic parameters in chronic coronary patients. During 3 months’ observation examined patients had KDR and KSR distinctly lowered, speed of shortening of miocardium fibrem and the function of throw and MV grew, tension in a pulmonary artery decreased. NEBILET’S prescription in dosage of 2,5-5 mg/ daily kindly influences the reduction of heart rythm’s disturbances, a distinct tendency to lowering of MMLV noted. NEBILET can be successfully used in a combinated therapy of CCD II-IV FK, its usage in cases of coronary deficiency and AG is mostly advisable

THE EVOLUTION OF UNDERSTANDING OF THE IMMUNE SYSTEM'S ROLE IN THE PATHOGENESIS OF INFLAMMATORY MYOCARDIAL DISEASES: TH17-MEDIATED IMMUNE MECHANISMS

The review article discusses recent advances in our understanding of viral myocarditis such as pathogenic role of infection and immune mechanisms in acute, sub-acute and chronic phases of the disease. A newly discovered Th17 lymphocyte subset and Interleukin 17 play an important role in the development of inflammatory myocardial diseases. The protective effect of Interferon y and Th1 immune response in acute myocarditis and the role of Th17-mediated mechanisms in progression of acute myocarditis to dilated cardiomyopathy are considered. The evidence of pathogenic role of Th17 lymphocytes in viral myocarditis in human is given