The role of cytokine gene polymorphism in the formation of arterial hypertension associated with metabolic syndrome.

We investigated the association of polymorphisms of genes tumor necrosis factors and their receptors (-308G/A TNFa, +250A/G Lta, +36 A/G TNFR1, +1663 A/G TNFR2) with the predisposition to the development of essential hypertension (EH) and the features of its clinical course in patients with metabolic syndrome. It has been demonstrated that the molecular genetic marker +36G TNFR1 (OR=1,25) is involved in the formation EH in individuals with metabolic syndrome. The risk of stage III EH in patients with metabolic syndrome is enhanced by genetic variants -308GA TNFa (OR=2,72), -308A TNFa (OR=2,72), +250G Lta (OR=1,80), and combinations thereof -308A TNFa with +1663G TNFR2 (OR=3,85), +250G Lta with +36G TNFR1 (OR=3,85), +250G Lta with +1663G TNFR2 (OR=3,85) while protective properties are inherent in -308GG TNFa (OR=0,32), +250AA Lta (OR=0,45), -308G TNFa (OR=0,37), +250A Lta (OR=0,56) and a combination of genetic markers -308GG TNFa with +250A Lta (OR=0,31), -308G TNFa with +250AA Lta (OR=0,39), -308G TNFa with +250A Lta (OR=0,31).

[The role of dynamic perfusion scyntiography of myocardium at rest and during exercise in the assessment of the clinical course of chronic cardiac failure and angina of effort in patients with stable forms of coronary heart disease].

The ever-growing morbidity, disablement, and mortality from coronary heart disease, chronic cardiac failure dictate the necessity of the search for new methods to verify, and evaluate prognosis of the clinical course of these diseases. Currently, myocardial perfusion scintiography is most widely used for the purpose.

[Erythrone system in aged patients with chronic cardiac insufficiency].

Basic mechanisms underlying the development of chronic cardiac insufficiency (CCI) in aged subjects were investigated in a randomized study of 30 patients with I-IV functional class CCI and preserved left ventricular systolic function. CCI affected the left side of the heart in 23 patients due to concurrent hypertensive disease and the right side in 7 patients with concomitant chronic broncho-pulmonary pathology. Mean age of the patients was 65 years. Control group comprised 8 practically healthy middle-age subjects. Erythrone system condition was evaluated from erythrocyte morphological characteristics and chemical composition studied by scanning electron microscopy on a FEI quanta 2003D apparatus in the Nanotechnologies and Nanomaterials Centre, Belgorod State University. Pathological changes in the erythrone system of CCI patients included changes of erythrocyte shape and chemical composition especially well apparent in cases with chronic pulmonary heart. As CCI progressed, erythrocytes in the form of bi-convex disks turned to spheres with the papillose surface. The sphere to disk ratio in the compensation, sub- and decompensation stages was 1:7, 1:4, and 9:1 respectively compared with 1:60 in controls. Spherocytes contained less nitrogen than normal diskocytes. Protein degradation was more apparent in aged CCI patients. Their erythrocytes contained 4.5-5, 2, 3 and 4 times more calcium, magnesium, aluminium, and silicon respectively than the cells of healthy subjects. It suggests development of calcium paradox, abnormal membrane permeability and gradual cell death (hemolysis). Anemia in aged CCI patients appears be of haemolytic nature. It occurred in 6.7-11.5% of the cases of left ventricular CCI and in 33.3% of the aged patients with chronic pulmonary heart, the lethality rate being 0.93 and 28.6% respectively. It is concluded that changes in the erythrone system in the form of erythrocyte spherulation, accumulation of calcium and other chemical elements suggest a poor prognosis of CCI in elderly patients.