[Effect of cascade plasma filtration on spectrum of subfractions of low density lipoproteins in blood plasma of patients with ischemic heart disease].

We studied effect of cascade plasma filtration on subfractions of low density lipoproteins (LDL) in 16 patients with ischemic heart disease (IHD) and hyperlipidemias refractory to drug therapy. The procedure caused 37.6 ± 1.4%, 43.1 ± 2.5%, and 50.9 ± 1.4% lowering of total, low density lipoprotein cholesterol, and apolipoprotein B-100, respectively. The use of filters led to removal of larger less atherogenic LDL-1 and LDL-2 subfractions with relative accumulation of small dense LDL-3, LDL-4, and LDL-5 subfractions. Lowering of concentrations of all LDL subfractions was caused by specific LDL apheresis by immunosorbtion in 4 patients with IHD. Removal of small dense LDL was more effective than that of large less atherogenic LDL-1 and LDL-2 subfraction. Thus we found differences in spectrum of LDL removed by cascade plasma filtration and immunosorbtion. The use of filters was associated with less effective removal of most atherogenic small dense LDL than of large LDL particles what led to redistribution of concentrations of various LDL subfractions towards atherogenic profile of lipoproteins. These results could constitute a basis for revision of methods of conduct of cascade plasma filtration procedures in patients with IHD.

[Autoantibodies against lipoprotein(a) in patients with coronary heart disease].

OBJECTIVE: Lipoprotein(a) - Lp(a) is an independent risk factor of atherosclerosis and its complications. In spite of the long period of Lp(a) research there is no complete understanding of its physiological role and atherogenic action. The goal of this study was to investigate the presence in human plasma of circulating autoantibodies to Lp(a) belonging to different classes of immunoglobulins, and to elucidate their relationship to the presence and severity of coronary atherosclerosis in middle aged patients with coronary heart disease. MATERIAL AND METHODS: Autoantibodies to Lp(a) and LDL level were measured in 97 men with quantitative angiography data. Among these patients 17 had intact vessels and 80 had stenoses >50% in 1 or more large coronary arteries. RESULTS: Lp(a) level in patients with coronary atherosclerosis (CA) was significantly higher (median 19.0 [95%CI 12.9-27.3] mg/dl) than in patients without CA (median 10.2 [95%CI 4.5-18.3] mg/dl, p=0.05). Level of IgG autoantibodies to Lp(a) was also elevated in patients with verified CA (264 ± 188 and 187 ± 59 RLU, respectively, p=0,003). Correlation analysis showed significant association between Lp(a) concentration and presence of CA (r=0.20, p=0.05). Level of antibodies against Lp(a) correlated with the quantity of affected coronary arteries (r=0.27, p=0.008). CONCLUSION: Plasma concentration of Lp(a) as well as elevated level of autoantibodies to Lp(a) were associated with the presence and severity of coronary atherosclerosis in examined patients.

[Radiation exposure of the patient and personnel during punctures controlled by roentgenotelevision and computed tomography]. / Luchevaia nagruzka na patienta i personal pri vypolnenii punktsii pod kontrolem rentgenotelevideniia i komp'iuternoi tomografii.

Determined by means of thermoluminescent dosimetry radiation exposure to a patient from punctures controlled by two-projection x-ray and TV was, on an average, 0.0176 Gy +/- 18%, and when controlled by CT it was 0.048 Gy +/- 22% which was comparable with dose exposure of 2 x-ray films in the first case and of 5 x-ray films in the second case. Assessment of radiation exposure to a physician was based on the ratio of single and maximum permissible annual equivalent doses. This ratio of doses to the gonads limited the permissible number of punctures controlled by two-projection x-ray and TV up to 80 per year and that of punctures controlled by CT up to 150 per year. Individual dosimetric control is obligatory for physicians regularly engaged in this type of investigations.