Subject(s)
Myocardial Ischemia/blood , Myocardial Ischemia/surgery , Transforming Growth Factor beta/blood , Tumor Necrosis Factor-alpha/blood , Biomarkers , Coronary Artery Bypass , Disease Progression , Electrocardiography , Female , Humans , Male , Middle Aged , Monitoring, Physiologic , Myocardial Ischemia/diagnosis , Myocardial Ischemia/physiopathology , Perioperative Period , Risk FactorsABSTRACT
Relationship between disorders of endothelial function, proinflammatory activity of leucocytes and effects of therapy with simvastatin or its combination with ezetimibe was studied in 72 patients with ischemic heart disease subjected to coronary artery bypass grafting (CABG). Vascular endothelial function was assessed by ultrasound detection of brachial artery response to its compression, oxidant activity of leucocytes - by chemiluminescent microscopy, severity of coronary artery atherosclerosis - by invasive coronary angiography. Twenty two healthy individuals comprised control group. Endothelial function, activity of leucocytes, and lipid levels were evaluated before and in 12 months after CABG. Patients with multivessel involvement revealed more complex disorders of endothelial function and higher levels of leucocytes activity compared to patients with single-vessel disease. CABG resulted in disappearance of anginal attacks and negative stress echo test during 1-year observation in 80.6% of patients. Patients with recurrent angina after CABG had more severe endothelial and leucocytes disorders. Combined lipid lowering therapy (simvastatin plus ezetimibe) compared to simvastatin alone demonstrated higher efficacy in terms of achievement of target lipid levels, improvement of endothelial function and leucocytes disorders.
Subject(s)
Anticholesteremic Agents/therapeutic use , Coronary Artery Bypass , Endothelium, Vascular/physiopathology , Leukocytes/metabolism , Myocardial Ischemia/physiopathology , Adult , Azetidines/therapeutic use , Case-Control Studies , Coronary Angiography , Drug Therapy, Combination , Endothelium, Vascular/metabolism , Ezetimibe , Female , Humans , Luminescent Measurements , Male , Microscopy/methods , Middle Aged , Myocardial Ischemia/blood , Myocardial Ischemia/drug therapy , Myocardial Ischemia/metabolism , Myocardial Ischemia/surgery , Oxidation-Reduction , Severity of Illness Index , Simvastatin/therapeutic use , Treatment OutcomeABSTRACT
Silver staining for nucleolar proteins was used to evaluate the ribosomal genes activity in cardiomyocytes (Cm) and fibroblast-like cells (FBS) of intraventricular septum, and other regions of the left ventricle. Specimens to be analysed were taken from 7 patients with idiopathic obstructive hypertrophic cardiomyopathy (OHCM). In this group the quantity of nucleoli and AgNORs, reflecting the transcriptional and processing level of pre-ribosomal RNA in all type of cells, was at least 2 and 3 times higher than in patients with essential hypertension and in healthy control, respectively. We suggest that nucleolar hypertrophy in patients with hypertrophic cardiomyopathies, inappropriate to hypertrophy in other pathological conditions, may be most probably of compensatory character, and this may be in part explained by nuclear hyperploidy and chromosomal endoreduplication. We have noted a marked heterogeneity in shape, size and quantity of nucleoli, and in AgNORs of FBC. Nuclei with modulated phenotype containing nucleoli of high activity were revealed. This article presents the first data on p53 mutation identification in patients with advanced OHCM.