[Influence of ω-3 PUFAs on predictors of sudden cardiac death in patients with Q-wave myocardial infarction].

OBJECTIVE: To assess effect of ω-3 polyunsaturated fatty acids (PUFAs) on non-invasive predictors of sudden cardiac death (ventricular arrhythmias, QT duration and variability, late ventricular potentials [LVP], microvolt-level T-wave alternans [MTWA], and heart rhythm turbulence [HRT]) in patients with Q-wave myocardial infarction (MI) and ventricular heart rhythm disturbances (VHRD). MATERIAL AND METHODS: The study included 140 men aged 52.5+/-1.3 years with primary diagnosis of Q-wave MI and I-IV Lown grade VHRD. Patients were randomized in 2 groups: index group (A) and control group (B) consisted of 70 persons each. Patients of index and control groups were divided into another 2 groups by severity of arrhythmic syndrome: Al (n=39) and Bl (n=38) with I-III grade VHRDs; A2 (n=31) and B2 (n=32) with IV-V grade VHRDs. In index groups (Al and A2) ω-3 PUFA medicine was administered additionally to standard therapy at a dose of 1 g/day during 6 months. All patients underwent standard clinical examination and 24-hour Holter ECG monitoring on days 10-14 and in 6 months after MI. RESULTS: Decreases of single and paired ventricular extrasystoles, ventricular tachycardia runs, total duration of myocardial ischemia were observed in patients of index groups Al and A2 after ω-3 PUFAs treatment. After 6 months of ω-3 PUFAs treatment significant QT shortening and increase of QTc variability were noted. Numbers of patients with LVP in Al and A2 groups decreased 21.3% (p<0.05) and 38.7% (p<0.0l), with HRT - 20.5% and 29.1% (p<0.05), with MTWA - 18% and 16.1% (p<0.01). In control groups the result was statistically insignificant. CONCLUSION: Administration of 1 g/day of a prescription preparation of 90% ω-3 PUFAs in patients with primary Q-wave MI was associated with decrease of ventricular ectopy severity in patients with low and high grade VHRD and simultaneous reduction of total myocardial ischemia time. ω-3 PUFAs administration for 6 months had marked positive effect on QT duration and variability, LVP, HRT, MTWA.

[Immunoinflammatory factors in unstable angina. Possibility of influence of atorvastatin].

In 101 patients with ischemic heart disease (unstable angina class I and II-III) with hypercholesterolemia at the background of standard therapy (51 patients) and after administration of atorvastatin (50 persons) prescribed from first day of hospitalization in mean dose 10.8 +/- 0.1 mg/day immune status was studied in accordance with 3 stage scheme of examination. In dynamics (before onset of treatment and after 6 months of therapy) a concentrations of a row of cytokines was studied: alpha-factor of tumor necrosis (TNFalpha) and C-reactive protein (CRP). At correlation analysis of parameters of plasma lipid composition and immune profile it has been established that in patients with unstable angina (in the presence of hypercholesterolemia) together with elevation of CRP level substantial signs of dysbalance in immune system are observed. These signs appear as elevation of levels of TNFalpha, interleukin-4, and especially interferon gamma with simultaneous depression of cells of immune defense. In has been demonstrated that atorvastatin not only exerts good hypolipidemic effect, but is capable to diminish immunoinflammatory shifts in patients with acute coronary pathology.

[Applicability of fozinopril for correction of basic manifestations of metabolic syndrome in women with arterial hypertension].

AIM: To evaluate effects of fozinopril on basic manifestations of metabolic syndrome in women with moderate and severe arterial hypertension (AH). Material and methods. Sixty women with AH aged 45 to 65 years entered the trial. Mean duration of the disease was 11 years. Arterial pressure (AP), carbohydrate, lipid and purin metabolism, lipid peroxidation, erythrocytic membranes resistance were examined before the trial and followed up for 6 months of the treatment. RESULTS: Fozinopril significantly reduced systolic and diastolic AP. A 6-month course of the drug brought target AP in 85.4% examinees, a good response was achieved in 96.4%. The treatment also significantly reduced the levels of insulin, C-peptide, triglycerides, increased content of HDLP cholesterol, relieved insulin resistance. Fozinopril demonstrated antioxidant, membrane stabilizing and hypouricemic efficacy. CONCLUSION: High antihypertensive efficacy and a positive action on basic manifestations of metabolic disorders allow us to recommend fozinopril as a basic drug for treatment of women with moderate and severe AH concurrent to insulin resistance syndrome.

[Use of antioxidants and trimetazidine in preparation of patients with ischemic heart disease for coronary angiography]. / Ispol'zovanie antioksidantov i trimetazidina pri podgotovke bol'nykh ishemicheskoi bolezn'iu serdtsa k koronaroangiografii.

Lipid peroxidation, cell stability, lipid spectrum, conjunctival microcirculation, levels of ceruloplasmin and myoglobin were studied in 107 males with ischemic heart disease before and after coronaroangiography by M. Judkins (CAG). It was found that CAG provokes oxidative stress, promotes membranodestructive processes, dyslipidemia and circulation disorders in the bulbar conjunctive. Preventive (3 days before CAG) administration of alpha-tocopherol or emoxipin proved cardioprotective. The highest cytoprotective effect was produced by trimetasidine given 10 days before the procedure.

[Application of high information technologies in predicting outcomes of cardiovascular diseases]. / K voprosu ispol'zovaniia vysokikh inforamtsionnykh tekhnologii v prognozirovanii serdechno-sosudistykh zabolevanii.

The authors review their studies conducted for many years on cardiological prognostication in the context of the republican program "Cardiology" performed in the Udmurt Republic. The lines of the research and results obtained are described.

[Mathematical model for prognostication of work capacity recovery in patients with myocardial infarct]. / Matematicheskaia model' prognozirovaniia vosstanovleniia trudosposobnosti u bol'nykh infarktom miokarda.

The impact of clinical and instrumental findings on prognosis was evaluated in patients with myocardial infarction and a mathematical model was proposed to predict their recovered working ability. The developed predictive index for prediction of recovered working ability is of high informative value and accuracy. It may be practically used by a cardiologist to choose a protocol of medical and rehabilitative measures in myocardial infarction.

[Immunological characteristics of patients with acute coronary syndrome (unstable angina and myocardial infarction)]. / Immunologicheskie osobennosti bol'nykh s ostrym koronarnym sindromom (nestabil'naia stenokardiia i infarkt miokarda).

Admission and discharge values of rosette formation, adhesive and phagocytic ability of neutrophils, exercise tests with calculation of the tension index (TI), serum concentrations of IgG, IgA and IgM, circulating immune complexes (CIC) and cardiolipin antibodies (CAB) were studied in 48 males with unstable angina pectoris and acute myocardial infarction. Acute coronary syndrome is shown to be associated with marked immune alterations, primarily, with elevated levels of CIC and CAB, reduced TI. These alterations persisted for 3-5 weeks of the hospital stay and provoked the risk of repeated infarctions and thrombotic complications after relief of clinical symptoms of acute coronary failure.

[Therapeutic plasmapheresis and alpha-tocopherol in patients with coronary heart disease]. / Lechebnoe primenenie plazmafereza i alpha-tokoferola u bol'nykh ishemicheskoi bolezn'iu serdtsa.

46 patients with coronary heart disease with hypercholesterolemia were exposed to therapeutic plasmapheresis (TP) in combination with alpha-tocopherol treatment (AT). The results of 3-month follow-up with assessment of the clinical status, lipid spectrum, lipid peroxidation, concentration of ceruloplasmin indicated high hypolipidemic effectiveness of TP 2-3 weeks after the treatment as shown by inhibition of lipid peroxidation and antioxidant system. The addition of AT prolonged the hypolipidemic effect of TP, promoted optimization of plasma antioxidant potential (a rise in HDL, stabilization of ceruloplasmin levels).