Risk of Cardiovascular Complications in Patients with Persistent Atrial Fibrillation after Dissolution of a Thrombus in the Left Atrial Appendage.

Aim      To compare the incidence of cardiovascular complications (CVC) in patients with persistent atrial fibrillation (AF) following thrombus dissolution in the left atrial appendage (LAA) and in patients with persistent AF without preceding LAA thrombosis.Material and methods  The main group included 43 patients who had been diagnosed with LAA thrombosis on the first examination, transesophageal echocardiography, and who showed dissolution of the thrombus on a repeated study performed after 7.1+2.0 weeks of the anticoagulant treatment. The control group consisted of 123 patients with a risk score >0 for men without LAA thrombosis and score >1 for women without LAA thrombosis according to the CHA2DS2­VASc scale. The patients were followed up for 47.3±17.9 months. The following unfavorable outcomes were recorded: all-cause mortality, ischemic stroke or systemic thromboembolism, hemorrhagic stroke or severe bleeding, and myocardial infarction (MI).Results Unfavorable clinical outcomes were observed in 39.5 % of patients in the main group and in 3.3 % of patients in the control group (p<0.001). Furthermore, the incidence of ischemic stroke (relative risk (RR), 12.9; 95 % confidence interval (CI), 2.89-57.2), and MI (RR, 5.72; 95 % CI, 1.09-30.1) was higher in the main group. However, the number of MI cases in both groups and the number of stroke cases in the control group increased during the entire follow-up period, while the number of stroke cases rapidly increased only during the first year of follow-up.Conclusion      In patients with persistent AF, the risk of CVC after LAA thrombus dissolution remains significantly higher than in patients with AF without LAA thrombosis.

[The changes of copper metabolism in rats fed with low- or high-calorie ration].

Copper is an essential micronutrient, because it is a catalytic and structural cofactor of enzymes that control the basic processes in all cells, and moreover it is a participant in signaling pathways. The toxic properties of copper ions, due to their chemical nature, are manifested when the cellular and/or organism systems for copper homeostasis are disturbed. Aim of the work was to study the relationships between the diet caloric and the copper status in the blood serum, the copper metabolism in the liver and white adipose tissue (WAT) of rats. MATERIAL AND METHODS: The work was performed on three groups (each n=5) of white outbred rats (average body weight 220±15 g), kept for 75 days on a standard, low-calorie (LCR) or high-calorie (high-fat) (HCR) rations. mRNA concentration was measured by qRT-PCR technology. The сeruloplasmin (CP) content was determined by the method of immune electrophoresis, immune blotting and by oxidase activity. The copper concentration was measured by atomic absorption spectrometry. RESULTS AND DISCUSSION: It has been shown that serum level of triglycerides increased in rats fed LCR. The main indicators of copper status (concentration of atomic copper, the level of holo-CP, and the content of immunoreactive CP) decreased in rats fed HCR. In the liver, none of the diets affected Cp gene expression level. In the cells of the subcutaneous fatty tissue, the concentration of both splice-forms of CP-mRNA significantly increased in rats fed LCR. In visceral adipose tissue the concentration of Cp-mRNA encoding the secretory CP did not change in LCR-rats, but the level of mRNA, encoding CP anchored to plasma membrane, dropped to almost zero as compared to the control group. There was no significant change in the level of both splice-forms of CP-mRNA in HCR-rats. The features of copper metabolism in the cells of the liver and WAT, due to the caloric content of ration, have been discussed. CONCLUSIONS: In rats' liver, the link between copper metabolism and calorie intake is manifested in changes in the expression of the CP gene at the translation level, and in white adipose tissue - at the level of transcription and post-transcriptional maturation of the pre-mRNA of this gene.

Role of Copper Dyshomeostasis in the Pathogenesis of Parkinson's Disease.

Serum concentration of copper, immunoreactive polypeptides of ceruloplasmin and its oxidase activity, and the number of copper atoms per ceruloplasmin molecule were decreased in patients with Parkinson's disease in comparison with the corresponding parameters in age-matched healthy individuals, but the ratio of apoceruloplasmin to holoceruloplasmin in patients with Parkinson's disease was similar in both groups. Treatment of blood serum with Helex 100, a high-affinity copper chelator, revealed reduced content of labile copper atoms per ceruloplasmin molecule in patients with Parkinson's disease in comparison with that in healthy controls. The mechanism underlying impaired metabolic incorporation of labile copper atoms into CP molecule is discussed as a possible cause of copper dyshomeostasis associated with Parkinson's disease.