THE ROLE OF LEFT VENTRICULAR HYPERTROPHY, RS1801253 AND RS1801252 ALLELIC POLYMORPHISMS OF ADRB1 IN ASSESSING THE RISK OF SUDDEN CARDIAC DEATH IN PATIENTS WITH ARTERIAL HYPERTENSION.

OBJECTIVE: The aim: To study the association of left ventricular hypertrophy (LVH) and polymorphisms rs1801253 and rs1801252 of the ADRB1 gene with the risk of sudden cardiac death (SCD). PATIENTS AND METHODS: Materials and methods: The study included 179 patients which underwent clinical investigation, echocardiography, elektrokardiography. The examined were divided into groups with a low (110 people) and high risk (69 people) of SCD. The distribution of allelic polymorphisms was investigated with polymerase chain reaction (PCR). RESULTS: Results: All patients of group with high-risk cardiovascular mortality showed a decrease in heart rate variability (RV) due to an increase in sympathetic activity (p=0.013). Also, in the group of patients with LVH, predictors of sudden cardiac death and arrhythmogenic substrate, were observed. The variability of the allele C1165G rs1801253 of the ADRB1 gene was associated with an increased risk (2.55-fold increase) of SCD and LVH. Also, the associations of polymorphic locus A145G (rs1801252) of the ADRB1 gene proved the presence of a permanent difference for the "risky" allele A in patients with a high risk of SCD. CONCLUSION: Conclusions: It was set the probable association of alleles rs1801253 (C1165G) and rs1801252 (A145G) ADRB1 at the patients with a high risk of SCD compared to the control group.

CLINICAL CASES OF LIFE-THREATENING ARRHYTHMIAS: LONG AND SHORT QT SYNDROMES.

OBJECTIVE: The aim: To present clinical cases of sudden cardiac death in patients with prolonged and shortened QT interval. PATIENTS AND METHODS: Materials and methods: The study includes description of two different clinical cases with prolonged and shortened QT interval after sudden cardiac death. Verification of the diagnosis was performed using the criteria recommended by the European Society of Cardiology (ESC) and European Heart Rhythm Association (EHRA). RESULTS: Clinical case: Two clinical cases of syncopе with life-threatening arrhythmias, confirmed by electrocardiographic and clinical diagnostic criteria, indicating a change in the dispersion of the QT interval, are presented. The first case represents a patient with intermittent syncope. The patient had previously had attacks of sudden palpitations with fainting. The patient came after another episode of syncope. Further follow-up revealed clinical and electrocardiographic signs of ventricular tachycardia paroxysm. Than the prolongation of the QT interval is set. In this clinical case, verification of QT prolongation syndrome was established in the elderly. Another clinical case is associated with QT syndrome, which remains difficult to diagnose. Such cases have been described relatively recently. The clinical picture of the syndrome of short QT interval in the presented clinical case was characterized by the appearance of syncopal states. The patient showed changes in the adjusted QT interval <320 ms. The causes of syncope in a patient with a short QT interval were paroxysms of atrial fibrillation (AF) or ventricular arrhythmias. At the same time the anatomical structure of a myocardium remains normal and unchanged. The hereditary nature of the disease in the patient has been proven. CONCLUSION: Conclusions: Timely diagnosis of prolongation (LQTS) or shortening (SQTS) of the QT interval after ECG and Holter monitoring allows you to identify a group of patients with an increased risk of developing ventricular arrhythmias, syncope and sudden cardiac death. Implantation of a cardioverter-defibrillator is an effective and safe method of preventing sudden cardiac death in patients with long and short QT syndromes.

ASSOCIATIONS OF POLYMORPHISMS NOS3-T-786C, MTHFR-C667T, P2RY12-T-744C, (GPIBα) -C482T AND GENE INTERACTIONS IN MACROANGIOPATHIES IN PATIENTS WITH COMBINED HYPERTENSION AND TYPE DIABETES MELLITUS 2.

OBJECTIVE: The aim: To establish the role of allelic polymorphisms NOS3-T-786C, MTHFR-C667T, P2RY12--744C, (GPIbα)-C482T in the development of vascular lesions in patients with hypertension and diabetes mellitus type 2. PATIENTS AND METHODS: Materials and methods: The study included 100 patients with hypertension and diabetes mellitus type 2 (main group) and 50 patients without type 2 diabetes (control group). Patients underwent echocardiography, color duplex scanning of extracranial, brachiocephalic and femoral vessels. The distribution of allelic polymorphisms was investigated by isolation DNA from leukocytes and polymerase chain reaction (PCR). RESULTS: Results: The risk of vascular damages increases 2-fold when carrying all 4 risk alleles in monozygotic genotypes of polymorphic loci in patients with hypertension with concomitant type 2 diabetes (p<0,05). In gene-gene interaction, the values of contributions and directions of interaction between alleles of polymorphic loci are established (p<0,05). Genes create a paired hierarchy of interaction according to their functional activity; the largest contribution to the probable vascular damage depends on the allelic polymorphism NOS3-786CT (p<0,05), the lowest - on the allelic polymorphism P2RY12-744CC (H2H2). The genetic polymorphism of the MTHFR gene is independent of the influence of other studied polymorphisms (p<0,05); the genes P2RY12-744CT and GPIbα 482CT act synergistically with the gene NOS3-786CT, being in a weak negative interaction with each other. CONCLUSION: Conclusions: Phenotypic manifestations of endothelial dysfunction may be modified by allelic polymorphism of genes associated with endothelial and platelet functions with the risk of vascular complications.

THE EXPERIENCE OF TREATMENT THE PATIENTS WITH COMPLICATED VIRAL RESPIRATORY TRACT INFECTIONS: ROLE OF HIGH-CONCENTRATED OXYGEN INHALATIONS ADDING CAMOMILE OIL.

OBJECTIVE: The aim: To study the clinical manifestations, capillary blood saturation, frequency of respiratory failure in patients with complicated forms of acute respiratory viral infections (ARVI). PATIENTS AND METHODS: Materials and methods: The study included 70 patients with ARVI (mean age was 46.5±9.2 years). Patients observed were randomized into 2 groups. In group 1 (n=30), the only basic therapy was prescribed. In group 2 in addition to the basic therapy the inhalations with high concentrated oxygen with Camomile Oil were used. RESULTS: Results: It is proved that the use of highly concentrated oxygen with camomile oil in the inhalation treatment regimen significantly reduces the duration of local respiratory symptoms (p<0.001) and symptoms of general intoxication (p<0.001), prolonged hospital stay decreases by an average of 5 days (p<0.001). The relief of symptoms of RF in group 2 was noted for 10 days of hospitalization with an increase in capillary blood saturation (SatO2,%) to 95.2±2.91. Absolute therapeutic efficacy (absolute efficacy) of the correction of RF during complex treatment with the addition of highly concentrated oxygen was 88.0% versus 57.0% in group 1. Relative efficacy (RE) - 0.65 [0.46-0.90], odds ratio (OR) - 0.19 [0.06-0.61], p<0.05. The positive effect of highly concentrated oxygen for local immunity state - the level of secretory immunoglobulin A (p<0.001) and lysozyme (p<0.001) was established. CONCLUSION: Conclusions: High-concentrated oxygen inhalations adding camomile oil is effective in complex treatment at patients with complicated forms of acute respiratory viral infections.