[Characteristics of autoimmune reactions in chronic cardiac failure of different etiology].

AIM: To characterize autoimmune reactions in patients with chronic cardiac failure (CCF) of different etiology. MATERIAL AND METHODS: Basic markers of immune activation were measured in 43 patients with coronary heart disease stage I-IIB (NYHA FC I-IV) and 44 patients with dilated cardiomyopathy (DCMP) stage I-IIB (NYHA FC I-IV). Antibodies to myocardial tissue were studied with indirect immunofluorescence. Echocardiography was made by standard recommendations with evaluation of systolic and diastolic left ventricular function. Concentrations of C-reactive protein, IgG, IgA, IgM were estimated nephelometrically. Enzyme immunoassay studied serum levels of IL-8, IL-2R, IL-6, IL-18, IL-10, IFN-gamma, endothelin. RESULTS: Patients with DCMP had higher titers of antimyocardial autoantibodies than in coronary heart disease (CHD) reflecting more severe autoimmune inflammation. In CHD endothelial, systolic and diastolic dysfunctions severity correlated with severity of inflammation. CONCLUSION: Some characteristics of autoimmune reactions in CCF determine severity of the disease course.

[The study of peculiarities of immunotropic action of statins in chronic heart failure of various etiology].

AIM: To study features of statin therapy in patients with heart failure (HF) of different etiology on immune system. MATERIAL AND METHODS: The basic markers of immune activation in 43 patients with chronic heart disease (CHD) and HF in New York Heart Association (NYHA) class I to IV were studied. Mine age was 48 +/- 8 years (from 33 to 64 years). 43 patients with dilated cardiomyopathy (DCM) and HF were also observed. Mine age was 43 +/- 10 years (from 22 to 61 years). Parameters of systolic and diastolic left ventricle (LV) function were measured. Also non invasive methods for evaluation of endothelial function were used. Concentrations of hsCRP, IgG, IgA, IgM were measured using commercially available kits. IL 6, IL 8, sIL 2R, IL 18, IL 10, IFN Y, endothelin levels were measured using enzyme linked immunosorbent assay method. RESULTS: Statin therapy has immunomodulation effect in patients with heart failure any etiology. This effect depends on etiology of HF. In CHD patients the decreasing of IFN Y, IL 8, sIL 2R, hsCRP and increasing of IL 18, IL 6 levels were observed. In DCM patients the decreasing of IL 8, IL 18, sIL 2R and increasing of IL 10 were observed. There was significant clinical improving in patients with DCM and HF after statin therapy. But there were no changes of endothelial function in patients with CHD and DCM. There were no changes of LV function in patients with CHD. So statin therapy may reduce level of proinflammatory mediators but not fully control inflammation process in patients with HF of different etiology.

[Immune mechanisms of inflammation in dilated cardiomyopathy].

AIM: To study immune mechanisms of inflammation in dilated cardiomyopathy (DCM). MATERIALS AND METHODS: The study of main markers of immune activation was conducted in 44 patients with DCM with stage I - IIB and NYHA functional class (FC) I - IV chronic heart failure (CHF). Among them there were 42 men (95%) and 2 women (5%) in the age from 22 to 61 years. Mean age was 43(10) years. According to FC the patients were distributed in the following way: FC I--10 (23%), FC II--9 (20%), FC III--13 (30%), FC IV--12 (27%). EchoCG was carried out by standard recommendations with assessment of systolic and diastolic function of LV. Measurement of CRP, IgG, IgA, IgM was based on nephelometric method of detection. Content of Il-6, Il-18, Il-10, Il-10, sIl-2R, Il-8, IFN-gamma in blood serum was measured by the method of immunoenzyme analysis. RESULTS: Elevation of levels of CRP, sIl-2R, Il-8 was established in DCM, what evidenced for the presence of inflammatory process. In the group of patients with DCM with rhythm disturbances (predominantly of atrial fibrillation type) elevation of levels of IFN-gamma, CRP was noted what probably was related to Th-1 type of inflammatory reaction. It was revealed that disturbances of diastolic function of the heart had inflammatory genesis (IFN-gamma correlated with parameter of diastolic function DT; elevation of Il-6 level was found in restrictive type of diastolic function). CONCLUSION: Elevation of proinflammatory factors in DCM evidence for the presence of inflammatory process. there exist a link between elevated level of mediators of inflammation and complications of the disease--arrhythmia, worsening of heart failure class, deranged diastolic function of the heart.

[The role of inflammatory factors in pathogenesis of ischemic heart disease].

PURPOSE: To study mechanisms of immune derangements in coronary heart disease (CHD). MATERIAL AND METHODS: We measured basic markers of immune activation in 43 patients with CHD and NYHA I-IV class heart failure (HF). There were 41 men and 2 women aged 33 - 64 years (mean 48 +/- 8 years). Concentrations of hsCRP, IgA, IgM, IgG were measured using commercially available kits. IL-8, sIL-2R, IL-6, IL-18, IL-10, IFN-gamma endothelin levels were measured using enzyme-linked immunosorbent assay method. RESULTS: We found evidence of participation of proinflammatory factors in pathogenesis of HF and established associations of mediators of inflammation (CRP, IL-8) with severity of HF, endothelial dysfunction, and impairment of cardiac function.