RELATIONSHIP BETWEEN CARBOHYDRATE METABOLISM VALUES AND CALPROTECTIN LEVELS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION WITH REGARD TO CONCOMITANT TYPE 2 DIABETES MELLITUS.

According to literature, the presence of concomitant diabetes mellitus type 2 (DM) is associated with a high frequency of complications in patients with acute myocardial infarction (MI) due to the development of repeated episodes of myocardial ischemia, left ventricular dysfunction, life threatening rhythm disorders, and thromboembolic events Aim: to analyze the state of immuno-inflammation based on the study of calprotectin, as well as to assess the presence and nature of links with carbohydrate metabolism parameters based on the study of blood glucose, insulin and insulin resistance. Patients with AMI in combination with DM 2 were found to have a significant increase in the level of calprotectin by 25.9% (p<0.001) compared to patients with AMI without DM 2. Assessment of carbohydrate metabolism rates revealed changes in the form of statistically significant increase in the concentration of fasting glucose in patients with AMI in combination with DM 2 by 41.8% (p<0.001) when compared to patients with isolated AMI. As for serum insulin, the level of this parameter when combined with the course of AMI and DM 2 significantly exceeded those in patients with AMI without DM 2. The level of HOMA index in patients with AMI with concomitant DM 2 when compared to patients with isolated AMI was also higher (differences are statistically significant, p<0.01). The study showed a correlation between serum calprotectin and insulinemia (R=0.57; p<0.05), HOMA index (R=0.52; p<0.05), fasting glycemia (R=0.59; p<0.05) and troponin I level (R=0,64; p<0,05). The obtained results indicate that the growth of immune inflammatory activity due to the proinflammatory parameter of calprotectin is accompanied by an increase in changes in carbohydrate homeostasis in the form of an increase in the degree of insulin resistance in patients with AMI and DM 2, and severity of cardiac ischemia.

[INFLUENCE OF THE METFORMIN THERAPY ON THE ACTIVITY OF ENDOTHELIAL-DEPENDENT MEDIATORS AMONG PATIENTS WITH ACUTE MYOCARDIAL INFARCTION AND CONCOMITANT TYPE 2 DIABETES MELLITUS].

Aim of study‒ estimate the influence of the metformin therapy on the sCD40-ligand and sVE-cadherinlevels among patients with acute myocardial infarction and concomitant type 2 diabetes mellitus. The study included44patients with AMI and type 2 diabetes whichweredividedintotwo groupsdependingonthe glucose lowering drugs they have been taken: I group ‒ 21patients who have been taken metformin; II group ‒ 23patients, who have been taken short-acting insulin. Accordingtotheobtainedresults using of metformin as a glucose lowering drug in comparison with patients who have been taken short-acting insulin causes faster decreasing of the sCD40L level (-29,3% and -24,4% accordingly; р<0,05). Whereas there was no significant differencesin the dynamics of sVE-cadherinlevels (-22,4% and -19,2% accordingly; р>0,05). Positive influence of them et form in on thes CD40-ligand level probably is caused by the inhibition of the Akt-kinase phosphorylation responsible for the activation of the nuclear factor kappa-b which controls expression of the immune response genes, particulary CD40. It leads to the inhibition of the thrombocytes activation and differentiation of the monocytes to the macrophages able to product proatherogenic factors. It was established that metformin therapy among patients with acute myocardial infarction and diabetes mellitus type 2 leads to the faster decreasing of sCD40-ligand in comparison with insulin therapy, which can contribute to the improvemenet of the prognosis in this cohort.

[GALECTIN-3 LEVEL IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION AND OBESITY OF DIFFERENT GRADE OF SEVERITY: LINK WITH ANTHROPOMETRY].

The im is to estimate the concentration of galectin-3 in patients with acute myocardial infarction depending on the presence of overweight and obesity of different severity, as well as to analyze the character of the relationship of this parameter with the anthropometric indices. The study involved 78 patients with acute myocardial infarction. The study group included 55 patients with acute myocardial infarction and concomitant obesity. The control group consisted of 23 patients with acute myocardial infarction and normal body weight. Patients of the main group were divided according to the degree of severity of obesity. Obesity of I degree was detected in 26 individuals, II-III degrees - in 17 persons. Overweight was defined in 12 patients. It has been established that the presence and progression of obesity in patients with acute myocardial infarction accompanied by hyperactivity of pro-inflammatory mediator galectin-3, peaking in obese II-III degrees provided abdominal type of fat distribution. Overweight in turn, was not associated with a marked increased of galectin-3 production compared to those with normal weight.

[GENE POLYMORPHISM Gln27Glu ß2-ADRENERGIC RECEPTORS IN PATIENTS WITH ISCHEMIC HEART DISEASE AS A FACTOR OF DEVELOPMENT AND PROGRESSION OF OBESITY].

Currently large numbers of genetic markers that are closely linked to the development of cardiovascular diseases and obesity are identified. The aim of our study was the study of polymorphism Gln27Glu ß2-adrenergic receptor gene as a possible factor in the pathogenesis of obesity in patients with coronary heart disease. We conducted a comprehensive survey of 337 patients with coronary heart disease. All patients were divided into two groups according to the presence of obesity: the first group - patients with coronary artery disease with normal body weight (n=115), the second group - patients with coronary heart disease and obesity (n=222). The control group consisted of 35 healthy people. It was established that the presence of the G allele and genotype G/G Gln27Glu ß2-adrenergic receptor gene are at risk of development and progression of obesity in patients with coronary heart disease.

Monocyte chemo attractant protein-1 in patients with chronic heart failure of different functional class with type 2 diabetes.

The aim of the study was to assess the dynamics of monocyte chemoattractant protein-1 in patients with chronic heart failure of different functional classes depending on the presence or absence of concomitant type 2 diabetes. 95 patients with chronic heart failure II - III FC were examined due to coronary heart disease who were treated at the cardiological department of the Kharkiv City Clinical Hospital № 27 (mean age 65,13±8,66 years). The first group included 52 patients with CHF with type 2 diabetes, the second - 43 CHF patients without type 2 diabetes. Research was excluded patients with acute coronary syndrome, acute myocardial infarction. 71 patients of patients had II NYHA FC, 24 patients - III FC. Among the patients of first group 40 patients were diagnosed in CHF FC II, 12 - III FC. In II group 31 patients were with CHF class II, 12 patients - with III FC. Concentration of proinflammatory cytokine interleukin-1ß and fibrosis factor monocyte chemoattractant protein-1 were determined by ELISA (enzyme-linked immunosorbent assay). In patients with chronic heart failure in presence or absence of type 2 diabetes increase in the profibrotic parameter monocyte chemoattractant protein-1 and proinflammatory cytokine interleukin-1ß were increasing in parallel with NYHA FC increasing. Presence of type 2 diabetes negatively affects the work of cytokines and markers of fibrosis, as evidenced by higher levels of interleukin-1ß and monocyte chemoattractant protein-1, compared with patients without diabetes in the presence of the same NYHA FC of chronic heart failure.

[Cardiohemodynamic features and character of depressive disorders in patients with anemia varying grades of severity with chronic heart failure and chronic kidney disease].

Anemia and renal dysfunction are considered as predictors of an unfavorable course of chronic heart failure, the presence of depressive disorders in these patients is a risk factor for recurrent hospitalizations and deaths. The aim--study of morphological and functional changes in the myocardium, as well as the assessment of the existence and character of depressive disorders in patients with anemia varying grades of severity, developed on a background of chronic heart failure and chronic kidney disease. Structural and functional parameters of myocardium were investigated by echocardioscopy. Beck Depression Inventory was used to assess the presence and character of depressive disorders. The progression of anemic syndrome was accompanied by dilation of the left and right cavities of heart, inotropic function decreasing. In patients with anemic syndrome on a base of chronic heart failure and chronic kidney disease depressive disorders are observed mainly due to the cognitive-affective disorders in 1st grade anemia, and their combination with somatic manifestations of depression in patients with anemia of 2d and 3d grade.

[Quality of life and iron metabolism in patients with anemic syndrome developed on the background of chronic heart failure].

The presence of concomitant anemia in many aspects defines an unfavorable course of chronic heart failure, affects patient's quality of life. Among anemic patients with chronic heart failure prevailed persons with a relative deficiency of iron. Aim of the study - to evaluate the quality of life for patients with anemia on the background of chronic heart failure, using a questionnaire FACT-An, and to analyze the existence and nature of the relations between quality of life and indicators of the iron metabolism, based on the study of transferrin saturation and ferritin. Ferritin concentration was determined by ELISA. Transferrin saturation were determined by the formula. Questionnaire FACT-An was used for assess the quality of life in anemic patients with chronic heart failure. The presence of functional iron deficiency in patients with chronic heart failure and anemic syndrome is accompanied by deterioration of parameters of quality of life mainly due to the scale of physical activity and social functioning.

Improving biocompatibility of heart valve and vascular transplants by their devitalization and repopulation by recipient cells.

Inoculation of cells derived from the aorta of Wistar rats on devitalized porcine aortic walls 2-4-fold reduced their calcinosis after subcutaneous implantation to Wistar rats. Inoculation of Wistar rat bone marrow mesenchymal cells selected by adhesion activity did not reduce tissue calcinosis. The results indicate good prospects of repopulation of devitalized heart valve and vessel transplants by recipient vascular cells for reducing transplant calcinosis and improvement of their biocompatibility.