Ukrainian Journal of Cardiology最新文献

{"title":"Dynamics of immunological indicators of blood in patients with chronic coronary artery disease in comparison with the development of cardiovascular episodes during long-term follow-up","authors":"O. Lomakovsky, M. Lutay, T. Gavrilenko, O. A. Pidgaina","doi":"10.31928/2664-4479-2022.3-4.714","DOIUrl":"https://doi.org/10.31928/2664-4479-2022.3-4.714","url":null,"abstract":"The aim – to assess the relationship between the dynamics of immunological and blood lipoproteid indicators in patients with chronic coronary artery disease and the development of cardiovascular episodes compared to patients with coronary artery disease without such episodes during 6.5 years of observation.Materials and methods. Patients with coronary artery disease with stable angina pectoris were divided into two groups: the first group (n=46) included patients without cardiovascular events during the observation period, the second group (n=36) included patients with the occurrence of such events within 6.5 years of observation. The material of the immunological study was peripheral venous blood. To determine the parameters of cellular and humoral innate and adaptive immunity in blood serum and supernatants of mononuclear cells, enzyme immunoassay was used.Results and discussion. Comparison of the dynamics of T-cell immunity: in the second and first groups, the dynamics of medians of T-suppressors (CD8) – from 22 to 33 (p=0.018) versus 27 to 33 % (p=0.10), the number of lymphocytes with a tendency to apoptosis in the second and first groups it was equal – from 18 to 27 (p=0.11) versus from 12 to 29 % (p=0.002). Between patients with the development of cardiovascular events compared with patients without them, the dynamics of median CRP, respectively, was from 6.7 to 7.8 (p=0.043) versus 3.2 to 3.8 mg/l (p=0.024), IL-6 in mononuclear cells – from 2239 to 5788 (p=0.47) vs. 2127 to 5544 pg/ml (p=0.005), IL-8 in mononuclear cells – from 2305 to 3536 (p=0.028) vs. from 1980 to 3820 pg/ml (p=0.0004), anti-inflammatory IL-10 in mononuclear cells – from 95 to 44 (p=0.69) vs. 220 to 68 pg/ml (p=0.97). Between patients of the second group, compared with the first, the dynamics of median levels of total cholesterol compared, respectively, from 6.9 to 6.0 (p=0.07) versus 5.9 to 6.5 mmol / l (p=0.15), triglycerides (TG) – from 2.2 to 1.1 (p=0.08) vs. 1.9 to 1.5 mmol/l (p=0.030), HDL cholesterol – from 1.15 to 1.28 (p=0.89) versus 1.10 to 1.40 mmol/l (p=0.0005), the dynamics of the median degree of peroxide modification of lipoproteins was from 7.1 to 2.6 (p=0.14) versus from 5.4 up to 3.1 conventional units (p=0.0008), free radical oxidation of proteins – from 3.3 to 5.0 (p=0.028) compared with 4.6 to 5.1 conventional units. (p=0.54).Conclusions. In patients with stable coronary artery disease, the activity of immune inflammation significantly increases for 6.5 years. The development of cardiovascular events is not accompanied by the peculiarities of the growth of immune inflammation indicators, the peculiarities of changes in the studied parameters of the humoral link of acquired immunity and the parameters of the phagocyte system in comparison with patients without such events. The occurrence of cardiovascular events is accompanied by greater activation of T-lymphocytes and a lower increase in the number of lymphocytes with a predisposition to apoptosis, ","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80165045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renin-angiotensin system: known scientific facts and modern conception of cardiometabolic effects","authors":"O. Kovalyova","doi":"10.31928/2664-4479-2022.3-4.4348","DOIUrl":"https://doi.org/10.31928/2664-4479-2022.3-4.4348","url":null,"abstract":"The article is devoted to review of published sources regarding the identification of renin-angiotensin system components and their trigger role in pathophysiological processes with transformation in cardiovascular diseases and metabolic dysfunction. Based on definition of biological effects the modern interpretation of the distribution the multifunctional complex in two parts as classical axis and non-classical axis of renin-angiotensin system is shown. The injure actions of classical axis of renin-angiotensin system with vasoconstriction, activation of proinflammatory cascade, oxidant stress, proliferative processes, violation of glucose and lipid homeostasis, cardiovascular remodeling, heart failure, insulin resistance, obesity are emphasized. The special attention is paid to the description of counterregulatory actions related to angiotensin ІІ of renin-angiotensin system alternative axis for protection of cardiovascular diseases, correction of metabolic disorders. Taking in account the results of experimental and clinical investigation is presented the argumentation for evaluation of agonists and antagonists relevant to alternative renin-angiotensin system components aimed to creation the novel class of pharmacological agents with future implementation in clinical practice.","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87136547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiotrophin-1 as a possible marker of myocardial remodeling in patients with essential hypertension, carrying polymorphic variants of the coding gene","authors":"M. O. Matokhnyuk, H. O. Palagniuk, S. Franchuk, V. Zhebel","doi":"10.31928/2664-4479-2022.3-4.3035","DOIUrl":"https://doi.org/10.31928/2664-4479-2022.3-4.3035","url":null,"abstract":"The aim – to improve the diagnosis of left ventricular remodeling in patients with essential hypertension (EH) by determining the concentration of cardiotrophin-1 (CT-1) in plasma in carriers of polymorphic variants of the CT-1 gene (rs8046707).Materials and methods. The study included 100 men aged 40–60, residents of Podillya with EH of varying severity. The first group included patients with stage II EH with a mean age of 50.62±0.73 years, and the second group included patients with EH complicated by chronic heart failure (CHF) with a mean age of 51.86±0.81 years. Structural and functional parameters of the myocardium were evaluated using ultrasound of the heart. Polymorphism of the CT-1 gene (rs8046707) was determined by the polymerase chain reaction method. Determination of the concentration of CT-1 was performed by enzyme-linked immunosorbent assay. Statistical analysis of the results was performed using the software package Statistica 10.0. All tests were bilateral, statistically significant differences were considered at p<0.05.Results and discussion. Carriers of GA+AA genotypes – 65.00 % (n=65) are significantly more often registered in men with EH of different severity than in GG genotype – 35.00 % (n=35) (p<0.05). It was found that in carriers of any polymorphic variant of the CT-1 gene, men with left ventricular hypertrophy (LVH) and chronic heart failure on the background of EH, concentric left ventricular hypertrophy (LVH) is most common. At the same time, the plasma level of CT-1 in EH is not only higher at higher left ventricular myocardial mass, but is also associated with the carrier of a certain variant of the coding gene. In particular, at EH the level of plasma concentration of CT-1 in eccentric left ventricular hypertrophy (ELVH) is probably higher in carriers of GA+AA genotypes of CT-1 gene (p<0.05). In EH with CHF, regardless of the polymorphism of the CT-1 gene, the concentration of this peptide in blood plasma in different variants of LV hypertrophy is higher than in patients with EH stage II (p<0.05).Conclusions. Thus, concentric LVH was significantly more common in men with EH stage II and EH with CHF carriers of polymorphic variants of the CT-1 gene. Men with stage EH II carriers of GA+AA genotypes had significantly higher levels of CT-1 in blood plasma with concentric LV hypertrophy (p<0.05). In the case of the development of chronic heart failure on the background of EH, the level of CT-1 in blood plasma when carrying any variant of the gene encoding it is higher than in EH stage II.","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"76 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86054349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"H-type of arterial hypertension: connection with atherosclerosis of carotid arteries","authors":"O. Rekovets, Y. Sirenko, O. Torbas, S. Kushnir","doi":"10.31928/2664-4479-2022.3-4.2229","DOIUrl":"https://doi.org/10.31928/2664-4479-2022.3-4.2229","url":null,"abstract":"The aim – determination of the relationship between arterial hypertension (AH) and hyperhomocysteinemia (H-Hcy) with the presence of atherosclerotic plaques in the carotid arteries.Materials and methods. Our research was carried out within the framework of the study HIPSTER in Ukraine. The study included 40 patients with I and II degrees of hypertension (average office systolic (SBP) / diastolic (DBP) BP – 155.88/92.60±1.63/1.43 mm Hg). The average age of the patients was 55.85±2.09 years. Patients with homocystein level ≥ 10 μmol/L were defined as patients with H-Hcy (H-type AH). The stiffness of blood vessels was determined by PWV. Patients were examined at the beginning, after 6 months of treatment. Determination of the presence of atherosclerosis of the carotid arteries was detected at the beginning and after 12 months.Results and discussion. We found that office blood pressure in patients with H-type hypertension at the beginning and after 6 months of treatment was higher compared to patients without hypertension (156.45±1.04 mm Hg vs. 152.55±1.41 mm Hg at the beginning (p<0.05) and 130.65±0.96 mm Hg versus 126.97±1.08 mm Hg after 6 months (p<0,05)). Patients with H-type AH compared to patients without H-Hcy had a more insulin resistance (HOMA index 4.27±0.18 vs. 3.20±0.24 units, p<0.05). Atherosclerotic plaques in carotid arteries were found in 56.7 % (n=17) of patients with H-type hypertension and in 40.0 % (n=4) of patients with hypertension without H-Hcy (p<0.05 between groups). Patients with H-type AH had a higher prevalence of carotid atherosclerosis – atherosclerotic plaque area measured by NASCET was 43.4 % vs. 26.7 %, p<0.05, and was greater than in patients with AH without H-Hcy. 3 patients (10.0 %) with H-type AH developed new atherosclerotic plaques after 12 months, and no patients from the AH group without H-Hcy. After regression analysis, homocysteine ​ was associated with PWV regardless of the reduction of blood pressure on the therapy, as well as with the level of LDL cholesterol and the presence of atherosclerotic plaques in the carotid arteries. Homocysteine ​​was associated with PWVel after treatment (β=0.307, р=0.001), LDL cholesterol level before treatment (β=–1.501, р=0.017), and the presence of atherosclerotic of plaques in carotid arteries after treatment (β=5.236, р=0.031).Conclusions. H-type of arterial hypertension was associated with the presence of atherosclerotic plaques of the carotid arteries.","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88449844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative characteristics of proximal and distal transradial approaches in clinical practice","authors":"S. V. Salo, O. Levchyshyna, A. Y. Gavrylyshyn, S. S. Shpak","doi":"10.31928/2664-4479-2022.3-4.3642","DOIUrl":"https://doi.org/10.31928/2664-4479-2022.3-4.3642","url":null,"abstract":"The literature review is devoted to the fact that for more than 30 years of the existence of vascular accesses in interventional cardiology, proximal and distal transradial, and the accumulation of knowledge about their advantages and disadvantages, there are still questions about the use of each of them in different clinical situations. Despite the dominance of the proximal transradial approach worldwide, which is associated with fewer potential complications and greater patient comfort compared to the transfemoral approach, more and more data are emerging about the advantages of the distal radial artery puncture. Our own experience, the foreign literature and different clinical studies comparing these two accesses gave us the opportunity to analyze the data we received and make a conclusion about the feasibility and safety of one or another arterial access.","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88921806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of risk factors, characteristic of the fatty acid spectrum of blood plasma and the state of providing medical care to patients with coronary heart disease – residents of various high-altitude zones of Transcarpathia","authors":"M. Rishko, M. Bychko, O. V. Ustych, A. Kedyk, O. O. Kutsin, I. Kogutych","doi":"10.31928/2664-4479-2022.3-4.1521","DOIUrl":"https://doi.org/10.31928/2664-4479-2022.3-4.1521","url":null,"abstract":"The aim – to identify risk factors and features of the clinical course of various forms of coronary heart disease in residents of the mountains and plains of the Carpathian region and to assess the effectiveness and scope of medical care for these patients.Materials and methods. 296 people were involved in the study, of which 105 were residents of mountain region and 191 were residents of plains. In patients who suffered myocardial infarction with and without elevation of the ST segment, the state of medical care was also evaluated. When examining patients, general clinical methods were used, anthropometric data were evaluated, total cardiovascular risk and cardiovascular risk were determined according to the SCORE scale, office blood pressure was measured, ECG was recorded, and lipid metabolism indicators were studied. In some patients with stable CAD, parameters of the fatty acid composition of blood plasma were assessed using the gas chromatography method.Results and discussion. The study compared two groups of patients: group 1 – patients with coronary artery disease living in mountainous areas (n=54); group 2 – patients with coronary artery disease living in a flat area (n=62). When comparing the fatty acid composition of blood plasma, significant differences were found between residents of plain and mountain region. Mountain dwellers compared to plain dwellers had statistically significantly higher levels of saturated myristic and stearic fatty acids, palmitoleic monounsaturated fatty acid, and two ω6-polyunsaturated fatty acids (γ-linolenic and digomo-gamma-linolenic fatty acids); these differences were found in the general comparison group and separately in the subgroups of men, people over 40 years old, in people with excess body weight or obesity (according to the body mass index), in people with abdominal obesity (according to the waist circumference indicator), who had at least one comorbid disease (hypertension, stable ischemic heart disease or type 2 diabetes). In mountain residents with excess body weight or obesity, the presence of type 2 diabetes or hypertension was also associated with lower levels of ω3-docosahexaenoic fatty acid.Conclusions. Higher levels of myristic fatty acid, ω6-andrenic fatty acid and lower levels of ω3-docosahexaenoic fatty acid in obese mountain people are likely predictors of the occurrence and progression of comorbid pathologies. When performing primary percutaneous coronary intervention, the mortality of patients with acute coronary syndrome does not depend on the region of residence (mountain, plain population). The further the catheterization center is located, the fewer patients undergo urgent primary percutaneous coronary intervention, which is associated with late diagnosis of acute coronary syndrome and, accordingly, with untimely transportation of the population to the catheterization laboratory. In order for patient transportation to take the least amount of time, catheterization centers shoul","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"37 8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82753609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supraventricular tachycardias: the underlying mechanisms and the choice of treatment options","authors":"O. Sychov, G. Solovyan, Т. V. Міkhalieva, S. V. Lyzogub","doi":"10.31928/1608-635x-2022.1-2.5771","DOIUrl":"https://doi.org/10.31928/1608-635x-2022.1-2.5771","url":null,"abstract":"The lecture is devoted to one of the most pressing problems of cardiology – the paroxysmal heart rhythm disorders in clinical practice. Supraventricular tachycardias (SVTs) is a common group of cardiac arrhythmias that requires a diagnostic search to establish the mechanisms of formation and selection of optimal treatment tactics. The basic principles of determination of SVTs and their electrophysiological mechanisms are reviewed. The clinical picture and ECG diagnostics of certain forms of tachycardia are outlined. The causes of wide QRS complex tachycardias, and electrocardiographic criteria for the differential diagnosis between ventricular and supraventricular tachycardias with conduction aberration are presented. The key aspects of the diagnosis of wide QRS complex tachycardias are discussed. The emergency care and long-term therapy for SVTs with narrow and wide QRS complexes are presented. According to updated 2019 ESC Guidelines for the management of patients with SVTs, the treatment options and the algorithms for the management of patients with SVT are shown. What should and should not be done? What’s new in 2019 Guidelines? The antiarrhythmic drugs and their use are given, and the principles of catheter treatment of tachycardia are stated.","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80757064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of three-year survival in hospitalized patients with atrial flutter","authors":"A. Aker, U. Chernyaha-Royko, M. Sorokivskyy, I. Tumak, Y. Ivaniv, O. Zharinov","doi":"10.31928/1608-635x-2022.1-2.5056","DOIUrl":"https://doi.org/10.31928/1608-635x-2022.1-2.5056","url":null,"abstract":"The aim – to estimate the survival analysis of patients with atrial flutter after index hospitalization during a three-year follow-up and to determine independent predictors of survival.Materials and methods. The one-center prospective study included 126 patients with various forms of AFL, among them 86 (68.3 %) men and 40 (31.7 %) women, the median age was 65.5 (quartiles 55–73) years. The median follow-up was 26 (quartiles 1–46) months after index hospitalization. Survival analysis was performed by Cox regression for continuous variables, also by estimating Kaplan – Meier curves and by χ2 for ranked variables (with more than 2 ranks) and using Cox’s F-test for binary variables.Results. During the three-year follow-up period 22 (17.5 %) patients died. The 36-months cumulative survival rate was 80.9 %. In multivariate Cox regression analysis presence of decreased left ventricular ejection fraction, left ventricular wall hypertrophy, previous episodes of AFL, hemodynamic instability during AFL and chronic kidney disease (p<0.05) were significant risk factors associated with mortality.Conclusion. The cumulative survival rate at 36 months of follow-up was 80.9 %. Independent predictors of poor survival are decreased left ventricular ejection fraction, left ventricular wall hypertrophy, presence of previous episodes of AFL, hemodynamic instability during AFL, chronic kidney disease.","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90454953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new paradigm of cardiohematological monitoring in patients with chronic myeloid leukemia taking tyrosine kinase inhibitors","authors":"N. Lopina, І. Dyagil, I. Dmitrenko, D. Hamov, D. Lopin","doi":"10.31928/1608-635x-2022.1-2.7286","DOIUrl":"https://doi.org/10.31928/1608-635x-2022.1-2.7286","url":null,"abstract":"Currently, significant progress has been achieved in patients with oncohematological diseases treatment, including chronic myeloid leukemia (CML). This is primarily associated with the development of targeted therapy named tyrosine kinase inhibitors (TKI) – imatinib, nilotinib, bosutinib, dasatinib, ponatinib, etc.). Along with the increased survival of patients with CML, special attention has recently been paid to cardiovascular complications in this group of patients due to the prevalence of cardiovascular diseases in the general population and the toxicity profile of targeted drugs. The article is devoted to the discussion of the cardiovascular risk-reducing strategy in patients with CML. The components of cardiovascular risk in patients with CML are described in detail, and current studies confirm the increased cardiovascular risk in this group of patients compared to the general population, which requires the widespread introduction of cardiovascular prophylaxis for patients with CML. The pathophysiology of the TKI effects on the cardiovascular system are presented, the profiles of cardiovascular toxicity of TKI are considered. The article proposes to implement two concepts in the strategy of cardiovascular prophylaxis in patients with CML – before the start of TKI therapy and during the TKI treatment. The article presents diagnostic measures before the TKI prescribing and for monitoring the TKI therapy, discusses the features of the TKI choice depending on concomitant conditions and diseases. Emphasis is made on the necessity of the risk stratification in patients with CML in accordance with general population algorithms, lifestyle modifications, statin therapy with the achievement of the targeted levels of cardiovascular markers in patients with CML. The article also presents unresolved issues of clinical recommendations and ways to further implement the strategy.","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87018116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Тhe link of T(–786)C аnd G894T polymorphisms of the endothelial NO-synthase gene with endothelial vasodilatory function and long-term clinical prognosis in patients with chronic heart failure and reduced left ventricular ejection fraction","authors":"L. Voronkov, I. D. Mazur, N. Gorovenko","doi":"10.31928/1608-635x-2022.1-2.4049","DOIUrl":"https://doi.org/10.31928/1608-635x-2022.1-2.4049","url":null,"abstract":"The aim – сhronic heart failure (CHF) is associated with endothelial dysfunction. The pivotal role of nitric oxide in the maintenance of endothelial function (EF) is well-known. But it is unknown whether endothelial nitric oxide synthase (eNOS) gene polymorphismis associated with both EF and clinical outcomes in systolic CHF.Materials and methods. 116 stable (NYHA II–III) ischemic CHF patients with left ventricular ejection fraction (LVEF)≤ 45 % were examined. Flow-mediated vasodilation (FMVD) of a. brachialis was carried out by standard cuff test. Patients were followed-up for a median of twenty months to determine long-term outcomes. The frequency of T(–786)C genotypes was: TT – 40.5 % (n=47), TC – 43.1 % (n=50), CC – 16.4 % (n=19); the frequency of G894T genotypes was: GG 56.0 % (n=65), GT 33.6 % (n=39), ТТ 10.4 % (n=12).Results and discussion. FMVD in patients with TT genotype of T(–786)C polymorphisms was 7.2 [4.7; 8.3] %, in patients with TC – 6.6 [4.4; 9.1] %, where as FMVD in patients with genotype CC was 4.7 [2.8; 6.0] %, p=0.034 for TT vs. CC; p=0.046 for TC vs. CC. FMVD in patients with GG genotype of G894T polymorphisms was 7.1 [4.3; 9.4] %, in patients with GT – 6.2 [5.1; 8.1] %, in patients with genotype TT was 4.2 [2.5; 5.3] %. The difference between FMVD was significant only TT vs. CC – p=0.030. The patients with CC genotype demonstrated a significantly higher heart failure hospitalization rate (log-rank 5.304, p=0.021) and higher cardiovascular (CV) mortality rate (log-rank 4.011, p=0.045) as compared with the TT homozygote group. LVEF, FMVD, and CC genotype were the predictors of CV mortality in univariate Cox regression analysis, and only LVEF and FMVD in multivariate Cox model. Long-term outcomes were similar in patients with GG, GT and TT genotypes of G894T polymorphisms.Conclusion. In stable ischemic systolic CHF CC T(–786)C eNOS genotype is associated with worse FMVD response and worse long-term outcome versus TT T(–786)C eNOS genotype. TT G(984)T eNOS genotype is associated with worse FMVD response only, but not with long-term outcomes versus GG G(894)T eNOS genotype.","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82155551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}