Development Of Cardiovascular Pathology Research Articles

Comparison of arterial stiffness index predictors in perimenopausal and postmenopausal women

ABSTRACT The present cross-sectional study aimed to compare climacteric symptoms and arterial stiffness indices between perimenopausal and postmenopausal women. The study sample comprised 70 healthy female participants, including 27 perimenopausal (49.8 ± 3.8 years) and 43 postmenopausal (55.7 ± 4 years) individuals. Validated methods were used to assess physical activity level, quality of life, climacteric symptoms, and anthropometric data. Arterial stiffness parameters were measured using Mobil-O-Graph. Pulse wave velocity (PWV) had a higher mean in the postmenopausal group than in the perimenopause group [8.04 m/s (SD 0.79) vs 7.01 m/s (SD 0.78), p < .001). PWV was strongly correlated with peripheral (r = 0.619) and central (r = 0.632) Systolic Blood Pressure (SBP) in postmenopausal group and an even stronger correlation was observed in perimenopausal group (r = 0.779 pSBP and 0.782 cSBP). BMI was a risk predictor in the perimenopausal group contributing positively to increase Pulse Pressure Amplification (PPA) (0.458, p < .05). In postmenopausal women, heart rate (HR) was a stronger predictor for central SBP, cardiac output, and total vascular resistance, whereas perimenopausal women HR influenced central diastolic blood pressure and PPA. Vascular changes initiating during perimenopause may contribute to the development of cardiovascular pathologies in the postmenopausal period. Further research with larger, representative samples is warranted to corroborate these findings.

PRIMARY PREVENTION OF CARDIOVASCULAR DISEASES AND WAYS OF IMPROVING RISK ASSESSMENT OF THEIR DEVELOPMENT IN CLINICAL PRACTICE

Introduction. Cardiovascular diseases are a global problem and one of the main causes of death worldwide. Aim. To highlight and analyze modern approaches to the use in routine practice of risk factors for the development of cardiovascular pathology, which is appropriate for further clinical decision-making based on a meta-analysis of literary sources, clinical guidelines and the results of multicenter studies. Materials and methods. The search and selection of publications, systematic reviews and current recommendations is carried out using PubMed and Google Scholar databases, their detailed analysis and description. Results and discussion. The article provides data on primary prevention, which includes assessment and implementation of measures to reduce the overall risk of developing cardiovascular diseases in patients. Methods for assessing individual total or relative risk (use of SCORE and SCORE 2 scales, various risk calculators, etc.) taking into account the level of cholesterol and its various fractions are given. The importance of taking into account additional independent risk factors for the development of cardiovascular diseases is also considered. The possibility of taking into account the level of lipoprotein (a), high-density lipoprotein, and high-sensitivity C-reactive protein to improve the accuracy of predicting cardiovascular risk is discussed. Attention is paid to the possibility of using such "non-metabolic" factors as environmental pollution, psychosocial stress and stressful conditions, sleep disorders and obstructive sleep apnea syndrome, family history and genetic factors to change the risk category. Conclusions. The results of the conducted analysis prove that the given methods and importance of detection of subclinical atherosclerosis especially in patients with low or medium (marginal) cardiovascular risk. The use of both primary and secondary risk factors may be appropriate to inform decisions about changes in the calculated risk of such patients, the use and effectiveness of specific cardiac treatments, and the implementation of preventive measures such as statin therapy.

New coronavirus infection COVID-19 as a predictor of the cardiovascular pathology development in health care workers

New coronavirus infection COVID-19 as a predictor of the cardiovascular pathology development in health care workers

Hyperprolactinemia of various genesis in premenopause: effect on cardiovascular risks, a practical aspect

The pathological aspects of hyperprolactinemia have been well studied to date and primarily affect changes in the reproductive system. Regardless of the genesis of hyperprolactinemia, negative changes include, first of all, dysmenorrhea and hyperan drogenism. Changes in the mammary glands include galactorrhea, mastopathy, and the development of breast cancer. The pathological effects of hyperprolactinemia on other organs and systems, including the cardiovascular system, have been studied less. Few existing studies suggest that elevated prolactin levels can potentially affect cardiovas cular risks and provoke myocardial remodeling, arterial hypertension, hyperhomocys teinemia, and disorders of the plasma lipid profile. Menopausal women are particularly vulnerable in this regard, as the cardioprotective role of estrogens is significantly re duced during this period. In this article, we examined the effect of hyperprolactinemia on the formation of cardiovascular disorders in premenopausal women. The purpose of the study was to evaluate the effect of hyperprolactinemia on the genesis of cardiovascular pathology in premenopausal women. Materials and methods: three groups of premenopausal patients were examined. The patients of the first group (n=26) had previously been diagnosed with pituitary adenoma and were treated with cabergoline, maintaining the target prolactin level for at least two years. According to pituitary MRI, prolactinoma and elevated prolactin levels were de tected in the patients of the second group (n=21), but these patients did not take prolac tin-lowering therapy for various reasons. The third group consisted of the patients with idiopathic hyperprolactinemia who did not receive prolactin-lowering therapy (n=19). The patients of all three groups underwent general clinical examination, determination of the daily blood pressure profile, ECG, echocardiography, determination of the level of lipidogram, homocysteine, and other markers of cardiovascular risk. The results of the study showed that regardless of its genesis, pathological hyperprolactinemia influences the development of cardiovascular pathology in premenopausal women.

Therapeutic combination of "keys" to target low-density lipoprotein cholesterol level

This article updates the continuing high prevalence of lipid metabolism disorders and their connection with the development of cardiovascular pathology associated with atherosclerosis. Attention is focused on the existing lack of adherence to the correction of dyslipidemia, both on the part of patients and medical workers, as well as the problem of failure to achieve target levels of low-density lipoprotein cholesterol with standard statin treatment. The evolution of modern therapy for lipid metabolism disorders is shown and the feasibility of early initiation of combination treatment in patients with very high and high cardiovascular risk in the presence of severe dyslipidemia is substantiated, and possible treatment strategies existing in current recommendations are outlined. In the presented work, using the example of an outpatient 54 years old after undergoing stenting of the coronary arteries, who has a very high cardiovascular risk (established diagnoses of coronary heart disease, post-infarction cardiosclerosis, hypertension) with failure to achieve the target level of low-density lipoprotein cholesterol of less than 1.4 mmol/l The therapeutic effectiveness of a double combination – an inhibitor of cholesterol absorption in the intestine – ezetimibe at a dose of 10 mg with a statin at the maximum tolerated dosage was demonstrated. It has been shown that the proposed combined lipid-lowering treatment is clinically and laboratory safe. Arguments in favor of starting combination treatment in this clinical case include not only the failure to achieve the target value of low-density lipoprotein cholesterol on high-intensity statin monotherapy as part of secondary prevention and possible familial hypercholesterolemia, but also a hereditary history of cardiovascular pathology, early onset of cardiovascular diseases in patient.

Changes in energy metabolism of rat myocardium during exposure to ionizing radiation

Objective. To study the effect of incorporated 137Cs on the energy metabolism of the myocardium of white rats. Materials and methods. The work was carried out on 8 male white rats divided into 2 experimental groups, which were fed products contaminated with 137Cs for 7 days. Polarography was used to study the rate of oxygen consumption by myocardial tissue preparations on endogenous substrates, with the addition of exogenous succinic and glutamic acids, and with the addition of an uncoupler of oxidative phosphorylation, 2,4-dinitrophenol.Results. An increase in the rate of respiration on endogenous substrates caused by the uncoupling of oxidative phosphorylation was noted. At the same time, no statistically significant change in the amount of endogenous substrates was found. Conclusion. The revealed violation of energy production in the myocardium of experimental animals is caused by the uncoupling of oxidative phosphorylation, and can be explained by a change in the operation of potassium channels, which can explain the development of cardiovascular pathology under the action of ionizing radiation.

Improvement of quality of life indicators in patients with metabolic syndrome after correction of hemodynamically significant coronary stenoses and dyslipidemia

It is known that metabolic syndrome is currently the leading cause of the development of cardiovascular pathology, which occupies a leading position in the structure of mortality not only in the Russian population, but also in the world. The prevalence of MS is growing, which is associated with stressful professions, eating disorders. The presence of MS is associated with arterial hypertension and atherosclerosis of the arteries of any localization. In this regard, the purpose of our study was to study the quality of life in patients with MS, depending on the severity of coronary atherosclerosis. Materials and methods: The study included 239 patients (142 men, 97 women) with MS with atherosclerosis of the coronary and carotid arteries. The number of subjects in group 1 (n=141), of which 101 were men and 40 were women. The second group consisted of 84 male and 14 female patients (n=98). The control group consisted of 70 people (27 men, 43 women) with grade 1-3 hypertension. The age of the subjects was 31-56 years. All patients underwent: collection of complaints and anamnesis, assessment of body mass index (BMI); determination of the lipid spectrum, blood glucose, glycated hemoglobin. Microalbuminuria and glomerular filtration rate were determined. Instrumental studies were carried out: ultrasound examination of brachiocephalic vessels with determination of the thickness of the intima-media complex and the percentage of carotid artery stenosis; coronary angiography on the General Electric Innova 3100 angiographic complex. Based on the results of coronary angiography, the patients were divided into two subgroups: group 1 - with coronary artery stenosis of less than 50% (n=141), group 2 - with stenosis of 50% or more (n=98), group 3 (control) without stenotic lesions of the coronary arteries. A non-specific questionnaire “SF-36 Health Status Survey” was used to assess the quality of life. Results: assessing physical functioning and mental health, there was a significant decrease in these indicators in patients of group 2, in whom, according to coronary angiography, hemodynamically significant coronary artery stenoses were diagnosed, a strong correlation (r=0.730; p=0.005) was revealed between deterioration in quality of life and hemodynamically significant stenosis of the carotid and coronary arteries. Restriction of physical activity and reduction of daily activities were more significant in group 2 compared to groups 1 and 3. The feeling of uncertainty with restless expectation and fears, as well as a feeling of depression prevailed in men. However, patients after percutaneous coronary intervention, as well as with lipidogram correction, assessed the quality of life with some restriction of physical activity, but with significant social functioning. Conclusions: hemodynamically significant atherosclerosis of the carotid and coronary arteries is a predictor of deterioration in the quality of life, especially in men. The use of the international questionnaire “SF-36 Health Status Survey” is appropriate for assessing the health and vital activity in patients with MS and hypertension, with signs of atherosclerosis. The interaction of a cardiologist, an endocrinologist and a psychotherapist are justified for the most optimal management of patients with comorbid pathology.

Lipoprotein dysfunction in patients with chronic kidney disease (CKD). Pathogenesis and treatment of CKD dyslipidemia (literature review)

Dyslipidemia develops in the initial stages of chronic kidney disease (CKD) and worsens as nephropathy progresses. The main manifestation of dyslipidemia is hypercholesterolemia, especially in nephrotic syndrome. However, with CKD of stages 4-5, it is replaced by hypertriglyceridemia in combination with an increase in blood levels of lipoproteins low and very low density. Such changes are closely related to the development of cardiovascular pathology with high mortality. The content of high-density lipoproteins (HDL) in the blood is gradually decreasing, as well as the reversible transport of cholesterol. Thus, their anti-atherogenic, antioxidant and anti-inflammatory functions are lost. The main components of HDL – apolipoproteins ApoA-I and ApoA-II, which provide functionality, are replaced by acute-phase proteins, and HDL lose their cardioprotective potential and acquire a proinflammatory and proatherogenic phenotype. According to modern concepts, HDL dysfunction, along with metabolic shifts, is largely due to epigenetic disorders affecting gene expression and partially eliminated by prescribing drugs containing microRNAs (mRNAs) or antisense nucleotides. Drugs with interfering RNAs created in recent years have been successfully used not only for the treatment of dyslipidemia in nephrological patients, but also in patients with neoplastic processes, inflammatory arthritis, degenerative diseases of the central nervous system, porphyria, hemophilia and many other diseases. The proposed review is devoted to the mechanisms of disorders of the structure and functions of HDL in patients with CKD and the correction of these disorders.

Lipid spectrum of cell membranes and blood plasma in adolescents with recurrent cephalgia associated with arterial hypertension. Methods of correction

Purpose. To study the characteristics of the content of neutral lipids and phospholipid fractions in the membranes of erythrocytes and blood plasma of adolescents with cephalalgia and arterial hypertension (AH). Materials and methods. Subject of the study – adolescents 12–17 years old (boys and girls) with cephalgia and the presence of AH (main group) and without AH (comparison group). Methods: questionnaires, laboratory, statistical. Examination program: verification of the clinical form of cephalgia (episodic, chronic); assessment of the presence of AH (using percentile tables, taking into account age, gender and height percentile); determination of the concentration of neutral lipids and phospholipid fractions in blood plasma and erythrocyte membranes using thin layer chromatography. Results. Of the 64 examined adolescents – patients of the pediatric department with recurrent cephalgia, the frequent (chronic) form of cephalgia was verified in 40 (62.5%) people, AH was diagnosed in 10 (25.0%) adolescents with chronic cephalgia and in 30 (75.0%) adolescents with this form of cephalalgia AH were not identified. Features of the lipid spectrum of adolescents with a chronic form of cephalgia associated with AH included a lower concentration of total lipids and triglycerides in erythrocyte membranes, higher values of the general phospholipids/free cholesterol ratio and a smaller number of statistically significant correlations. Conclusion. The features we identified in the lipid spectrum of erythrocyte membranes and blood plasma in adolescents with a frequent (chronic) form of cephalalgia associated with AH may indicate the presence in adolescents of initial minimal changes in the biochemical status of cell membranes at the stages of development of cardiovascular pathology – hypertension and coronary heart disease.

Redox-signalling and Redox Biomarkers in Cardiovascular Health and Disease.

Overproduction of reactive nitrogen and oxygen species (RNS and ROS) has been linked to the pathogenesis of diabetes, hypertension, hyperlipidemia, stroke, angina, and other cardiovascular diseases. These species are produced in part by the mitochondrial respiratory chain, NADPH oxidase, and xanthine oxidase. RNS and ROS both contribute to oxidative stress, which is necessary for the development of cardiovascular disorders. In addition to ROS species like hydroxyl ion, hydrogen peroxide, and superoxide anion, RNS species like nitric oxide, peroxynitrous acid, peroxynitrite, and nitrogen dioxide radicals have also been linked to a number of cardiovascular conditions. They promote endothelial dysfunction, vascular inflammation, lipid peroxidation, and oxidative damage, all of which contribute to the development of cardiovascular pathologies. It's crucial to understand the mechanisms that result in the production of RNS and ROS in order to identify potential therapeutic targets. Redox biomarkers serve as indicators of oxidative stress, making them crucial tools for diagnosing and predicting cardiovascular states. The advancements in proteomics, metabolomics, genomics, and transcriptomics have made the identification and detection of these small molecules possible. The following redox biomarkers are notable examples: 3-nitrotyrosine, 4-hydroxy-2-nonenal, 8- iso-prostaglandin F2, 8-hydroxy-2-deoxyguanosine, malondialdehyde, Diacron reactive oxygen metabolites, total thiol, and specific microRNAs (e.g. miRNA199, miRNA21, miRNA1254, miRNA1306-5p, miRNA26b-5p, and miRNA660-5p) are examples. Although redox biomarkers have great potential, their clinical applicability faces challenges. Redox biomarkers frequently have a short half-life and exist in small quantities in the blood, making them challenging to identify and measure. The interpretation of biomarker data may also be influenced by confounding factors and the complex interplay of various oxidative stress pathways. Therefore, in-depth validation studies and the development of sensitive and precise detection methods are needed to address these problems. In the search for redox biomarkers, cutting-edge techniques like mass spectrometry, immunoassays, and molecular diagnostics are applied. New platforms and technologies have made it possible to accurately detect and monitor redox biomarkers, which facilitates their use in clinical settings. Our expanding knowledge of RNS and ROS involvement in cardiovascular disorders has made it possible to develop redox biomarkers as diagnostic and prognostic tools. Overcoming the challenges associated with their utility and utilizing advanced detection techniques, which will improve their clinical applicability, will ultimately benefit the management and treatment of cardiovascular conditions.

Clinical and functional features and quality of life in various phenotypes of occupational asthma

Purpose. To study the characteristics of the content of neutral lipids and phospholipid fractions in the membranes of erythrocytes and blood plasma of adolescents with cephalalgia and arterial hypertension (AH). Materials and methods. Subject of the study – adolescents 12–17 years old (boys and girls) with cephalgia and the presence of AH (main group) and without AH (comparison group). Methods: questionnaires, laboratory, statistical. Examination program: verification of the clinical form of cephalgia (episodic, chronic); assessment of the presence of AH (using percentile tables, taking into account age, gender and height percentile); determination of the concentration of neutral lipids and phospholipid fractions in blood plasma and erythrocyte membranes using thin layer chromatography. Results. Of the 64 examined adolescents – patients of the pediatric department with recurrent cephalgia, the frequent (chronic) form of cephalgia was verified in 40 (62.5%) people, AH was diagnosed in 10 (25.0%) adolescents with chronic cephalgia and in 30 (75.0%) adolescents with this form of cephalalgia AH were not identified. Features of the lipid spectrum of adolescents with a chronic form of cephalgia associated with AH included a lower concentration of total lipids and triglycerides in erythrocyte membranes, higher values of the general phospholipids/free cholesterol ratio and a smaller number of statistically significant correlations. Conclusion. The features we identified in the lipid spectrum of erythrocyte membranes and blood plasma in adolescents with a frequent (chronic) form of cephalalgia associated with AH may indicate the presence in adolescents of initial minimal changes in the biochemical status of cell membranes at the stages of development of cardiovascular pathology – hypertension and coronary heart disease.

Lipid spectrum of cell membranes and blood plasma in adolescents with recurrent cephalgia associated with arterial hypertension. Methods of correction

Purpose. To study the characteristics of the content of neutral lipids and phospholipid fractions in the membranes of erythrocytes and blood plasma of adolescents with cephalalgia and arterial hypertension (AH). Materials and methods. Subject of the study – adolescents 12–17 years old (boys and girls) with cephalgia and the presence of AH (main group) and without AH (comparison group). Methods: questionnaires, laboratory, statistical. Examination program: verification of the clinical form of cephalgia (episodic, chronic); assessment of the presence of AH (using percentile tables, taking into account age, gender and height percentile); determination of the concentration of neutral lipids and phospholipid fractions in blood plasma and erythrocyte membranes using thin layer chromatography. Results. Of the 64 examined adolescents – patients of the pediatric department with recurrent cephalgia, the frequent (chronic) form of cephalgia was verified in 40 (62.5%) people, AH was diagnosed in 10 (25.0%) adolescents with chronic cephalgia and in 30 (75.0%) adolescents with this form of cephalalgia AH were not identified. Features of the lipid spectrum of adolescents with a chronic form of cephalgia associated with AH included a lower concentration of total lipids and triglycerides in erythrocyte membranes, higher values of the general phospholipids/free cholesterol ratio and a smaller number of statistically significant correlations. Conclusion. The features we identified in the lipid spectrum of erythrocyte membranes and blood plasma in adolescents with a frequent (chronic) form of cephalalgia associated with AH may indicate the presence in adolescents of initial minimal changes in the biochemical status of cell membranes at the stages of development of cardiovascular pathology – hypertension and coronary heart disease.

Зміни експресії довгих некодуючих РНК H19, TUG1, GAS5, MIAT при ішемії-реперфузії міокарда

Long non-coding RNAs (lncRNAs) are the most numerous group of transcripts performing various functions, including the development of cardiovascular pathologies. We investigated the changes in expression of four long non-coding RNAs (H19, TUG1, GAS5, MIAT) under conditions of anoxia-reoxygenation in neonatal rat cardiomyocyte culture and ischemia-reperfusion in adult Wistar rats. A significant decrease in the expression of all four long non-coding RNAs in cell culture under experimental conditions was established. The regime of prolonged anoxia-reoxygenation led to a sharp increase in the expression level of long non-coding RNA MIAT by twice, but compared to normoxia, these changes were not significant. After ischemia-reperfusion in rat myocardium, the content of long non-coding RNA TUG1 increased by 22 times, while the expression of H19 decreased by 3.79 times, and in rat plasma, the expression of long non-coding RNA MIAT increased by 3.79 times. The obtained results allow considering long non-coding RNAs H19 and TUG1 as potential targets in ischemic myocardial injury, and MIAT as a biomarker of cardiovascular pathologies.

PATHOGENESIS OF IMMUNE DYSFUNCTION IN THE SETTING OF METABOLIK SYNDROME IN CORONARY HEAT DISEASE. QUALIFYING SCENTIFYING WORK ON THE RIGHTS OF THE MANUSCRIPT

PATHOGENESIS OF IMMUNE DYSFUNCTION IN THE SETTING OF METABOLIK SYNDROME IN CORONARY HEAT DISEASE. QUALIFYING SCENTIFYING WORK ON THE RIGHTS OF THE MANUSCRIPT

Role of chronic constipation in development of cardiovascular pathology

Today, constipation is one of the most important medical and social problems of world health. Its prevalence, according to various estimates, exceeds 30%. There is no doubt that this pathology precedes the occurrence of a number of diseases and not only of the gastrointestinal tract. For example, studies conducted at La Trobe University in Australia have shown a link between chronic constipation and the development of cardiovascular diseases. In the management of a patient suffering from chronic constipation, in addition to knowledge about the regulation of intestinal secretion and motility, recognition and possible elimination of the cause of its development, the choice of therapy tactics, taking into account concomitant diseases, especially in the presence of pathology from the cardiovascular system, is of great importance. In the treatment regimens, it is customary to use drugs with a laxative effect and different mechanisms of their action, allowing achieving a rapid positive effect in a short time.

Risk factors for the development of heart failure with a preserved left ventricular ejection fraction in workers of the main professions of the coal industry

Introduction. In the coal industry, 78.7% of employees work in places with harmful working conditions, which play a leading role in the development of not only professional, but also industrial diseases, the leading of which are diseases of the cardiovascular system. The identification of preclinical systolic dysfunction of the left ventricle and the assessment of the role of traditional and professionally determined risk factors for the development of systolic dysfunction of the left ventricle in workers of the main professions of the coal industry is of scientific interest.&#x0D; The study aims to assess the risk factors for the development of heart failure with a preserved left ventricular ejection fraction in workers of the main professions of the coal industry.&#x0D; Materials and methods. The study included 101 employees of the main professions of the coal industry and 80 employees of the paramilitary mine rescue unit. The subjects had no somatic pathology, which could lead to structural and functional changes of the heart. The scientists performed echocardiographic and ultrasound examinations of the main arteries according to standard methods and assessed the generally accepted risk factors for the development of cardiovascular pathology (smoking, abdominal obesity, body mass index, total cholesterol, triglycerides, high and low density lipoprotein cholesterol, glycated hemoglobin).&#x0D; Results. The researchers revealed systolic dysfunction of the left ventricle significantly in miners more often in the form of a decrease in longitudinal deformation (27.7% of miners versus 7.6% of paramilitary rescuers, p=0.0005), while its average value is also significantly lower in miners and has a value below the established norm (–17.2±0.044 and –19.3±0.03, p=0.0005). The authors found no significant differences in the frequency of commonly accepted risk factors: abdominal obesity, smoking, atherosclerosis of the main arteries, dyslipidemia and the level of glycated hemoglobin in miners and workers of the mine rescue unit, as well as in miners, depending on the index of longitudinal deformation of the left ventricle.&#x0D; Conclusion. The obtained results indicate the need for a prenosological diagnosis of systolic dysfunction of the left ventricle, studying it in dynamics and simultaneously expanding the search for risk factors, which will allow early prevention of this complication in workers in harmful working conditions.&#x0D; Ethics. The study was conducted in compliance with the standards of the Bioethical Committee of the Research Institute of Complex Problems of Hygiene and Occupational Diseases, established in accordance with the Helsinki Declaration of the World Association "Ethical Principles of Scientific Medical Research with Human Participation" as amended in 2013 and the "Rules of Good Clinical Practice" approved by Order of the Ministry of Health of the Russian Federation dated 01.04.2016 No. 200n. The subjects signed an informed consent to participate in the study.

Clinical and prognostic significance of left ventricular dysfunction predictors in patients with ventricular ectopy and without structural heart disease

Aim. To determine the predictors of left ventricular dysfunction in patients with ventricular ectopic beats without structural heart disease.Material and Methods. We modeled ventricular ectopy in rats through early afterdepolarization (aconitine-induced arrhythmia) and delayed afterdepolarization (adrenaline arrhythmia). In addition, we modeled ventricular ectopy in rabbits and cats by delayed afterdepolarization (barium chloride-induced and strophanthin arrhythmias, respectively) and also modeled ventricular ectopy in dogs by re-entry hydrogen peroxide-induced arrhythmia. In addition to conventional electrocardiography parameters, we analyzed pre-ectopic interval, its variability, and the internal deviation index. Further, the study included 514 patients aged 16 to 34 years (mean 21.2 ± 0.2 years), and the number of premature ventricular contractions (PVCs) per day of observation ranged from 6,157 to 37,254 (mean 19,706 ± 656 PVCs). We registered the same parameters as in experimental arrhythmias but calculated them separately for mono- and polymorphic, left and right ventricular out-flow tract arrhythmias. The duration of follow-up of patients was up to 10 years. The endpoint was the detection or absence of cardiovascular and/or extracardiac pathology.Results. We recorded polymorphic PVCs and early monomorphic PVCs when modeling ventricular arrhythmias by the mechanism of delayed post-depolarization and early post-depolarization, respectively. Both early and late monomorphic PVCs were documented when inducing ventricular arrhythmias by re-entry. When modeling hydrogen peroxide-induced and strophanthin arrhythmias, we observed significantly higher values of PVC-QRS complex and ventricular arrhythmia internal deviation index in comparison with aconitine-induced arrhythmia. Favourable outcome was registered in 50.97% of patients, whilst coronary artery disease, arterial hypertension, and mitral valve prolapse were documented in 7.98%, 16.73% and 2.92% patients. The rest of the patients had gastrointestinal diseases. In patients with favourable outcome, the signs of monomorphic PVCs correlated with those revealed during the modeling of ventricular ectopy by early afterdepolarization (r = 0.92), whereas those signs of polymorphic PVCs correlated with those observed at barium chloride-induced delayed afterdepolarization (r = 0.94). In patients with CAD, signs of PVCs correlated with those registered during re-entry hydrogen peroxide-induced arrhythmia (r = 0.93), Finally, in patients with arterial hypertension and mitral valve prolapse signs of PVCs correlated with those documented at strophanthin-(r = 0.92) and adrenaline-induced delayed afterdepolarization (r = 0.89). In these patients, the values for both monomorphic and polymorphic PVCs, ventricular arrhythmia internal deviation index, duration of PVC-QRS complex and PVC-QRS/QRSaverage did not exceed 0.42 units, 149 ms and 1,44 units, respectively. The development of coronary artery disease and arterial hypertension well correlated with an increase in ventricular arrhythmia internal deviation index ≥ 0.56 units and QRS complex duration ≥ 157 ms. Mitral valve prolapse was associated with the duration of the QRS complex ≥ 159 ms of polymorphic PVCs.Conclusion. In patients with ventricular ectopy but without structural heart disease, an increase in the values of ventricular arrhythmia internal deviation index and the duration of PVC-QRS complex was ≥ 0.48 units and 149 ms, respectively, associated with the development of cardiovascular pathology. Development of coronary artery disease and hypertension correlated with ventricular arrhythmia internal deviation index ≥ 0.56 units, and QRS complex duration ≥ 157 ms in monomorphic and polymorphic PVCs, whereas development of mitral valve prolapse correlated QRS complex duration ≥ 159 ms in polymorphic PVCs.

Immune system rejuvenation—approaches and real achievements

Interest in the mechanisms of aging of the immune system has not faded over the past 100 years, and it is caused by the immune-mediated development of age-related pathology, including autoimmune organ damage, reduced vaccination efficiency, atherosclerosis, the development of cardiovascular pathology, etc. In contrast to many other organs and systems, the immune system aging begins at an early age and has more pronounced changes that lead to the development of secondary pathology, which significantly affects life expectancy. But an effective strategy to restore immune function has not been developed yet. During this time, the mechanisms of age-related dysfunction of organs and cells of both the adaptive and innate immune systems were studied in detail—thymus involution, a decrease in the potential of hematopoietic stem cells, impaired differentiation and functions of immunocompetent cells, as well as the ways of their interaction. Numerous potential therapeutic targets have been identified and various approaches have been used to implement such therapeutic interventions. The review is devoted to replacement therapy using transplantation of hematopoietic stem cells (HSCs) and young lymphoid cells and tissues, cellular and systemic factor exchange in heterochronic parabiosis, and some other widely used life extension approaches. It has been proven that cell therapy using young cells to rejuvenate the old immune system, unfortunately, often turns out to be ineffective because it does not eliminate the root cause of age-related changes. The phenomenon of inflamm-aging that develops with age can significantly affect both the aging of the organism in general and the functioning of immunocompetent cells in particular. Therefore, the most promising direction in the restoration of immune functions during aging is systemic approaches that have a complex effect on the organism as a whole and can slow down the aging process.

Cardiotrophin-1 as a prognostic biomarker of cardiovascular complications in comorbid patients with hypertension and concomitant type 2 diabetes mellitus and obesity

Background. Since cardiovascular diseases (CVD) still occupy a leading place in the structure of mortality, the study of biomarkers that can be key in the diagnosis of early signs of the development of cardiovascular pathology continues. One such promising molecule is cardiotrophin-1 (CTF-1). The purpose of this study is to determinate of the circulating level of CTF-1 in comorbid patients with hypertension, and comparative analysis of its serum concentration in the presence of various comorbidities. Materials and methods. 111 patients with hypertension (men/women - 50/61) aged 54.37±1.18 and 20 persons of the control group were examined. In the process of careful examination and supervision of patients, they were divided into 4 groups depending on the presence of comorbid pathology in them: patients with AH- group 1 - 22 people; patients with AH + OB - group 2 - 30 people; AH+T2DM – group 3 – 31 people; patients with AH+T2DM + OB - group 4 - 28 people. Results. A direct correlation of CTF-1 level with weight, BMI, glycated hemoglobin level, SBP and DBP was established (p&lt;0.001). The data we obtained prove that CTF-1 can be a trigger for the occurrence of cardiovascular complications, since its level progressively increases with increasing severity of comorbid pathology, and its highest serum concentration is found in patients with hypertension with concomitant T2DM and obesity. Conclusions. The level of CTF-1 was significantly higher in patients with AH, T2DM, OB compared to patients with AH, patients with AH and OB, as well as with this indicator in the control group. The study of the relationship between the serum level of CTF-1 and metabolic and hormonal indicators in comorbid patients is a promising direction for further research.

Розлади ендотеліальної функції в дітей, які перехворіли на інфекцію COVID-19

Purpose - to learn the features of clinical condition and state of endothelial function as the marker of the development of cardiovascular pathology in children who suffered from COVID-19. Materials and methods. The research group consisted of 70 children aged 7-14 without chronic pathology who suffered from COVID-19 and had laboratory confirmation of the disease. Assessment of the functioning of the vessels’ endothelium was done by studying the dynamics of blood flow in the brachial artery and changes of it diameter at rest and during reactive hyperemia after an occlusion test. Statistical assessment of the obtained data was carried out by the application package «Statistica 10.0 for Windows» using the method of variational statistics. Student’s t-test was calculated to assess the reliability of mean values differences. Results. The state of endothelial function show that 85.4% of children after COVID-19 infection had signs of endothelial dysfunction, mainly hypoergic (32.9%) and paradoxical (30%) forms, while normoergic function of the endothelium was found only in 14.6% of children. In the same time in the group of children who did not suffer from COVID-19, was found that the normorergic form registrated in 80.0%, hyperergic endothelial dysfunction was found in 13.3% of children, and hypoergic - in 6.7% of children. Paradoxical endothelial dysfunction was not found in any child from this group. Conclusions. COVID-19 infection has negative consequences on the endothelium function and contributes to the development of endothelial dysfunction regardless of the severity of the disease course. Our results obtained the need of future study to develop an affordable and low-cost algorithm for routine use and identification of children with markers of lesion of cardiovascular system. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.