The work considers the causes of the coronary X syndrome development in women by assessing the experimental group and the control group with typical angina pectoris with angiographically altered vessels. Each group included 30 patients. When studingy medical records of the patients in the study group, we found out that in the reproductive period all of them had hyperestrogenemia, confirmed by the laboratory data, with the corresponding consequences in the form of various gynecological diseases, while the patients of the control group had unburdened gynaecological history. In terms of the lipid spectrum, the results turned out to be opposite. In the experimental group, the rates were within the normal range, and the control level of LDL-C significantly exceeded the required values. Despite the fact that estrogens increase the concentration of high density lipoprotein (HDL) in the blood and lower the content of low density lipoprotein (LDL) that are atherogenic, their surplus has a less negative effect than their lack, as the risk of developing atherosclerosis increases with decreasing concentration, and with an increase there is a risk of developing endothelial dysfunction, which provokes the development of coronary syndrome X. These date confirm the development of endothelial dysfunction in the patients of the experimental group with hyperestrogenemia in the history resulted from the impairment of the process of proliferation of endothelial cells with subsequent imbalance of secretion of biologically active substances. Among them, there is nitric oxide, which causes the relaxation of smooth myocytes, thus resulting in vasodilatation, and endothelins, providing the opposite, vasodilating effect. Prostacyclines and thrombomodulins secreted by the vascular endothelium in physiological conditions, counteract platelet aggregation. In the case of damage to the vascular wall, the production of prostacyclin and thrombomodulin is suppressed, but the release of thromboplastin, platelet activation factor and von Willerband factor activates that promote platelet aggregation and blood clotting. Under the participation of other physiologically active substances, selectins, endothelial cells promote adhesion to their surface and further penetration into the site of inflammation of neutrophils, blood acidophils. Selectin is accumulated in the cytoplasm of the endothelial cells in the form of specific electron-cellular inclusions, the so-called bodies of Weibel-Palade. Normally, vascular endothelium is impervious to blood components. However, being affected by a number of factors, and in particular histamine, endothelial cells lose contact with each other and decrease in number. This leads to the release of water and plasma proteins into the intercellular medium causing oedema. Due to the ability of the inner layer of vessels to produce a large number of biologically active substances, such changes can hardly be corrected by therapy.
CAUSES OF THE DEVELOPMENT OF CORONARY SYNDROME X IN WOMEN
