Peculiar features of arterial hypertension state on the background of atherosclerosis (clinical and instrumental comparisons)

A comparative analysis of the clinical and functional state of patients with arterial hypertension (AH), depending on the presence or absence of arterial sclerotic disease of the arterial bed is represented. 2 groups of 110 and 60 patients respectively were formed. The 1st group included persons with arterial hypertension (AH) and atherosclerotic changes in the arterial bed, the 2nd — with hypertension and without any atherosclerotic changes. It is shown that patients with hypertension and stenotic changes of the vascular bed are characterized by an increase in the levels of diastolic blood pressure and indicators of systolic and diastolic pressure load during the day. They have signs of structural changes in the cardiovascular system, as proved by indicators of arterial stiff ness, myocardium remodeling, circadian rhythms of blood pressure abnormalities, and, in addition, kidney damage in a chronic form of disease, stage 2–3.On the contrary, hypertension without atherosclerotic changes of the vascular bed is characterized by higher values of systolic blood pressure, increased variability of systolic and diastolic blood pressure during the day, and, in addition, atherogenic dislipoproteinemia and hyperuricemy within the metabolic syndrome are present. As a clinical sign of atherosclerotic vascular changes in patients with hypertension, more “severe” blood pressure is observed. It requires combined antihypertensive therapy, consisting of 3 or more groups of medications.

Left ventricular noncompaction in children: clinical manifestations and prognosis

Left ventricular noncompaction (LVNC) is a disease of myocardium presumably caused by developmental arrest during embryogenesis. LVNC is characterized by the presence of pathological trabeculae in left ventricle. LVNC can be associated with different congenital heart diseases. Different types of myocardium remodeling are follows: dilated, hypertrophic, restrictive and mixed phenotypes. It is unclear whether LVNC is a distinct disease or a morphological feature of different cardiomyopathies. Distinction between pathological trabeculae constituting LVNC and normal phenotype is often difficult. For the time present the considerable attention is paid to the study of disease. Despite the progress in the study of the disease significant controversy remains around understanding of etiology, pathogenesis, clinical characteristics and prognosis of LVNC. Current literature review is aimed to discuss mentioned aspects with a focus on pediatric population.

Predictor value of the inflammation biomarkers regarding the post-infarction remodeling of myocardium

Aim.To study the trait of the changes of circulating level of pro- and antiinflammatory biomarkers as well as metalloproteinase 8 (MMP-8) in the first 7 days after revascularization in patients with acute myocardial infarction with ST segment elevation (STEMI) for assessment of their prognostic value regarding post-infarction remodeling pattern.Material and methods.In 113 patients with STEMI which developed in 5 months after angioplasty adaptive myocardium remodeling (AMR) (n=56) or pathological myocardium remodeling (PMR) (n=57), determined by enzyme-linked immunosorbent assay (ELISA) method daily serum concentration of pro-inflammatory ((high sensitive C reactive protein, interleukins (IL) 1, 6, tumor necrosis factor alpha and monocyte chemoattractant protein 1)), anti-inflammatory biomarkers (IL-4, IL-10, IL-33, IL-1 receptor antagonist and heregulin-1beta) аs well as ММР-8 in the first 7 days after myocardium revascularization. According to clinic-demographic indices both groups were comparable. Obtained data have been compared with results of 20 healthy persons (control group).Results.The dynamics of pro-inflammatory biomarkers did not differ in patients with AMR and PMR after revascularization. It was characterized by a significant biomarker increase at 3-rd day followed by a decline toward 7-th day up to initial level. Among anti-inflammatory biomarkers IL-4 and IL-10 have manifested by a distinct dynamic in concern to myocardial remodeling pattern. In both groups these interleukins decreased after angioplasty, reaching a minimal level at 3-rd day. However, in patients with AMR since 4-th day has been established an increase of serum content of IL-4 and IL-10, their increment being at 7-th day in a range of 52-55% (p<0,05). In patients with PMR the interleukins rise was negligible: 5,7-5,8%. MMP-8 dynamics also has been different in groups and was correlated with dynamics of IL-4 and IL-10. Thus, in patients with AMR its level has fallen since 4-th day up to 7-th day by 46,6%, while in group with PMR metalloproteinase level in this period practically did not change, remaining significantly higher than control by 45-53%.Conclusion.In our study the serum content of main pro-inflammatory biomarkers (hsCRP, IL-1, IL-6, TNF-ɑ) didn’t differ in the first 7 days after revascularization in patients with adaptive and pathological postinfarction remodeling of myocardium, and thus don’t have predictive value concerning the remodeling pattern. Among anti-inflammatory cytokines dynamics of IL-4 and IL-10 differed in dependence on remodeling pattern. Their significant elevation by 52-55% from 4th up to 7th day after angioplasty was established in patients with adaptive myocardium remodeling, while in PMR their level didn’t change during this period that can emphasize their prognostic value. The character of MMP-8 change is pathogenetically correlated with dynamics of IL-4 and IL-10.

Vitamin D deficiency and cardiovascular pathology

Vitamin D deficiency is widespread worldwide and present in about 30-50% of population. In most cases, this problem is associated with musculoskeletal system pathology: rickets in children, and osteomalacia or osteoporosis in adults. However, in recent years, convincing data was obtained on the links between vitamin D deficiency and cardiovascular pathology. Low Vitamin D levels in humans are associated with the unfavorable cardiovascular risk factors, such as arterial hypertension (AH), diabetes mellitus, and dyslipidemia, which are the predictors of the severe cardiovascular diseases, including strokes and infarctions. It has been demonstrated that vitamin D has a strong vasoptotective effect via endothelial dysfunction improvement, prevents blood vessels and myocardium remodeling, improves blood pressure parameters, reduces the risk of development of left ventricular hypertrophy, slows down fibrosis, reduces the risk of atherosclerosis, reduces insulin resistance, and also affects inflammation and immunity. This article provides data of Russian and foreign studies demonstrating the effect of Vitamin D deficiency on the development of atherosclerosis, AH, heart rhythm disorder and progression of chronic heart failure.

Phenylephrine-induced cardiac hypertrophy is attenuated by a histone acetylase inhibitor anacardic acid in mice

Cardiac hypertrophy is a complex process involving highly coordinated but tight regulation of multiple elements, such as in epigenetics, which make an important contribution to myocardium remodeling and cardiac hypertrophy.