Solyeyko O. V., Kochan V. V., Suchań S. S., Chernykh M. O.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Ukraine takes one of the first places among European countries in terms of mortality from coronary artery disease (CAD). According to official statistics, there are more than 9 million patients with CAD in Ukraine, 36% of which are patients with angina pectoris. The course of coronary artery disease, along with traditional risk factors, significantly influenced by concomitant diseases and conditions of the third order, collagen abnormalities in particular, which includes non-differentiated dysplasia of connective tissue (NDCT). NDСT problem is of interest for cardiology because heart and blood vessels disorders are of the most common and clinically important NDCT manifestations. Aim of study — to analyze the nature of coronary arteries (CA) lesions in patients with chronical forms of CAD (CCAD) on the background of NDCT. Materials and methods. The study involved 120 patients aged 26 to 86 years (mean age (61,53 ± 1,07) years) with CCAD. Exclusion criterions were comorbid nosologies affecting the clinical features, course and development of Q-MI complications: hypertension, obesity (Quetelet index > 30 kg/m2), diabetes, other severe comorbidities (COPD, malignancies), mitral valve prolapse. All patients was performed general clinical, laboratory, anthropometric and coronary ventriculografy examinations. All patients were divided into 2 groups using a specially designed questionnaire to identify NDCT stigmas based on M. J. Glesby phenotypic map. The main group included 60 patients with 6 or more NDCT stigmas, the comparison group — 60 patients with a number of stigmas NDCT up to 5. Each group was divided into two subgroups. Ia subgroup included 30 patients with CCAD and postinfarction cardiosclerosis (Q-myocardial infarction) on the background of NDCT (with average number of stigmas 8,34 ± 0,92), and the Ib — 30 patients with CCAD on the background of NDST — (8.31 ± 0,74) stigmas. Accordingly, the IIa subgroup included 30 patients with CCAD and postinfarction cardiosclerosis without NDCT and IIb — 30 patients with CCAD without NDCT. Average number of atherosclerotic injured arteries in patients with CCAD on the background of NDCT (1,02 ± 0,33) proved to be significantly lower compared with patients with CCAD without NDCT (1,93 ± 0,22) (p<0,05). Also found that Ia subgroup patients had anterior interventricular branch of left CA significantly less often injured than comparison subgroup (p<0,05). Congenital CA anomalies revealed only in patients with CCAD on the background of NDCT. Congenital anomalies are CA agenesis of peripheral section of one of the CA, pathological tortuosity and muscle “bridges”. CA atherosclerotic lesions with stenosis ≤75% and local VA stenosis were identified significantly more often in patients with CCAD and postinfarction cardiosclerosis on the background of NDCT than in patients without NDCT (p<0.05). Hemodynamically insignificant local stenosis were detected in 2 patients (6.7%) of Ia subgroup and in 12 (40%) of Ib subgroup. In persons with CCAD on the background of NDCT a direct correlation of medium strength found (r=0,51; p<0,05) between the number of NDCT markers and CA local stenosis incidence. Thus, the presence of CA congenital anomalies in patients with NDCT should be considered as an additional risk factor for CAD.

chronic ischemic heart disease, coronary artery, non differentiated dysplasia of connective tissue

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«Bulletin of problems biology and medicine» Issue 2 part 1 (128), 2016 year, 112-115 pages, index UDK 616.12-005.4:616-018.2-007.17:612.13:575.21