Honchar O. O.

NITRIC OXIDE–PRODUCING ENZYMES AND SERUM CORTISOL LEVELS IN PATIENTS WITH Q-WAVE MYOCARDIAL INFARCTION DURING TREATMENT DYNAMICS

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About the author:

Honchar O. O.

Heading:

CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

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The search for new pharmacological strategies to mitigate ischemic myocardial injury remains one of the most critical challenges in modern cardiology. Particular focus is directed toward endothelial dysfunction, dysregulation of the nitric oxide (NO) system, and neurohumoral imbalance –specifically alterations in serum cortisol levels. A promising therapeutic direction involves evaluating the cardioprotective properties of anxiolytics, specifically temgicoluril, as a component of comprehensive targeted management for acute Q-wave myocardial infarction. This study aimed to evaluate the effect of incorporating temgicoluril into standard treatment protocols for patients with Q-wave myocardial infarction on the activity of nitric oxide synthase isoforms, serum concentrations of nitrites and peroxynitrites, and serum cortisol levels. The study evaluated 80 patients with acute myocardial infarction, stratified into groups based on the presence or absence of a Q wave, and further divided into subgroups according to the administration of temgicoluril at a dose of 500 mg three times daily for one month alongside guideline-based medical therapy and multidisciplinary cardiac rehabilitation. The control group comprised 20 healthy individuals. Serum activities of inducible (iNOS), endothelial (eNOS), and neuronal (nNOS) nitric oxide synthases were quantified spectrophotometrically by measuring the rate of L-citrulline accumulation. Serum levels of nitrites, peroxynitrites, and cortisol were likewise determined using spectrophotometric assays. Statistical analysis was performed using Microsoft Office Excel equipped with the Real Statistics 2019 add-in package (Charles Zaiontz; License CC BY 4.0). The results demonstrated that standard therapy for Q-wave myocardial infarction is accompanied by a significant suppression of excessive nitric oxide production alongside a reduction in serum cortisol levels. Concurrently, the addition of temgicoluril to the treatment protocol preserves total NO production through a more moderate modulation of inducible isoform (iNOS) activity and maintains optimal adaptive serum cortisol concentrations. Thus, the incorporation of temgicoluril into standard management protocols for patients with Q-wave myocardial infarction exerts a pathogenetically grounded modulating effect on the nitric oxide system and serum cortisol levels, offering new avenues to enhance myocardial cytoprotection and patient rehabilitation.

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Publication of the article:

«Bulletin of problems biology and medicine», 2026 Issue 3, 182, 253-258 pages, index UDC 616.127-005.8-085

DOI:

10.29254/2077-4214-2026-3-182-253-258