Govoruha O. Yu., Turitska T. G., Lapko К. Yu.

THE ROLE OF INFLAMMATORY PROCESSES IN ISCHEMIC HEART DISEASE TAKING INTO ACCOUNT RELATED RISK FACTORS

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About the author:

Govoruha O. Yu., Turitska T. G., Lapko К. Yu.

Heading:

CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

Annotation:

Cardiovascular diseases (CVD), despite modern diagnostic and treatment technologies, continue to lead the population in terms of prevalence, disability and mortality. Often, the etiological factors that trigger the single mechanisms of pathogenesis make it possible to consider atherosclerosis not as a nosological form of the disease, but as a syndrome. From these positions, it is proposed to consider the relationship between the atherosclerosis syndrome and the inflammatory syndrome. The aim of the work was to study the pathogenetic role of risk factors for cardiovascular diseases in the development of inflammation, the formation of lesions of coronary vessels and the course of cardiovascular pathology. Material and methods. The study included 424 patients of the Dnipropetrovsk Regional Clinical Center of Cardiology and Cardiosurgery (Dnipro) with cardiovascular diseases who underwent a general clinical examination (biochemical blood parameters, determination of insulin resistance, calculated the Caro index, HOMA indices, general analysis blood and urine; blood pressure, heart rate control, anthropometric studies were performed). Determination of acute phase proteins (orozomucoid, ceruloplasmin, alpha-1-antitrypsin, C-reactive protein, haptoglobin and C3 component of complement) was carried out by the method of radial immunodiffusion according to Manchin. The results. In patients with CHD, atherosclerotic lesions of coronary vessels are most interrelated with an increase in LDL (correlation index of LDL with CI=0.59). An increase in LDL in patients with coronary heart disease is accompanied by a significant increase in acute-phase proteins Hr, C3, ZR, CP, CRP and pro-inflammatory cytokines INF-γ, IL-6, IL-8, which indicates a mutually determined influence of lipid metabolism disorders and inflammation on the development of atherosclerosis. Hypercholesterolemia in patients with CVD was accompanied by an increase in CRP, α1-AT and a decrease in RR, C3 component of complement. Multiple lesions of the coronary vessels were also noted in the group of patients with concomitant type 2 diabetes and obesity. Instability of atherosclerotic plaques was more often found in patients with type 2 diabetes. The levels of BGF and proinflammatory cytokines in patients with coronary heart disease increased with concomitant hypertension and type 2 diabetes, with significantly maximum values of Hp, C3, RR, CRP, INF-γ, IL-6, and IL-8 in the presence of two risk factors. The relationship between lipid metabolism, carbohydrate metabolism and inflammation was confirmed by correlations: the atherogenicity index was correlated with CRP and IL-8; LDL – with IL-4, IL-8. The relationship between obesity and inflammation was confirmed by the correlation between the average BMI and IL-4, and the percentage of visceral adipose tissue and fibrinogen. The relationship between inflammation and carbohydrate metabolism disorders was indicated by high correlation indices of the level of stimulated glucose with TNF-α, IL-4, fasting insulin with CRP, the Саро index with fibrinogen, CRP, TNF-α, IL-6. Conclusions. Analysis of the relationship between inflammation and risk factors for cardiovascular diseases revealed an increase in the severity of subclinical inflammation against the background of concomitant dyslipidemia, type 2 diabetes, obesity, and arterial hypertension, which leads to multivessel damage of the coronary arteries, instability of atherosclerotic plaques, and determines the severity of the course of coronary heart disease and development of myocardial infarction with its complications.

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Bibliography:

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Publication of the article:

«Bulletin of problems biology and medicine», 2023 Issue 1, 168, 148-160 pages, index UDC 616.12-005.4-074

DOI:

10.29254/2077-4214-2023-1-168-148-160