Hemorheologic findings in patients with ischemic heart disease

The paper deals with the rheological properties of the blood of 38 male patients affected by ischaemic heart diseases (age: 40-75 years) and 19 healthy test persons of comparable age. The following haemorheological properties were measured. 1. Relative plasma viscosity 2. Erythrocyte aggregation 3. Erythrocyte deformability 4. Thrombocyte aggregation and 5. Whole blood viscosity. For the purpose of representing and assessing the results of measurement obtained a division was made into different groups according to the appearances of ischaemic heart disease (chronic ischaemic heart disease, unstable angina pectoris, acute heart infarct) and risk factors (smoking, diabetes mellitus, blood high pressure and hyperlipidaemia). The methods 1-3 proved to be especially suitable for representing gradual differences in the examined rheological parameters. The results obtained are discussed and evaluated.     

Activation of lipid peroxidation processes in chronic ischemic heart disease

The content of lipid peroxidation products--hydroperoxides with conjugated double bonds and fluorescent compounds, which are formed on interaction of primary lipid peroxidation products and proteins, considerably increases in blood plasma of patients suffering from coronary heart disease. Treatment with combined vitamins E and C enables the blood plasma lipid peroxidation products to be decreased to a far greater extent as compared with conventional therapy.     

Subpopulations of t lymphocytes in patients with ischemic heart disease

T-cells subpopulations were determined with theophylline test in 42 patients with the ischemic heart disease, including 31 patients with the history of myocardial infarction, and in 78 healthy volunteers. The patients' age was between 20 and 40 years and between 60 and 80 years. Defect of theophylline-sensitive fraction (suppressor T-cells and cytotoxically not specific lymphocytes in young patients has been observed. This defect gradually diminished with patients' age. Moreover, and increase in the percentage of theophylline-resistant fraction of the delayed rosettes, containing among other helper T-cells for the production of antibodies, and a decrease in the percentage of early rosette fraction containing precursor cells have been noted in the group of young patients. This defect is normalized in the group of older patients.     

Dehydroepiandrosterone sulfate and growth axis hormones in patients with ischemic heart disease

BACKGROUND: The present study aimed to determine whether decreases in dehydroepiandrosterone sulfate (DHEA-S) and growth axis components precede cardiovascular disease or are a consequence of it. METHODS: We measured the concentrations in serum of DHEA-S, ACTH, cortisol, growth hormone, insulin-like growth factor-1 and insulin-like growth factor-binding protein-3 in 30 male controls and also in 37 male patients on days 0, 2, 5, 7 and 9 after suffering a myocardial infarction (MI). RESULTS: There was no significant variation in any of these parameters between the controls and the patients on day 0. However, we found a significant (p < 0.001) reduction in the DHEA-S concentrations of the patients between day 0 and subsequent days (days 2, 5, 7 and 9). CONCLUSION: We conclude that the decrease in DHEA-S in patients with MI is a consequence and not a cause of the disease.     

Activity of selected proteinase inhibitors in patients with disorders of lipid metabolism]

The study was aimed at verification of previously found, in animals with experimentally induced atherosclerosis, the disturbances of serum proteinases inhibitors: alpha-2-antiplasmin, alpha-1-antitrypsin and alpha-2-macroglobulin. In humans with hypercholesterolemia the decrease of serum activity of alpha-2-antiplasmin was observed. In humans with hypercholesterolemia and increased serum concentration of triacylglycerols no significant changes in activity of alpha-1-antitrypsin and alpha-2-macroglobulin were found--in comparison with control subjects.     

Adaptive changes in the myocardium of patients with ischemic heart disease

Changes in the human heart muscle resulting from chronic coronary insufficiency have been analyzed using biopsies taken during surgery from nine patients with ischemic heart disease (IHD) and six patients with the WPW syndrome (without IHD). Histochemical analysis have shown that the atrial myocardium in IHD patients is characterized by an increased density of the microvascular network, increased phosphorylase activity, and decreased succinate dehydrogenase activity. Virtually the same changes have proved to occur in the myocardium of rats adapted to hypoxia by means of repeated exposure in a low-pressure chamber. According to the results of two-dimensional electrophoresis and immunoblotting, acid (but not alkaline) isoforms of inducible HSP70 proteins appear in the myocardium of IHD patients. It is concluded that the myocardium of IHD patients undergoes adaptive changes at the tissue level in response to repeated exposure to ischemia in the course of development of this disease. It is proposed that activation of the synthesis of alkaline HSP70 isoforms in the myocardium of cardiological patients may provide the possibility of improving its resistance to the impact of ischemia and reperfusion (this possibility is not realized under conditions of IHD).     

The dermatoglyphic characteristics of patients with ischemic heart disease]

The dermatoglyphic studies showing the existence of genetic predisposition to the development of coronary heart disease were conducted. Methods based on the mathematical theory of pattern recognition were used for multifactorial analysis of the material. It was established that complex evaluation of 20 dermatoglyphic parameters could be reliable in predicting genetic risk factor in the development of this cardiovascular pathology.     

Copper and ischemic heart disease

Absolute or relative deficiency of copper is hypothesized to be of prime importance in the etiology of ischemic heart disease. According to recent estimates, only 25% of the diets in the United States contain the 2 mg of copper thought to be required daily by adults. Some of these diets have ratios of zinc to copper greater than those that have produced hypercholesteremia in animals. There are many epidemiologic associations between the ratio of zinc to copper and dietary characteristics, organ analyses, clinical status, and environmental features that relate the metabolism of these elements to the anatomy, chemistry, pathology, pharmacology, and physiology of ischemic heart disease. Animals deficient in copper or exposed to a high dietary ratio of zinc to copper, which can produce a relative copper deficiency, are hypercholesteremic and hyperuricemic, and have glucose intolerance and abnormalities of the electrocardiogram. Their hearts and arteries have abnormal connective tissue, lipid deposits, and inflammatory changes; they die suddenly, often with ruptured hearts. Hypercholesteremia and glucose intolerance have been found in men depleted of copper and in children with Menkes’ disease, an inability to absorb copper.     

Properties of plasma low density lipoproteins in patients with hypertriglyceridemia and ischemic heart disease

It has been shown that low-density plasma lipoproteins in patients with ischemic heart disease and hypertriglyceridemia are heavier in density, smaller in size, more negatively charged and more inclined to peroxide modification and aggregation than in healthy persons. The protein in the composition of such lipoproteins deviates towards the water phase, which may result in the masking of the domen, recognized by the BE-receptor and may lead to hyperlipidemia of a retaining character.     

Low density lipoprotein metabolism in hypertriglyceridemic and normolipidemic patients with coronary heart disease

The turnover rates of low density lipoprotein-apolipoprotein B (LDL-apoB) were determined in 32 men with coronary heart disease (CHD) and 11 control men with normal plasma lipids. Thirty patients with CHD had normal levels of LDL-cholesterol (LDL-C); of these patients, 9 had hypertriglyceridemia and 21 had normal plasma lipids. Mean concentrations of total cholesterol and LDL-C were similar among the control subjects and CHD patients, although the latter had significantly lower HDL-C. In control subjects, transport rates and fractional catabolic rates (FCR) of LDL-B were 10.6 +/- 0.5 (SEM) mg/kg-day and 0.31 +/- 0.01 pools/day, respectively. In 10 hypertriglyceridemic patients with CHD, transport rates were 21.7 +/- 1.7 mg/kg-day, and FCRs averaged 0.56 +/- 0.06 pools/day; both were significantly higher than normal (P less than 0.05). Six normolipidemic patients also had abnormally high transport rates of LDL-apoB (19.4 +/- 2.8 mg/kg-day) and FCRs (0.51 +/- 0.03 pools/day); again both were higher than normal. The remaining 16 normolipidemic patients with CHD had normal transport rates (9.9 +/- 0.6 mg/kg-day) and FCRs (0.28 +/- 0.01 pools/day). Thus, hypertriglyceridemic patients with CHD and a portion of normolipidemic patients with CHD were characterized by increases in both transport and fractional catabolic rate of LDL-apoB; these abnormalities in LDL metabolism may have contributed to their coronary heart disease. However, the majority of normolipidemic patients with CHD did not show a distinct defect in their LDL metabolism.     

2型糖尿病伴冠心病患者肠道菌群分布及其与糖、脂代谢指标的相关性

探讨2型糖尿病伴冠心病患者肠道菌群分布及其与糖、脂代谢指标的关系,为该类患者的治疗提供参考。

选取2021年1月至2021年12月我院收治的2型糖尿病伴冠心病患者50例作为试验组,选择50例同期在我院体检的健康人作为对照组,比较2组对象基本资料、肠道菌群分布（肠杆菌、肠球菌、双歧杆菌、拟杆菌、乳杆菌）、糖代谢指标[空腹血糖（FPG）、糖化血红蛋白（HbA1c）、空腹胰岛素（FINS）]水平、脂代谢指标[甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）]水平,分析肠道菌群分布与糖、脂代谢指标的相关性。

2组对象年龄、性别、体质量指数、收缩压、舒张压、吸烟史、高血压史比较差异均无统计学意义（均P＞0.05）。试验组患者肠道肠杆菌、肠球菌数量均高于对照组,双歧杆菌、拟杆菌、乳杆菌数量均低于对照组（均P＜0.05）。试验组患者FPG、FINS、血清HbA1c水平均高于对照组（均P＜0.05）。试验组患者血清TC、TG、LDL-C水平均高于对照组,而血清HDL-C水平低于对照组（均P＜0.05）。试验组患者肠道肠杆菌、肠球菌与FPG、HbA1c、FINS、TC、TG、LDL-C水平均呈正相关,与HDL-C均呈负相关（均P＜0.05）;而肠道双歧杆菌、拟杆菌、乳杆菌与FPG、HbA1c、FINS、TC、TG、LDL-C均呈负相关,与HDL-C均呈正相关（均P＜0.05）。

2型糖尿病伴冠心病患者肠道肠杆菌、肠球菌数量升高,双歧杆菌、拟杆菌、乳杆菌数量降低,且肠道菌群数量与糖、脂代谢指标具有显著相关性。

     

Gene:environment interaction in lipid metabolism and effect on coronary heart disease risk

Both genetic and environmental factors influence coronary heart disease, therefore studies of coronary heart disease risk are often confounded by gene:gene and gene:environment interactions. Such interactions imply that at the molecular level there is synergy between the gene products or with the by-products of the environmental insult, resulting in a greater than additive effect on risk. Genetic risk is thus modifiable in an environment-specific manner. This review focuses on recently reported effects of smoking (environmental factor) on the impact of variation in the genes for glutathione S-transferase, paraoxonase and apolipoprotein E on the risk of coronary heart disease and effects on intermediate lipid traits. We end on a cautionary note for the need for repeat studies to confirm these reported gene:environment effects.     

Adherence to cardioprotective medications and mortality among patients with diabetes and ischemic heart disease

Background

Atrial electrical remodeling has been shown to influence the outcome the outcome following cardioversion of atrial fibrillation (AF) in experimental studies. The aim of the present study was to find out whether a non-invasively measured atrial fibrillatory cycle length, alone or in combination with other non-invasive parameters, could predict sinus rhythm maintenance after cardioversion of AF.

Methods

Dominant atrial cycle length (DACL), a previously validated non-invasive index of atrial refractoriness, was measured from lead V1 and a unipolar oesophageal lead prior to cardioversion in 37 patients with persistent AF undergoing their first cardioversion.

Results

32 patients were successfully cardioverted to sinus rhythm. The mean DACL in the 22 patients who suffered recurrence of AF within 6 weeks was 152 ± 15 ms (V1) and 147 ± 14 ms (oesophagus) compared to 155 ± 17 ms (V1) and 151 ± 18 ms (oesophagus) in those maintaining sinus rhythm (NS). Left atrial diameter was 48 ± 4 mm and 44 ± 7 mm respectively (NS). The optimal parameter predicting maintenance of sinus rhythm after 6 weeks appeared to be the ratio of the lowest dominant atrial cycle length (oesophageal lead or V1) to left atrial diameter. This ratio was significantly higher in patients remaining in sinus rhythm (3.4 ± 0.6 vs. 3.1 ± 0.4 ms/mm respectively, p = 0.04).

Conclusion

In this study neither an index of atrial refractory period nor left atrial diameter alone were predictors of AF recurrence within the 6 weeks of follow-up. The ratio of the two (combining electrophysiological and anatomical measurements) only slightly improve the identification of patients at high risk of recurrence of persistent AF. Consequently, other ways to asses electrical remodeling and / or other variables besides electrical remodeling are involved in determining the outcome following cardioversion.