The purpose of this study was to assess the properties of left ventricular myocardial deformation in patients with coronary artery disease (CAD) with various degrees of coronary lesions. Methods and Results: The study included 74 patients with stable angina pectoris Class II-IV aged between 40 and 70 years. All patients underwent the following examinations: assessment of traditional risk factors, physical examination, general clinical and laboratory blood tests, 12-lead ECG, 24-hour ABPM, transthoracic echocardiography, two-dimensional speckle tracking echocardiography (STE), and coronary angiography (CAG). The SYNTAX score was calculated retrospectively according to the SYNTAX score algorithm. All patients were divided into 3 groups: Group 1 included 21 patients with a low SYNTAX score (0–22), for whom standard drug therapy was recommended; Group 2 included 28 patients with an intermediate SYNTAX score (23–32), to whom PCI was recommended; Group 3 included 25 patients with a high SYNTAX score (≥33), to whom CABG was recommended. Left ventricular ejection fraction (LVEF) obtained using the modified biplane Simpson's method was significantly lower in Group 3 than in Groups 1 and 2 (P=0.001); it should be noted that this indicator was within the normative values in Groups 1 and 2, and belonged to the gradation “mild dysfunction.” A more objective quantitative assessment of the contractile function of the LV myocardium was obtained by assessing the GLS and SR. The comparative analysis of the LV myocardial deformation properties in the three studied groups showed that in Group 3 the GLS and SR indicators were significantly lower than in Group 1 (P=0.000 and P=0.0020). Moreover, GLS (global longitudinal strain) and SR (strain rate) were significantly higher in Group 1 than in Group 2 (P=0.0001 and P=0.0133, respectively). GLS significantly correlated with LVEF (r=0.57; P<0.05), E/A (r=0.22; P<0.05), and SYNTAX score (r=-0.63; P<0.05). SR significantly correlated with LVEF (r=0.49; P<0.05) and SYNTAX score (r=-0.37; P<0.05) Conclusion: The results obtained indicate the diagnostic value of STE with the determination of GLS and SR in a comprehensive assessment of the severity of SAD. GLS and SR significantly correlate with the clinical course of the disease, as well as indicators of LV remodeling and LV diastolic dysfunction. STE analysis of GLS and SR has incremental diagnostic value over transthoracic echocardiography in predicting significant CAD.

The purpose of this study was to evaluate the prognostic value of HRV in elderly patients with multivessel coronary artery disease (MVCAD) on the background of invasive and non-invasive treatment. Methods and Results: This study included 254 patients over age 65 with lesions of the left trunk of the left coronary artery in combination with lesions of 2 or more coronary arteries. To assess HRV, all patients underwent 24-hour Holter ECG monitoring at baseline and one year later. Depending on the treatment strategy, patients were divided into 3 groups. Group 1 consisted of 99 patients who, in addition to the standard treatment, underwent PSI (from 1 to 4 stents); Group 2 included 86 patients who, in addition to the standard treatment, underwent CABG (from 2 to 4 shunts); Group 3 included 69 patients who received only optimal drug therapy (ODT). The results have shown that a decrease in HRV is an independent predictor of complications associated with an increase in coronary insufficiency in CAD patients. Such indicators of HRV as SDNN, SDNNi, TP, VLF, and LF have a significant positive predictive value in patients undergoing ODF and/or undergoing PCI. For patients undergoing CABG, at least in the first year after surgery, HRV cannot be considered as an independent prognostic marker. For elderly patients with MVCAD, 24-hour Holter ECG monitoring with subsequent analysis of HRV is recommended to assess the recovery process and pharmacotherapy.

There were examined 183 Uzbek patients with unstable angina. The basic group consisted of 125 patients with unstable angina (UA) and control group consisted of 58 healthy persons. Presence of CHD in family history among Uzbek patients with UA was associated with the accumulation of "damaging" alleles: "A" (M1-) G-A polymorphism of APOA1, "ε4" of APOE gene, and "D" I/D polymorphism of ACE gene. Meanwhile, there were no differences revealed in the frequency of carriage "T" allele of-516C/T polymorphism of APOB gene.

Изучить влияние семейного анамнеза ишемической болезни сердца (ИБС) на распределение полиморфизма генов аполипопротеинов (апо) А1, В и Е липид-транспортной системы и I/D полиморфизма гена ангиотензин-превращающего фермента (АПФ) у больных нестабильной стенокардией (НС) узбекской национальности. Материал и методы. Обследованы 125 больных узбекской национальности с НС из них I группа (гр.) (n=63) имела отягощенный семейный анамнез и II гр. (n=62) без отягощенного анамнеза. Гр. контроля-58 здоровых лиц. G-A полиморфизм гена апоA1,-516C/T полиморфизма гена апоB, ε2/ε3/ε4 полиморфизм гена апоE и I/D полиморфизм гена АПФ определяли с использованием набора реагентов Diatom TM DNA Prep 200 (производство ООО «Лаборатория ИзоГен»). Результаты. При изучении распределения «повреждающих» аллелей изучаемых генов среди больных НС в сравнении со здоровыми, выявлена большая распространенность носительства аллели А апоA1 (OР 3,63, 95% ДИ 1,63-8,04, p=0,002). При сравнительном анализе II гр. с гр. сравнения распределение «повреждающих» аллелей достоверно не различалось, тогда как в I гр. отмечалось достоверно большее накопление аллелей «А» G-A полиморфизма гена апоА1 (OР 5,99, 95% ДИ 2,52-14,24, р=0,001), аллели «ε4» гена апоЕ (OР 2,91, 95%, ДИ 1,12-7,62, р=0,044), аллели «D» I/D полиморфизма гена AПФ (ОР 2,88, 95% ДИ 1,33-6,27, р=0,024). При этом не было выявлено различий в частоте носительства «Т» аллели-516C/T полиморфизма гена апоВ. Заключение. Наличие семейного анамнеза ИБС среди лиц узбекской национальности с НС ассоциируется с накоплением «повреждающих» аллелей: «А» (М1-) G-A полиморфизма гена апоА1, «ε4» гена апоЕ, и аллели «D» I/D полиморфизма гена АПФ. При этом не выявлено различий в частоте носительства «Т» аллели-516C/T полиморфизма гена апоВ. Ключевые слова: нестабильная стенокардия, полиморфизм гена ангиотензин-превращающего фермента, семейный анамнез ишемической болезни сердца, комплекс интима-медиа.