Cardiovascular system diseases (CSD)-is one of the most acute medical and social problems of modern society. Ischemic heart disease (IHD) and acute disturbance of cerebral circulation were and remain the leading cause of death and disability. At present, it has been established that in the progression of IHD and its complications, an increase in the level of homocysteine and deficiency of vitamin D are essential. Purpose of the study: to study the effect of hyperhomocysteinemia and deficiency of vitamin D on the course of atherosclerosis and ischemic heart disease. Materials and methods. The study analyzed laboratory data from 58 patients with atherosclerosis. Depending on the prevalence of atherosclerosis patients were divided into 2 groups. All those examined had vitamin D deficiency, as well as hyperhomocysteinemia. These changes were more pronounced in patients with multifocal atherosclerosis, which required a more thorough medication correction after surgical intervention on the coronary and carotid arteries. Results: Of practical interest is the analysis of blood plasma homocysteine concentration values depending on the localization of atherosclerotic lesion. In our study, in the first group, the median plasma homocysteine concentration was significantly higher. Moreover, there was a strong correlation between high concentrations of homocysteine and advanced atherosclerotic lesions. These results may indicate a possible destabilization of atherosclerosis course with hyperhomocysteinemia in combination with vitamin D deficiency. Patients of the first group with multifocal atherosclerosis had significantly higher homocysteine indices and a more pronounced vitamin D deficiency. No less important is the fact that in the examined patients both in one group and in the other group a significant vitamin D deficiency was detected. Conclusions. Hyperhomocysteinemia and vitamin D deficiency-are risk factors for the development of coronary heart disease and are associated with an unfavorable course of coronary pathology. All patients with ischemic heart disease had vitamin D deficiency and hyperhomocysteinemia, more pronounced with multifocal atherosclerosis, which should be considered when prescribing medication after myocardial revascularization.

Заболевания сердечно-сосудистой системы (ЗССС) – одна из самых острых медицинских и социальных проблем современного общества. В настоящее время установлено, что в прогрессировании ишемической болезни сердца (ИБС) и ее осложнений существенное значение имеет повышение уровня гомоцистеина. Однако в медицинских публикациях недостаточно освещены вопросы влияния гипергомоцистеинемии (ГГЦ) на течение атеросклероза и функциональное состояние миокарда, что требует более детального изучения этой проблемы. Цель исследования – изучить функциональное состояние миокарда в зависимости от степени ГГЦ у больных ИБС, требующих хирургического вмешательства. В исследовании был проведен анализ лабораторных данных 30 пациентов, страдающих атеросклерозом. Указанные изменения сократительной способности миокарда были более выражены у пациентов с гипергомоцистеинемией и мультифокальным атеросклерозом, что требует более тщательной медикаментозной коррекции после вмешательств на коронарных и сонных артериях.

To date, it has been established that in the progression of cardiovascular (CV) disorders, an increase in the level of homocysteine (HC) and hypovitaminosis D play an important role. According to the latest recommendations, the modern clinician should consider risk factors not as a diagnostic sign, but as a prognostic, contributing factor, which to some extent can lead to destructive changes in the vascular wall. The aim. To study the morphological changes of the vascular wall depending on the degree of hyperhomocysteinemia and hypovitaminosis D. Materials and methods. We analyzed data from 54 patients who, in addition to determining the level of HC and vitamin D, underwent morphological studies of fragments of the great saphenous vein and aorta. Samples were obtained during coronary artery bypass grafting. Depending on the degree of hyperhomocysteinemia and the level of vitamin D, the patients were divided into 3 groups. Results. Morphological examination of the great saphenous vein and aorta showed normal structure of the vascular wall in patients with normal levels of HC and vitamin D (78.5% and 71.4%, respectively). Patients from the groups 2 and 3 with hyperhomocysteinemia had more pronounced changes in the venous wall, regardless of the level of vitamin D. These data suggest a probable association of HC levels with the changes in the vascular wall. It was also noted that the patients of group 3 had more pronounced inflammatory infiltration of the vascular wall. Conclusions. Hyperhomocysteinemia and hypovitaminosis D are independent predictors of CV disorders and have a detrimental effect on the vascular wall and blood coagulation system, creating conditions for the progression of atherosclerosis. The higher is the level of HC, the more pronounced are morphological changes in the vascular wall of the vein, leading to hypertrophy of all layers, regardless of the level of vitamin D.

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