The aim – to reveal features of the coronary vascular system, structural and functional state of the heart and endothelium-dependent vasodilatation in ST-elevation acute coronary syndrome (STEMI) patients of different age groups. Materials and methods. We analyzed the data of instrumental examination of patients who were admitted to the emergency departments from 2000 to 2015, with STEMI. Patients were distributed into two groups depending on age: 1 group – patients < 45 years, 2 group ≥ 45 years. Coronary angiography (CAG) was performed within the first hours after the admission. Endothelium-dependent, flow-mediated vasodilation (FMD) test and echocardiography were performed within 24 hours of admission and again on the 7th day. Results and discussion. According to сoronary angiography, elder patients were more likely to have infarction-dependent coronary artery disease (33.3 vs. 20.3 %; p=0.037), and multi-vessel coronary artery disease (12.0 vs. 4.8 %; p=0.048). Patients in the 1st group demonstrated a lower frequency of hemodynamically significant lesions of coronary vessels (p<0.001) and less marked disorders of the lipid spectrum. Patients of the group 1 had less thickness of the interventricular septum. 10.7±1.5 mm versus 11.6±1.6 mm, p=0.024). Young patients had initially better diastolic function (Е/А) (1.29±0.40 versus 1.00±0.52, p=0.008). At day 7 in patients of the 1st group there was a more marked increase in the left ventricular ejection fraction and end-diastolic diastolic index of the left ventricle (7.6 versus 3.4 %; p<0.05) than in the patients of the 2nd group. Young patients demonstrated a tendency to increase of end-diastolic index > 10 %, in dynamics, at 39.7 versus 27.8 % elder patients (p=0.053), lower growth of the diameter of the brachial artery (4.7±4.1 vs. 6.7±5.1 %; p<0.05), but more rapid improvement of endothelial function in the dynamics of observation (104 vs. 23 %; p<0.05). Conclusions. The percentage of damage of coronary artery disease in STEMI young patients did not differ from elder patients but insignificant coronary artery stenosis is detected more often (р<0.001) and acute myocardial infarction in the right coronary artery is less common (р<0.037). Young patients with multi-vessel coronary disease have significant violations of the lipid blood spectrum (increased levels of total cholesterol, low density lipoprotein cholesterol). Indicators of intracardiac hemodynamic did not differ between age groups initially, however, the course of acute myocardial infarction in young patient was characterized by the tendency to develop early post-infarction dilatation (p=0.053). According to the FMD test young patients at the onset had a worse indicator of than elder patients (p<0.043), however the diameter of the brachial artery in the dynamics of observation, significantly increased (p<0.05).

Ефективність інгібітору 5-ліпоксигенази кверцетину у пацієнтів із гострим інфарктом міокарда (ГІМ), яким з метою реперфузії вводили тромболітичні препарати, була доведена на початку 2000-х років. Застосування препарату дозволяло суттєво обмежити зону некротизованого міокарда та зменшити кількість клінічних ускладнень як протягом госпітального періоду, так і за результатами трива-Îðèãèíàëüíûå èññëåäîâàíèÿ Original Researches лого спостереження у цієї категорії хворих [1, 2]. Це дозволило зареєструвати кверцетин для лікування

The article presents the case of the development of acute thrombosis of two coronary arteries in a 35-year-old patient without atherosclerotic lesion of the heart vessels according to optical coherence tomography. Acute myocardial infarction in a patient developed on the background of previous diffuse myocarditis, foci of which of different time were identified during magnetic resonance imaging. Smoking and chronic intoxication due to contact with paint and varnish materials and regular intake of alcohol were the only risk factors for myocarditis and coronary thrombosis that were able to be detected in this patient.

В данной работе были обследованы пациенты, которые обращались за помощью по поводу гипертензивного криза. Больные получали лечение посредством внутривенного введения гипотензивных препаратов: нитроглицерина или урапидила. В момент поступления и после стабилизации артериального давления было проведено ультразвуковое исследование скорости кровотока в аорте, почечной артерии, в месте отхождения от аорты и в месте вхождения в почку. На фоне лечения отмечалось одинаковое снижение систолического артериального давления и среднего артериального давления. Уменьшилась скорость кровотока в аорте и в почечной артерии в месте отхождения от аорты. При применении урапидила скорость кровотока в почечной артерии, в месте вхождения в почку, улучшалась, что свидетельствует о поддержании или даже улучшении почечного кровотока. При введении нитроглицерина скорость почечного кровотока достоверно снижалась.

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