Цель. Изучить влияние триметазидина МВ на динамику биомаркеров некроза миокарда и сердечной недостаточности в раннем послеоперационном пери-оде у больных ишемической болезнью сердца (ИБС), подвергающихся вне-сердечным торакальным хирургическим операциям. Материал и методы. В исследование включено 72 мужчины в среднем воз-расте 61,0 (57-66) год. Пациенты рандомизированы в группу вмешательства (n=35), в которой перед операцией назначался триметазидин МВ (Предуктал МВ ® ) в дозе 35 мг 2 раза в день сроком на две недели, и контрольную группу (n=37). В исследуемых группах оценивали и сравнивали периоперационную динамику тропонина I, белка, связывающего жирные кислоты (БСЖК) и N-концевого фрагмента предшественника мозгового натрийуретического пептида (NT-proBNP), определяемых в крови накануне, через 24 и 48 ч после операции. Результаты. Исходный уровень всех биомаркеров в группах не различался. После вмешательства в обеих выборках отмечен прирост тропонина I в преде-лах нормальных значений. Уровень тропонина I >0,1 нг/мл отмечен у двоих пациентов контрольной группы. Средний уровень БСЖК увеличился после операции в обеих группах. Через 48 ч в группе триметазидина МВ, по сравне-нию с контролем, были ниже (р<0,05) медиана БСЖК (1,0 и 1,9 нг/мл, соответ-ственно) и доля пациентов с БСЖК >5,0 нг/мл (2,9% и 18,9%). Медианы NTproBNP через 24 ч (184,0 и 293,3 пг/мл) и 48 ч после вмешательства (160,6 и 334,0 пг/мл) также были ниже в группе триметазидина МВ. У пациентов группы триметазидина МВ через 48 ч после операции NT-proBNP реже дости-гал уровня 300 пг/мл и выше (в 20,0% и 51,4%). Аналогичный результат был получен в подгруппах пациентов с исходно нормальным уровнем NT-proBNP до операции. В данных подгруппах различалась также степень прироста NTproBNP через 24 ч после операции (на 160,3 и 242,2 пг/мл). Заключение. Полученные результаты свидетельствуют о кардиопротек-тивном эффекте триметазидина МВ у больных ИБС в условиях периопера-ционного миокардиального стресса, вызванного полостной внесердечной операцией. Aim. To investigate on the influence of trimetazidine MR on biomarker dynamics of myocardial necrosis and heart failure in early post-surgery period in coronary heart disease (CHD) patients, undergoing extracardiac thoracal surgery. Material and methods. Totally, 72 men included, mean age 61,0 (57-66) y. o. Patients were randomized to the intervention group (n=35), receiving trimetazidine MR (Preductal MR ® ) 35 mg b. i.d., prescribed before operation for 2 weeks, and controls (n=37). In the studied groups, we assessed and compared perioperational troponin I dynamics, fatty acid binding protein (FABP) dynamics, and N-terminal pro-brain natriuretic peptide (NT-proBNP), measured the day before, and in 24 and 48 after surgery. Results. Baseline level for all biomarkers did not differ in groups. After the intervention, in both groups there was increase of troponin I, but not outside reference range. Troponin I >0,1 ng/mL was found in 2 patients from control group. Mean level of FABP increased after the operation in both gr...

Aim. To study the perioperative dynamics of myocardial injury biomarkers and determine their significance in assessing the postoperative mortality risk in patients with nonsmall cell lung cancer.Methods. The study included 82 male patients with non-small cell lung cancer undergoing pneumonectomy. The median age was 64 (59; 67) years. The blood levels of cardiac troponin I (cTnI), N-terminal pro b-type natriuretic peptide (NT-proBNP) and fatty acid-binding protein (FABP) were noted before and after surgery. The rate of myocardial injury after non-cardiac surgery (MINS) was determined. The postoperative cTnI level above 0.023 μg/L was considered as MINS criterion. The significance of the studied biomarkers in predicting the total mortality within 6 months after surgery was assessed using the univariate and multivariate Cox regression and ROC analysis.Results. Compared to baseline levels, all myocardial injury biomarkers increased in 24 and 48h after surgery: cTnI by 120 and 85%, NT-proBNP by 128 and 129%, FABP by 207 and 31%, respectively. The postoperative cTnI levels met the MINS criterion in 45.1% of patients. During the follow-up period 12 patients died, 9 (75%) of those were diagnosed with MINS. Based on the results of the univariate Cox regression overall postoperative mortality was associated with NTproBNP levels before and after the surgery, cTnI growth rate after the surgery and MINS. According to the multivariate Cox regression (adjusted for age and other clinical parameters), preoperative NT-proBNP and atrial fibrillation proved to be the independent predictors of postoperative mortality. The cut-off value of preoperative NT-proBNP was 225 pg/mL; relative risk of death above that value was 5.9 and 95% confidence interval of 1.74–20.0.Conclusion. In patients with non-small cell lung cancer the increase of cTnI, NT-proBNP and FABP mean levels was observed in 24 and 48 hours after pneumonectomy. MINS was diagnosed in 45.1% of patients. According to the univariate regression analysis, MINS and preoperative and postoperative NT-proBNP levels were associated with the risk of total six-month postoperative mortality. The preoperative NT-proBNP was proved to be an independent predictor of adverse outcome.

Aim. To investigate the relationship of soluble ST2 (sST2) to acute heart failure (AHF) and compare the predictive value of sST2 and brain natriuretic peptide in patients with ST-elevation myocardial infarction (STEMI).Material and methods. In 136 STEMI patients, the serum sST2 concentration was determined during the first 24 hours of hospitalization. We assessed levels of sST2, N-terminal pro-brain natriuretic peptide (NT-proBNP), incidence of Killip class II-IV AHF during hospitalization, myocardial necrosis biomarkers, parameters of complete blood count and biochemical blood tests, the incidence of cardiovascular diseases and risk factors. The predictive value of sST2 for AHF development was assessed using logistic regression. ROC analysis was performed. The areas under the ROC curve were compared for sST2 and NT-proBNP. The cut-off sST2 value was determined for predicting AHF.Results. The mean sST2 level was 43,4 (33,6-73,9) ng/ml. During the followup period, AHF was diagnosed in 54 people (39,7%). The prevalence of AHF in the 1st, 2nd and 3rd tertiles of sST2 was 15,6%, 33,3% and 69,7%, respectively. The NT-proBNP levels were 319 (128-1072) pg/ml, 430 (147-1140) pg/ml and 1317 (533-2386) pg/ml. The predictive value of 3rd sST2 tertile was retained adjusted for age, sex, NT-proBNP, troponin T, creatine phosphokinase-MB, high-sensitivity C-reactive protein, hemoglobin, blood glucose, left ventricular ejection fraction. The areas under the ROC curves for sST2 and NT-proBNP were comparable (0,828 and 0,733, respectively; p=0,056). The cut-off sST2 value was 64 ng/ml, above which the odds ratio of AHF was 11,1 (95% confidence interval, 4,7-26,1.Conclusion. An increase in blood sST2 is associated with an increase in AHF (Killip II-IV) prevalence in hospitalized patients with acute STEMI. Soluble ST2 has an independent predictive value for AHF in STEMI, comparable in strength and predictive model quality to NT-proBNP. The cut-off sST2 value for AHF (>64 ng/ ml) was calculated, which provides an optimal balance of sensitivity, specificity and accuracy of the prognostic model. These data support the potential value of sST2 as a biomarker of AHF in STEMI.

Несмотря на успехи в коррекции острой печеночной недостаточности, продолжается поиск биомедицинских методов, направленных на регенерацию и восстановление поврежденной печени. На модели пострезекционной печеночной недостаточности после 70%-й резекции печени у крыс при однократном введении экзогенного фактора роста гепатоцитов установлено уменьшение воспалительного ответа и сохранность неспецифической резистентности организма в ранние сроки после резекции. Ключевые слова: печеночная недостаточность, фактор роста гепатоцитов, неспецифическая резистентность, воспалениеHGF is one of the factors taking part in regeneration and recovery of liver after injury. The article is dedicated to the study of influence of single HGF intake on the indices of non-specific immune response in rats after 70% liver resection in the early postoperative period. Research was conducted on 42 six-months white male Wistar rats of 250-300 g. It was revealed that level of segmentonuclear neutrophils and lymphocytes in the group with HGF intake stand at normal level on the 2 nd day and normalizes to the 11 th day that testifies to the decrease of inflammatory response. Increased level of leukocytes and monocytes is registered in the group with HGF intake. Also integrity of non-specific resistance in the early postoperative period on the 2 nd day is registered. Suppression of phagocytosis indices with preservation of functional activity of phagocytes was registered to the 11 th day.