Objective: to evaluate the severity of immuno-inflammatory responses under stable stenocardia in patients with ischemic heart disease (IHD). Patients and intervention: the study included 83 patients suffering from IHD. Among them 30 cases were diagnosed as functional class (FC)-II stenocardia, 27 cases as FC-III stenocardia and 26 cases as FC-IV stenocardia. The control group included 25 healthy persons. For characterizing the immuno-inflammatory responses we examined the level of C-reactive protein (CRP), pro-inflammatory (IL-1b, IL-6, TNF-α) and anti-inflammatory (IL-4, IL-10) cytokines by the immunoenzymic procedure. Results: FC-II stenocardia showed normal levels of CRP and pro-inflammatory cytokines. FC-III stenocardia was associated with a moderate increase in markers of an inflammation. FC-IV stenocardia was characterized by maximum levels of CRP and pro-inflammatory cytokines. Conclusion. The intensity of immuno-inflammatory responses depends on more or less serious course of stenocardia in patients with IHD.

Aim: to establish the role of insulin-growth factor (IGF)-1 in myocardial remodeling in female patients with arterial hypertension (AH) and metabolic syndrome (MS) and different stages of obesity Materials and methods. The study included 108 women with AH and MS, divided into 3 groups according to stage of obesity, and 28 healthy women. It was assessed the concentration of IGF-1, status of hemodynamic and types of left ventricle's remodeling. Results. Concentric remodeling and IGF-1 elevation prevailed in patients with AH and first stage of obesity. Concentric hypertrophy of left ventricle and normal level of IGF-1 were established in patients with second stage of obesity. Lack of IGF-1 were determined in women with obesity 3rd stage and eccentric hypertrophy. Correlation analysis in patients with 2-3 stages of obesity showed the linkages between concentration of IGF-1 and hemodynamic parameters. Conclusion. The level of concentration of IGF-1 in patients with AH and MS correlates with remodeling types and stage of obesity.

Aim. To elucidate effect of b-adrenoblockers on remodeling of myocardium and adhesive function of endothelium in with ischemic heart disease with chronic heart failure (CHF) and addition of atrial fibrillation (AF). Material and methods. We included into the study 77 patients with functional class II–III CHF and AF of ischemic genesis randomized in 2 groups, In group 1 were included 40 patients who during 24 weeks used carvedilol at the background of basic therapy, in group 2–37 patients receiving metoprolol tartrate. In the work we used clinico-instrumental (echocardiography, test with 60 minute walk), immunoenzymatic (soluble intercellular adhesion molecules (sVCAM, SE – selectin) methods of investigation. Results. Application of both BAB improved clinical state and physical working capacity of patients with CHF and AF. Carvedilol more significantly than metoprolol tartrate prevented remodeling of myocardium, inhibited expression of cellular adhesion molecules. Levels of sE-selectin and VCAM-1 decreased under action of carvedilol. Conclusion. Carvedilol in long term therapy of CHF with AF exerts substantial influence on adhesive function of endothelium and improves hemodynamics.

Aim.To evaluate the effect ofb-blockers (BB) on myocardial remodeling and endothelial adhesive function in patients with chronic heart failure (CHF) and atrial fibrillation (AF) of ischemic origin. Material and methods.The study included 77 patients with functional class IIIII CHF and AF who had previously suffered a large-focalQ-myocardial infarction. Patients were randomized into 2 groups, comparable in clinical and instrumental characteristics and homogeneous in basic therapy of CHF and AF. Group 1 included 40 patients who took carvedilol for 24 weeks as part of the basic therapy of CHF and AF, and group 2 included 37 patients who received metoprolol tartrate. We used clinical and instrumental (echocardiography, 6-minute walking test, clinical assessment scale) and enzyme immunoassay (analysis of the level of soluble molecules of intercellular adhesion sVCAM-1 and sE-selectin) research methods. Results.The use of carvedilol a non-cardioselective BB that performsa1,b1andb2-adrenoblockade, andb1-selective, short- acting BB metoprolol tartrate as part of basic therapy improved the clinical condition and physical performance of patients with CHF and AF. It was found that carvedilol more significantly than metoprolol affects the state of intracardiac hemodynamics, slows down the processes of remodeling of the left atrium and left ventricle, increases the contractile function of the myocardium. Carvedilol as part of basic therapy reduces endothelial adhesion and inhibits the overexpression of intercellular adhesion molecules sVCAM-1 and sE-selectin, and when using metoprolol tartrate, there is only a tendency to decrease these indicators. Conclusion.Carvedilol as part of the basic therapy of CHF and AF has significant endothelial-protective and clinical-hemodynamic effects, positively affects the adhesive function of the endothelium and the processes of left atrium and left ventricle remodeling.