Pharmacological correction of pro- and anti-inflammatory cytokine induction and energy metabolism system state in patients with coronary heart disease and chronic heart failure

Abstract

Aim. To investigate the associations between the severity of inflammatory reaction and bio-energetic insufficiency development in patients with coronary heart disease (CHD) and reduced cardiac contractility; to assess the effectiveness of the pharmacological correction of these disturbances. Material and methods. This randomised, controlled study included 92 CHD patients (mean CHD duration 5,4±4,8 years) with effort and rest angina, Stage II-III arterial hypertension, and cardiac arrhythmias and blocks of various aetiology. The control group (CG) received standard treatment, while the main group (MG) was also administered a cardio-tonic and cardio-protective medication, adenocin, for 10-14 days. Venous blood levels of pro- and anti-inflammatory cytokines, aldosterone, and redox NAD/NADH potential were measured. Results. Adenocin treatment was associated with an improvement in chronic heart failure (CHF) symptoms, cardiac remodelling regression, increased velocity of circular shortening of myocardial fibres, increased ejection fraction (EF), and normalised diastolic function. The improvement in intra-cardiac hemodynamics correlated with increased plasma NAD/NADH potential. In the CG, the summary ratios of pro- and anti-inflammatory cytokine levels did not change, while in the MG, they nearly halved after the treatment course. Conclusion. Myocardial remodelling regression, induced by adding adenocin to the complex therapy of CHD patients with CHF and left ventricular dysfunction, was associated with improved cardiac geometry, systolic and diastolic function, increased redox potential, and reduced maladaptation of immune and inflammatory reactions.

Keywords

• coronary heart disease
• left ventricular dysfunction
• cytokines
• redox potential
• adenocin