Кардиоваскулярная терапия и профилактика (Oct 2011)

Endothelial dysfunction and prognosis after coronary interventions in patients with coronary heart disease and arterial hypertension

  • M. V. Kazak,
  • N. A. Sukhovey,
  • M. G. Omelyanenko,
  • I. K. Tomilova,
  • E. L. Aleksakhina,
  • V. G. Plekhanov,
  • S. V. Romanchuk

DOI
https://doi.org/10.15829/1728-8800-2011-5-30-36
Journal volume & issue
Vol. 10, no. 5
pp. 30 – 36

Abstract

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Aim. To assess the effects of endothelial dysfunction (ED) on the post-coronary intervention (CI) prognosis in patients with acute and chronic coronary heart disease (CHD) and arterial hypertension (AH). Material and methods. In total, the study included 142 CHD patients and 64 blood donors (control group, CG). Group I included patients with chronic CHD, who underwent CI 5-8 years ago (sub-groups A and B included, respectively, patients with good and poor post-CI prognosis). Group II included patients with chronic CHD, treated conservatively. Group III and IV, respectively, included patients with myocardial infarction (MI), treated by CI or conservatively. ED assessment was performed, using the levels of nitrates and nitrites (NOx), nitrates only (NO3-), citrulline (LC), arginine (LА), and desquamated endotheliocytes (DE).Results. Plasma concentrations of NO3-, LА, and DE, or NOx, LC, and DE comprised one integral parameter of endothelial dysfunction (EDIP). In Groups I and II, EDIP levels were similar and close to 0. Compared to Group I, Group IV demonstrated a decrease in NOх and LC, DE increase, and a substantial EDIP reduction. In Group III, NOx and LC levels, as well as EDIP, were increased. At baseline, Group I subgroup A had lower DE levels than subgroup B. Five-eight years after CI, subgroup A demonstrated increased NO production and reduced endothelial desquamation. Based on EDIP values, subgroup B had significantly more pronounced ED, both at baseline and after CI. Conclusion. A complex index EDIP was developed. In patients with chronic CHD, ED was compensated regardless of therapeutic strategy. In MI patients, decompensation of the NO-endothelium system was followed by its relatively fast post-CI recovery. Among individuals with poor post-CI prognosis, ED was manifested to a greater extent than in patients with good prognosis.

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