COMPARATIVE CHARACTERISTIC OF INDICATORS OF CHRONIC SYSTEM INFLAMMATION AND CENTRAL HEMODYNAMICS IN PATIENTS WITH STABLE ISHEMIC HEART DISEASE AND WITH ITS COMBINATIONS WITH AUTOIMMUNE TIREOIDITIS

Kazakov Yu. M., Chekalina N. I., Mamontova T. V., Vesnina L. E., Nakaznenko N. V., Kocur G. V.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

The urgency of the problem is in the progressive increase in the incidence of CHD in Ukraine and around the world, the effect of AIT on the course of coronary heart disease in combination of the specified pathology, which requires a detailed study of the pathogenetic mechanisms of CHD development under conditions of autoimmune inflammation and the search for new effective methods of diagnosis and treatment. Recognition of the leading role of chronic systemic inflammation in the pathogenesis of both pathological conditions allowed to conduct the scientific research in this direction. Purpose: to study and compare the indices of systemic inflammation and central hemodynamics in patients with stable coronary heart disease (CHD) and in conditions of its combination with autoimmune thyroiditis (AIT). Object and methods. In a single-stage open clinical study, 230 patients with IHD took part: stable angina pectoris, II FC, CH-0, and 50 patients with stable ischemic heart disease in combination with AIT in the stage of euthyroidism. Patients underwent laboratory studies to determine the levels of pro- and anti-inflammatory cytokines (interleukin 1β, interleukin 10 and tumor necrosis factor alpha in the blood and Echocardiography to detect violations of central hemodynamics. Results. The study showed an increased in the level of proinflammatory cytokines with a moderate predominance in patients with the combination of IHD with AIT – more high level of tumor necrosis factor alpha in the blood, a negative effect of the inflammation on the systolic and diastolic functions of the left ventricle, with a predominance of diastolic dysfunction in patients with IHD in combination with AIT. When comparing the data of patients with stable IHD and IHD in combination with AIT, differences were noted with respect to the time of early diastolic filling of left ventricular (DT), which was significantly higher in patients with AIT (p <0,05), as well as in the phase of early diastolic filling of left ventricular, the maximum rate of which (E) in patients with AIT was significantly lower (p <0,05). The prevalence of severity of violations of the diastolic function of the left ventricle in patients with AIT may indicate significant changes in the myocardium under the conditions of the autoimmune process, as well as a greater degree of inflammatory activation of the endothelium with a violation of endothelial-dependent functions under chronic inflammatory conditions. Conclusions. The results obtained define chronic systemic inflammation as a leading factor in the development and progression of IHD in combination with AIT and an important target for the development of pathogenetically valid approaches to treatment in conditions of comorbidity.

ischemic heart disease, autoimmune thyroiditis, chronic systemic inflammation, central hemodynamics

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«Bulletin of problems biology and medicine» Issue 3 (145), 2018 year, 113-118 pages, index UDK 616.12-008.46+616.441-002.2

10.29254/2077-4214-2018-3-1-145-113-118