Clinical Features, Course and Indicators of Endothelial Function and Systemic Immune-Inflammatory Response in Patients with Chronic Coronary Artery Disease Depending on Affected Coronary Artery Number

  • Iryna Kupnovytska Ivano-Frankivsk National Medical University
  • Nelia Romanyshyn IFNMU
Keywords: coronary artery disease, stable angina, coronary arteries, endothelial dysfunction, immune-inflammatory activation

Abstract

In Ukraine, cardiovascular diseases are the leading cause of morbidity and rank second among primary diseases. Nowadays the most common cardiovascular disease is coronary artery disease that accounts for 33.7% of total cardiovascular pathology cases.            The objective of the research was to study clinical manifestations and indicators of endothelial function and immune-inflammatory response in the patients with coronary artery disease, heart failure with preserved left ventricular ejection fraction depending on affected coronary artery number.            Materials and methods. The study included 62 patients with chronic coronary artery disease, heart failure with preserved left ventricular ejection fraction who underwent coronary artery stenting. Among the examined patients, males prevailed – 52 (83.9%) individuals. All the patients were randomized according to the number of the affected coronary arteries and divided into two groups. Clinical manifestations were studied; the patients’ quality of life was assessed; the functional state of the myocardium was determined according to the six-minute walk test; the indicators of endothelial dysfunction were analyzed by endothelin-l level; the indicators of immune inflammatory response were analyzed by serum levels of C-reactive protein and tumor necrosis factor.             Results. In the examined patients, the clinical course did not depend on the number of the affected coronary arteries; however, to reduce the incidence of cardiac pain, the patients with multivessel coronary artery disease received 2±0.1 extra nitroglycerin tablets.            Conclusions. Quality of life and physical well-being were better in the patients with single-vessel coronary artery disease (p<0.05). Myocardial functional reserves were lower in the patients with multivessel coronary artery disease (p<0.05), while the intensity of immune inflammation and endothelial dysfunction reduced in case of multivessel coronary artery disease that confirmed a strong correlation between the indicators of tumor necrosis factor and endothelin-l.

References

Andrushko II. Concentration of C-reactive protein and interleukin-6 in patients with coronary disease: a correlation with the structural functional condition of the myocardium. Bukovinian Medical Herald. 2008;12(2):70-74. [published in Ukrainian]

Bugaenko VV, Golikova IP, Sheremet MYu. Gender-specific features of the diagnosis, course and treatment of coronary heart disease. Praktychna anhiolohiia. 2015;2;55-66. [published in Russian]

Gaysenok OV, Martsevych SYu. Opredeleniye pokazaniy k provedeniyu koronarografiyi u patsiyentov bez klinicheskikh proyavleniy zabolevaniya i bolnykh so stabilnoy stenokardiyey. Kardiologiia. 2014;54(10):57-62.

Gandzyuk VA. Analysis of ischemic heart disease morbidity in Ukraine. Ukrainian Cardiology Journal. 2014;3:45-52. [published in Ukrainian]

Horbas IM. Ishemichna khvoroba sertsia: epidemiolohiia i statystyka. Zdorovia Ukraiiny. 2015;3:32-33.

Yelskiy VN. Rol disfunktsiyi endoteliya v geneze serdechno-sosudistykh zabolevaniy. Zhurnal AMN Ukraiiny. 2008;14(1):51-62.

Yepanchintseva OA, Nadorak OP, Borkhalenko YuA, Zharinov OY. Quality of life in patients with stable coronary artery disease: a place of ranolazine. Ukrainian Cardiology Journal. 2015;3:79-83. [published in Ukrainian]

Zaremba YeKh, Besedina AS, Zaremba-Fedchyshyn OV. Determination of endoteline-1 level for estimation of endothelic dysfunction correction in patients with chronic heart failure. Medical and Clinical Chemistry. 2011;13(4):73-74. [published in Ukrainian]

Kirichenko AA. Stabilnaya stenokardiya napryazheniya: otsenka prognoza i lecheniye. Russkiy meditsinskiy zhurnal. 2014;2:106-110.

Kudashev VKh, Marusanov VYe, Semkichev VA. Vliyaniye nitroglitserina na osnovnyye pokazateli gemodinamiki v bolnykh s ostrym perednim infarktom miokarda. Skoraya meditsinskaya pomoshch. 2013;14(4):37-40.

Kravchun PG, Shelest MO, Kovalyova YuO et al. Peculiarity of inflammatory markers dynamic in patients with ischemic heart diseases associated with obesity. Medytsyna siohodni i zavtra. 2013;2:38-42. [published in Ukrainian]

Prasolov AV, Kniazeva LA, Likov VF. Indices of immune inflammation, rigidity of vascular wall in patients with stable angina receiving bisoprolol. Russian Journal of Cardiology and Cardiovascular Surgery. 2011;4(4):37-40. [published in Russian]

Tomilova DI, Byazrova FF, Buza VV et al. Inflammatory markers and their role in assessing prognosis of patients with stable coronary artery disease after coronary stenting. Kardiologiia. 2015;55(11):88-93. [published in Russian] DOI: https://doi.org/10.18565/cardio.2015.11.88-93

Semenchuk SA, Stotska TV. Otsinka yakosti zhyttia u khvorykh iz postinfarktnym kardiosklerozom na foni metabolichnoii terapii. ScienceRise: Medical Science. 2017;8(16):42-44. DOI: https://doi.org/10.15587/2519-4798.2017.109226

Eapen DJ, Manocha P, Patel RS et al. Aggregate risk score based on markers of inflammation, cell stress, and coagulation is an independent predictor of adverse cardiovascular outcomes. J Am Coll Cardiol. 2013;62(4):329-337. DOI: https://doi.org/10.1016/j.jacc.2013.03.072 [PMid:23665099 PMCid:PMC4066955]

Kohn CG, Parker MW, Limone BL, Coleman CI. Impact of angina frequency on health utility values of patients with chronic stable angina. Health Qual Life Outcomes. 2014;12:39. DOI: https://doi.org/10.1186/1477-7525-12-39 [PMid:24628859 PMCid:PMC3995582]

Schlesinger S, Sonntag SR, Lieb W, Maas R. Asymmetric and Symmetric Dimethylarginine as Risk Markers for Total Mortality and Cardiovascular Outcomes: A Systematic Review and Meta-Analysis of Prospective Studies. PLoS One. 2016;11(11):e0165811. DOI: https://doi.org/10.1371/journal.pone.0165811 [PMid:27812151 PMCid:PMC5094762]

Published
2019-06-02
Section
Original Research