[The Input of Professor V. I. Kalmykova into Studying Pathogenesis of Atherosclerosis (to Ninetieth Anniversary)].

The atherosclerosis is considered among the most prevalent diseases. In Russia, N. N. Anitchkov and A. L. Miasnikov are founders of atherosclerosis studies. Valentina Iosifovna Miasnikova, doctor of medical sciences, professor of the Chair of Faculty Therapy #2 of the Sechenov University is one the numerous followers of A. L. Miasnikov. From the early 1960s, Valentina Iosifovna, proceeding with ideas of N. N. Anitchkov and A. L. Miasnikov, actively investigated pathogenesis of atherosclerosis. The professor V. I. Kalmykova, one of the first in Russia presented pathogenesis of atherosclerosis as a multi-factorial process and, combining theories existed at that moment, described effect of peroxidation of lipids on all stages of development of atherosclerotic plaque. She carried out a unique scientific investigation concerning studying intensity of peroxidation of lipids and antioxidant activity of lipids in patients with various degree of expression of ischemic heart disease. The gender characteristics of content of peroxides and antioxidant activity of lipids of blood serum were established. The research works of professor V. I. Kalmykova made an invaluable contribution into comprehension of pathogenesis of atherosclerosis and obtained an international approval. The scientific data obtained by V. I. Kalmykova were confirmed by studies of national and international researchers. Nowadays, the role of oxidation process in pathogenesis of atherosclerosis and ischemic heart disease is generally acknowledged.

[Myocardial infarction in colon cancer].

Paraneoplastic syndromes have a variety of clinical manifestations most frequently resembling systemic diseases and phlebothrombosis. Also, hypercoagulative paraneoplasic syndrome may have some clinical features of myocardial infarction which makes difficult nosological diagnostics.

[Lipid peroxidation and antioxidative protection in patients with coronary heart disease].

Total cholesterol as well as cholesterol of low and high density lipoproteins, lipid peroxidation products (LPP), such as dienic conjugates and compounds reacting with thiobarbituric acid, were measured in a single blood sample from each of the 295 patients with CHD and 20 apparently healthy subjects. FC II and III angina was diagnosed in 142 and 151 CHD patients respectively. Certain samples were used to additionally detect homocysteine, activity of anti-oxidative enzymes (superoxide dismutase and glutathione peroxidase) in erythrocytes and ceruloplasmin/transferrin anti-oxidative system in plasma. Patients with FC III angina had significantly higher LPP levels but lower activity of tissue and plasma anti-oxidative systems than patients with FC II angina or healthy subjects. Patients with stable forms of CHD showed correlation between lipid composition, LPP contents, homocysteine level, and activity of anti-oxidative enzymes.

[Correction of antioxidative state during statin therapy of coronary heart disease with dyslipidemia].

Treatment with simvastatin (vasilip) at a daily dose of 20 mg combined with conventional cardiac therapy was given for 3 months to 132 patients with coronary heart disease and postinfarction cardiosclerosis with dyslipidemia. Activity of tissue and plasma antioxidative enzymes increased in 60% of the patients and decreased in 40%. Treatment with antioxidants 2-ethyl-6-methyl-3-oxypiridine succinate (mexidol) and ubichinon (cudesan QIO) improved antioxidative status of the patients and clinical picture of cardiac pathology.

[The influence of the bioflanoid dicvertin on the antioxidative system ceruloplasmin-transferrin and lipid peroxidation in patients suffering from stable coronary heart disease with dyslipidemia].

Thirty-two patients with coronary heart disease (CHD)--exertional angina and postinfarction cardiosclerosis with dislipidemia--were treated with dicvertin (2,3-dihydro-3,5,7-trihydroxi-2(3,4-dihydroxiphenyl)-4H-1-benzopyran-4-on), a Russian antioxidant, during two months in a day dose of 80 mg in addition to conventional cardial therapy. The therapy resulted in positive changes including improvement of CHD clinical picture and biochemical serum indices, such as a 6% decrease in cholesterol level, a 12% decrease in low-density lipoproteins cholesterol level, and a 14% increase in high-density lipoproteins cholesterol level. The intensity of lipid peroxidation decreased, the levels of diene conjugates and TBA-reactive products lowered by 38% and 40%, respectively. The fibrinogen level lowered by 20%. The antioxidative status of the patients increased.

[Experience in coenzyme Q10 application in complex therapy of coronary heart disease with dyslipidemia].

The subjects of the study were 43 patients with II- III functional class coronary heart disease (CHD) and dyslipidemia, who received conventional cardial therapy. The patients were divided into two groups: group I (26 subjects) received vasilip, a simvastatin generic, in a dose of 20 mg a day; group 11 (17 subjects) received vasilip in a dose of 20 mg a day plus cudesan in a dose of 1 ml a day, which contained 30 mg of ubiquinone Q 10 and 4.5 mg of alpha-tocopherol. Effects of the therapies on blood lipids, their peroxides, and the antioxidative status of blood were studied. After one month, vasilip was effective in achieving the target level of low-density lipoprotein cholesterol in 62% of group I patients and 65% of group II patients; at the same time, its use led to a significant increase in the level of primary and secondary lipid peroxidation (LP) products (25% and 29%, respectively), and lowering of the antioxidative status of blood, which consisted in a decrease in ceruloplasmin (CP) serum level and CP: transferrin (CP:TF) ratio by 6% in group I patients. The use of cudesan in combination with vasilip led to a significant decrease in the level of primary and secondary LP products (30% and 29%, respectively), and an increase in the level of serum CP by 25.7%, and CP: TF ratio by 12.5%.

[Effects of mexidol on the antioxidative status of patients suffering from coronary heart disease with dislipidemia].

The subjects of the study were 36 patients suffering from coronary heart disease with exertional angina and postinfarction cardiosclerosis with dislipidemia. The patients were administered mexidol (2-ethyl-6-methyl-3-oxipyridin succinate), a domestically produced antioxidative agent, for 1 month in a dose of 325 mg/day together with conventional cardial therapy. The result was good and included clinical improvements and improvements in biochemical serum parameters: cholesterol level decreased by 10%, the level of low density lipoprotein cholesterol decreased by 25%, high density cholesterol level elevated by 15%. The intensity of lipid peroxidation lowered, which was manifested by decrease of the level of diene conjugates and TBA-reactive products by 27% and 42%, respectively. The patients' antioxidative status increased.

[Study of serum levels of homocystein, lipids and their peroxidation products in patients with coronary heart disease].

The subjects of the study were 30 patients with coronary heart disease (19--with stable, and 11--with instable angina), and 15 practically healthy individuals. The study included measurement of the levels of homocysteine (HC), total cholesterol, cholesterol of low-density lipoproteins, cholesterol of high-density lipoproteins, and lipidperoxidation (LP) products (TBA-reactive products), as well as coagulo-fibrinolytic parameters. The study revealed that patients with instable angina had significantly higher levels of HC and TBA-reactive products compared to those with stable angina and healthy controls. HC level correlated with LP processes in CHD patients (r = 0.55). Methionine loading allowed revealing latent hyperhomocysteinemia.

[Prestarium treatment of essential hypertension]. / Ispol'zovaniie prestariuma u bol'nykh gipertonicheskoi bolezn'iu.

The aim of the study was to assess prestarium effects on central and renal hemodynamics, blood lipids in hypertensive subjects. Prestarium was given in a daily dose 4-6 mg to 30 patients with essential hypertension stage II free of cardiac decompensation and renal failure. Echocardiography, tetrapolar chest rheoplethysmography with assessment of hemodynamics, radionuclide tracing of renal blood flow, tests for cholesterol and blood electrolytes were made before treatment, on treatment weeks 2-3 and 12. It was found that prestarium lowers blood pressure and total peripheral vascular resistance. Myocardial conductivity was not affected, whereas renal circulation activated. Low-density lipoproteins cholesterol fell. No significant changes in electrolytes were seen. The drug was well tolerated. In view of good clinical effect and tolerance prestarium is recommended for treatment of essential hypertension stage II in the absence of cardiac decompensation and renal dysfunction.