[Myocardial and Arterial Stiffness Important Determinant of NT-ProBNP at Development of Heart Failure in Survivors of Myocardial Infarction].

AIM: To study diagnostic value of myocardial-arterial stiffness (MAS) as a determinant of N-terminal pro-brain natriuretic peptide (NT-proBNP) expression in patients with chronic heart failure (CHF) with ischemic or postinfarction left ventricular (LV) dysfunction. MATERIAL AND METHODS: We analyzed 6 months prognosis of 54 patients (mean age 61.7+/-8.6 years) with II-III NYHA class CHF divided into 2 groups: (I, n=18) with class II CHF and preserved LV ejection fraction (EF) (55+/-10.4%), (II, n=36) with class III CHF and low LF EF (30.4+/-6.8%). MAS was measured by echocardiography as ratio of arterial elasticity (Ea) and end-systolic elasticity of LV myocardium (Es). Serum NT-proBNP was measured by immunoenzyme assay. RESULTS: During 6 months follow-up one group II patient with initial NT-proBNP level 2020 rg/ml died. NT-proBNP level in group I was significantly lower than in group II (313 and 647 rg/ml, respectively). Ea/Es ratio was significantly higher (p=0.001) in group II. Multifactorial analysis demonstrated moderate correlation of NT-proBNP with Ea/Es ratio (r=0.50, p=0.0001) and negative correlation with LVEF (r=-0.45, =0.003) among patients with II-III class CHF. CONCLUSION: As correlation between symptoms and severity of clinical manifestations of ischemic or postinfarction cardiac dysfunction at development of CHF was not high it appears rational to consider MAS estimated by Ea/Es ratio as independent predictor of cardiovascular complications. Sufficiently close correlation between NT-proBNP and Ea/Es ratio allows to improve stratification of risk and to assess objectively prognosis of the disease using easier obtainable parameter Ea/Es in cases when possibility to measure NT-proBNP is not available.

[Comparative evaluation of the impact of four-week therapy with amlodipine and atenolol on quality of life and blood lipid composition in patients with coronary heart disease associated with metabolic syndrome].

AIM: To comparatively estimate the time course of changes in key metabolic parameters and quality of life (QL) in patients with coronary heart disease during 4-week therapy with atenolol and amlodipine. SUBJECTS AND METHODS: The 4-week randomized open-label trial included 60 patients with functional classes II-III stable angina pectoris on exertion associated with metabolic syndrome (all male patients aged 29 to 62 years (mean age 48.1 +/- 0.9 years)). Along with the traditional studies accepted in specialized cardiology practice, QL was assessed using the EORTC QLO CORE 30 questionnaire prior to treatment and on the last day of the trial. RESULTS: Four-week therapy with the individually adjusted dosages of atenolol (68.7 +/- 4.17 mg/day) or amlodipine (5.5 +/- 0.34 mg/ day) ensured comparable positive changes in the subjective assessment of QL. CONCLUSION: The positive changes in exercise tolerance that was considered to be an objective indicator for physical improvement in the treatment with amlodipine were more pronounced than those in that with atenolol. Therapy with amlodipine caused no change in blood lipid parameters while that with atenolol was associated with a 9.7% increase in blood triglyceride concentrations.

Stimulation of mouse resistance to bacterial infection with muramyl dipeptide glycoside.

We studied the capacity of 9 new muramyl dipeptide glycosides to stimulate mouse resistance to experimental sepsis induced by intraperitoneal injection of salmonella typhimurium culture. Preventive intraperitoneal injections of muramyl dipeptide beta-glycosides better improved survival of infected animals compared to the original (unmodified) muramyl dipeptide and muramyl dipeptide alpha-glycosides. The most effective drug muramyl dipeptide beta-heptylglycoside injected during sepsis development also reduced animal mortality, decreased bacterial contamination of the viscera, and increased phagocytic activity of peritoneal macrophages in infected animals.