GENDER DISPARITIES OF CIRCULATORY DISEASE PROGRESS IN THE CHORNOBYL ACCIDENT CLEAN-UP WORKERS AND PHOSPHODIESTERASE 4D GENE rs966221 POLYMORPHISM. / GENDERNI VIDMINNOSTI ROZVYTKU ZAKhVORIuVAN' SYSTEMY KROVOOBIGU V UChASNYKIV LIKVIDATsIÏ NASLIDKIV ChORNOBYL'S'KOÏ AVARIÏ I POLIMORFIZM rs966221 GENA FOSFODIESTERAZY 4D.

OBJECTIVE: Evaluation of the hypertensive disease (HD) and coronary heart disease (CHD) progress in the ChornobylNPP (ChNPP) accident clean-up workers (ACUW) and persons not exposed to ionizing radiation depending on gen-der and genotype of the phosphodiesterase 4D (PDE4D) gene rs966221 polymorphism. MATERIALS AND METHODS: There were male ACUW (ACUWm; n=515) and female ACUW (ACUWf; n=145) involved in thestudy since 2013 till 2018. Participation in the clean-up works took place in 1986-1987. The control group includ-ed male (CGm; n=162) and female (CGf; n=120) persons not exposed to ionizing radiation. All study subjects havehad neither signs nor symptoms of HD or CHD before the ChNPP accident. RESULTS: Review of the Kaplan-Meier survival tables indicated that according to median survival the HD emerged inACUWm and ACUWf in a younger age (47.5 ± 0.6 and 50.7 ± 0.7 years old, respectively) vs. CGm or CGf (54.9 ± 1.1 and54.4 ± 1.1 years, respectively). The same was true for CHD where the median values were (56.8 ± 0.5), (61.2 ± 0.8),(61.6 ± 1.0) and (64.2 ± 1.4) years respectively. Review of cumulative incidence of HD and CHD revealed no associ-ation of the PDE4D gene rs966221 polymorphism with the diseases of concern. The TT gene carrier state comparedto the CC or CT genes features an increased risk of myocardial infarction (MI) 2.9 times in ACUWm, 4-fold in CGm, and5.5 times in CGf (p < 0.05). No any gene carrier state was associated with MI in the ACUWf. Onset of menopause wasfollowed by an increase in HD incidence vs. males. CONCLUSIONS: The male and female ChNPP ACUW were developing HD and CAD at a younger age compared with cor-responding non-irradiated control. In male ACUW in comparison with female ACUW the cumulative morbidity ratefor MI was higher in any age range, whereas for CAD it was higher from 23 to 74 years, and for HD from 25 to 53 yearsof age. In male and female ACUW as well as in non-irradiated control the HD developed much earlier than CHD. Thecarrier state of TT genotype of PDE4D gene rs966221 polymorphism increases the risk of MI in males of all ages, inthe non-irradiated controls it is increased in 65 years for men and in 60 years for women. No data on association ofthe genotype of the described gene polymorphism with MI were found in female ACUW.

[Structure peculiarities, conditions and factors preceding the development of heart rhythm disorder in Chernobyl cleanup workers].

3595 participants of liquidation of consequences of Chernobyl accident (LCA) have been follow-upped since 1986. Structure and factors prior the development of heart rhythm derangements, results of physical examination, tonometry, ECG daily monitoring with taking into account the variability of heart rhythm, data of echocardiography with Doppler analysis have been established in 742 patients. Extrasystolic arrhythmia (50.8%) and atrium fibrillation prevailed in clinical structure of clinical structure of heart rhythm disorders (HRD). Etiological factors of HRD in 91.1% of cases were ischemic heart disease (IHD), hypertension and especially their combination, in 4.6%--other disorders, 4.6%--idiopathic HRD. It is possible to address special significance among factors before the development of HRD the following ones: participation in LCA since 1986, shift team work, ionizing radiation > or = 25 c3B, negative thoughts and memory about these events, from style of living--smoking habit, professional contact with xenobiotics, increased levels of arterial pressure, cholesterin, body weight index. Especial attention should be given to as predictors of the development of HRD -increased myocardium weight index > or = 170 gr/M2, duration of common and painless myocardial ischemia, basal frequency of heart rhythm > or = 75 b./m. It was established reliable relation between ventricular extrasystole and decreased of common BCP (r = -0.57; P < 0.05), spectrum power, (r = -0.52; P < 0.05), correlation disorder between its components. It is logical there was influence caused by combination of factors arised in connection with Chernobyl accident, life style and structural and functional changes of myocardium, hypertension and ischemic heart disease which are often found in Chernobyl disaster fighters.