MMP-2 and TIMP-2 in Patients with Heart Failure and Chronic Kidney Disease.

The aim of the study was to assess MMP-2 (matrix metalloproteinase-2) and TIMP-2 (tissue inhibitor of metalloproteinase-2) serum levels in patients with diverse types of heart failure (HF) and chronic kidney disease (CKD). 101 patients with chronic HF were enrolled. Each patient has assessed the serum levels of MMP-2, TIMP-2, and NT-proBNP. Patients were initially classified into 2 groups based on their LVEF. 43 patients were classified into the HFREF group (HF with Reduced Ejection Fraction) and 58 characterized as HFPEF (HF with Preserved Ejection Fraction). Next, all patients were subdivided into 4 groups according to the degree of diastolic dysfunction. 38 patients with CKD were classified into HF/CKD(+) group. The HF/CKD(-) (HF without CKD) group comprised 61 patients. This study provides original data on positive correlation between ejection fraction and MMP-2 levels in all patients with heart failure. Elevated levels of MMP-2 and TIMP-2 were found in serum from patients with chronic kidney disease; in addition, serum levels of MMP-2 were correlated with the degree of kidney failure. In all groups of patients there was positive correlation between MMP-2 and TIMP-2. Among patients with heart failure etiology was not related to MMP-2 and TIMP-2 serum levels.

Expression of Proinflammatory Factors, Proangiogenic Factors and Endostatin in Patients with Heart Failure and Different Grades of Collateral Circulation Development.

BACKGROUND: The process of collateral vessel maturation is stimulated by numerous factors affecting the endothelium and smooth muscle cells building the vessel wall. Looking for arteriogenesis stimulating factors means looking for a potential innovative heart failure treatment method in the patients unresponsive to traditional therapies. OBJECTIVES: The purpose of this study was to assess the changes in serum concentrations of pro-inflammatory factor IL-6, growth factors FGF (FGFa, FGFb, FGFbH), HGF, VEGF and endostatin in heart failure patients in relation to the coronary collaterals development stage. MATERIAL AND METHODS: This study included 22 patients with chronic heart failure NYHA II or III (mean age 62.5 ± 11.6 years) and 8 control patients (mean age 58.4 ± 10.7 years). Coronary angiography was performed and the presence and grade of collateral circulation was assessed by a four-level scale proposed by Rentrop and Cohen. The level of the studied factors was determined in the blood samples collected during the angiographic procedure. RESULTS: The concentration of IL-6 was significantly higher in the heart failure patients than in the control group (p < 0.001) and in NYHA III vs. NYHA II patients (p < 0.02). Patients with heart failure and collaterals grade 1 or 2 exhibited higher serum concentrations of FGFbH (from p < 0.03 to p < 0.01). The serum VEGF level in NYHA III patients was significantly higher than in NYHA II individuals (from p < 0.03 to p < 0.01). CONCLUSIONS: Higher levels of IL-6 and FGFbH were observed in patients with heart failure. Collaterals formation seems to be associated with the activation of pro-inflammatory factors, growth factors and endostatin.

Impact of nebivolol on levels of serum nitric oxide, plasma von Willebrand factor and exercise stress testing parameters in hypertensive and ischemic heart disease patients.

BACKGROUND: The dysfunction of vascular endothelium precedes the development of atherosclerosis in patients with arterial hypertension. Nebivolol is a very specific beta-blocker, which can be characterized by a strong endothelial vasodilatative effect. The aim of the study was the assessment of changes in concentrations of serum nitric oxide (NO), plasma von Willebrand factor (vWf) and selected parameters of electrocardiographic exercise tests after 4-week nebivolol treatment. METHODS: Twenty-one patients were included in the study, aged from 34 to 82 years with primary arterial hypertension or primary arterial hypertension and ischemic heart disease. Blood samples were taken for measurements of serum NO and plasma vWf. Electrocardiographic stress tests were also performed. Subsequently, nebivolol was administered for four weeks and the aforementioned measurements were repeated. RESULTS: A significant increase in serum NO concentration was found in all the investigated patients after nebivolol treatment. A prolongation of exercise time, increase in metabolic equivalent and decrease in double product were also noted in patients after nebivolol treatment. CONCLUSIONS: Nebivolol treatment improves parameters of electrocardiographic exercise test in patients with arterial hypertension. The improvement of the parameters of the exercise test was not observed in those patients who showed no significant increase in serum NO concentration following nebivolol treatment.

[Plasma urotensin II level in patients with chronic congestive heart failure]. / Stezenie urotensyny II w osoczu u chorych na przewlekla zastoinowa niewydolnosc serca.

Urotensin II (UTII) is recently discovered neurohumoral factor influencing function and structure of the myocardium and remodeling of the vessels, and it may contribute to pathogenesis of chronic congestive heart failure. The aim of the study was estimation of plasma concentration of UTII in patients with chronic congestive heart failure. The investigations were performed on 79 patients (37 women and 42 men) aged 43-87 yr. (mean 69.2 +/- 9.8 yr.) and 15 healthy individuals. In all patients, echocardiographic examination of the left ventricle structure and function was performed and serum concentration of electrolytes and creatinine were measured. Plasma levels of UTII were determined before treatment and after 1 week, 2 and 4 weeks of treatment using RIA Peninsula Lab. Inc. Plasma level of UTII in patients suffering from chronic congestive heart failure was significantly lower than in healthy individuals before the treatment and after achieving compensation of the circulatory system using standard treatment, independently from sex, kind of heart failure (systolic-diastolic or diastolic) or coexistence arterial hypertension or pulmonary hypertension, ischemic heart disease or diabetes and impaired glucose tolerance. Treatment of chronic congestive heart failure resulted in a transient increase in UTII concentration except for patients with diastolic heart failure or diabetes. Only patients without ischemic heart disease have a permanent increase in UTII concentration at the time of the treatment. After achieving compensation of the circulatory system in the patients suffering from systolic-diastolic heart failure, UTII concentration was significantly lower than in the patients suffering from diastolic heart failure, in the patients suffering from ischemic heart disease significantly lower than in patients without ischemic heart disease, in the patients with arterial hypertension significantly higher than in those with normal arterial tension, in group of the patients with pulmonary hypertension lower than in group of the patients without pulmonary hypertension and significantly higher in group of the patients suffering from diabetes or impaired glucose tolerance than in group of the patients without this metabolic disorders.

[The leptin concentration in patients with primary arterial hypertension]. / Ocena stezenia leptyny u chorych na pierwotne nadcisnienie tetnicze.

UNLABELLED: Leptin seems to play a role in the pathogenesis of arterial hypertension by activation of the sympathetic nervous system, influencing water - electrolyte balance and vascular remodeling. It is not known whether leptin is a factor participating in the pathogenesis of primary arterial hypertension or its higher concentration in patients with arterial hypertension reflects only the presence of other factors leading to increased blood pressure. The aim of the study was to try to estimate the leptin participation in the development of the arterial hypertension, to evaluate the concentration of leptin in blood serum of patients with mild, moderate and severe arterial hypertension and to determine the relationships between the observed leptin concentration, arterial hypertension degree according to WHO criteria and body mass. The investigations were performed on 74 untreated patients aged 19-74 years (mean 47 +/- 12 years ). In this group there were 33 women aged 35-74 years (mean 51 +/- 10 years) and 41 men aged 19-73 years (mean 45 +/- 14 years). The mild arterial hypertension was observed in 24 patients, moderate hypertension in 34 patients and severe hypertension in 16. The obesity, identified when BMI was equal or higher than 30 kg/m2, was observed in 4 patients with mild hypertension, in 9 with moderate hypertension and in 6 with severe hypertension. All patients had normal renal function. The leptin concentration was determined by the radioimmunological method using the Human Leptin RIA Kit by LINCO Research, Inc. (Cat# HL-81 K). The analysis of the obtained results was performed using Statistica for Windows PL.V5.0. RESULTS: The concentration of leptin in patients with mild hypertension was 3.61 +/- 2.22 ng/ml, in patients with moderate hypertension was 12.65 +/- 8.48 and in patients with severe hypertension 33.51 +/- 28.45 ng/ml. The concentration of leptin in obese patients was 24.83 +/- 26.60 and in patients without obesity was 10.57 +/- 11.99 ng/ml. CONCLUSIONS: 1. In patients with moderate and severe hypertension the leptin serum concentration is significantly higher than mild hypertension, and in patients with severe hypertension the leptin serum concentration is significantly higher than in patients with moderate hypertension. 2. In patients suffering from arterial hypertension the leptin serum concentration is positively correlated with the body mass index. 3. The leptin serum concentration is statistically significantly higher in women with arterial hypertension as compared to the male patients with the same disease. 4. In both male and female groups of patients the leptin serum concentration is positively correlated with the arterial hypertension degree. 5. In female patients suffering from arterial hypertension the leptin serum concentration is positively correlated with the body mass and body mass index.

[Estimation of the P wave and PQ interval dispersion in patients with the recent myocardial infarction]. / Ocena dyspersji zalamka P i odstepu PQ u chorych ze swiezym zawalem miesnia serca.

UNLABELLED: The supraventricular arrhythmia, and especially paroxysmal atrial fibrillation occurred in patients with the recent myocardial infarction are considered to be important therapeutical problem. The estimation of the P wave dispersion could be a method useful to differentiate the group of patients liable to suffer from this dysrhythmia. The aim of this paper was to estimate the P wave and PQ interval dispersion in patients with the recent myocardial infarction in dependence on the location, applied fibrinolytic treatment and the presence of the supraventricular arrhythmia. MATERIAL AND METHODS: The investigations were conducted on 46 patients (included 16 women) in age 41 to 84 years (mean 60+/-11.8 years), and among them there were 24 patients (8 women and 16 men) aged from 41 to 84 suffering from the inferior myocardial infarction and 22 patients (8 women and 14 men) aged from 44 to 81 with the anterior myocardial infarction. The estimation of the P wave and PQ interval dispersion was made by two independent researches on the 12-lead electrocardiogram, by using scanner and computer program Photo-Finish. There were analysed two electrocardiograms made in the first day, immediately after admitting of patient and 3 hours later, as well as the electrocardiograms made in the second, third, fourth and fifth day of disease. During the echocardiography the dimensions of the left atrium were estimated, and in the first and fifth day of hospitalization there was made 24-hours ECG monitoring by Holter method for the supraventricular arrhythmia diagnosing. CONCLUSIONS: 1. In patients with the recent myocardial infarction, irrespective of the location, applied fibrinolytic treatment or the supraventricular arrhythmia occurrence, the minimal and maximal lasting period of P wave and its dispersion were significantly higher comparing to control group. 2. The minimal and maximal lasting period of P wave and its dispersion were significantly lower in the following examinations comparing to the initial examination. 3. There were no significant differences in the maximal and minimal lasting period of P wave and its dispersion shown in patients suffering from the supraventricular arrhythmia comparing to the patients without the supraventricular arrhythmia. 4. It was no correlation between the left atrium dimensions and the maximal and minimal lasting period of P wave and its dispersion in the estimated groups. 5. The PQ interval dispersion and the minimal and maximal lasting period of PQ interval was not different only in the patients effectively treated by fibrinolysis comparing to the control group. 6. In all the patients in the fifth day of disease, the maximal and minimal lasting period PQ interval and its dispersion were significantly lower comparing to the electrocardiogram made after the admitting. 7. Till the fourth day (included) in patients suffering from the anterior myocardial infarction of the maximal and minimal lasting period of PQ interval was significantly longer than in patients with the inferior myocardial infarction, but there were no differences in PQ dispersion between them. 8. In patients with the myocardial infarction without the assisted supraventricular arrhythmia, the PQ interval dispersion measured in the electrocardiograms made three hours after the admitting and in these made in the following days was significantly lower comparing to the group of patients with supraventricular arrhythmia. 9. It was no correlation between the left atrium dimensions and the maximal and minimal lasting period of PQ interval and its dispersion.

[Estimation of the P wave and PQ interval dispersion in patients after the myocardial infarction]. / Ocena dyspersji zalamka P i odstepu PQ u chorych po przebytym zawale miesnia serca.

AIM: Because in patients with the recent myocardial infarction the noticeable differences in the P wave and PQ interval dispersion were observed in comparison to the control group, consisted of the healthy persons, it was an intresting problem to define the period of persistence of these visible changes on the electrocardiograms made in patients after the myocardial infarction. The aim of the study was to estimate the P wave and PQ interval dispersion in patients after the myocardial infarction in dependence on its location and applied fibrynolytical treatment. MATERIAL AND METHOD: The investigations were conducted on 36 male and female patients in age 40 to 84 years (mean 56 +/- 10,8 years), divided into groups of patients suffering from the inferior myocardial infarction and anterior myocardial infarction. The estimation of P wave and PQ interval dispersion was made by two independent researches on the 12 offtake electrocardiogram, by using scanner and computer program Photo-Finish. There were analysed electrocardiograms made in 10th day, 6 weeks of recovery and successively in 3rd, 6th, and 12th month after the recovery. During the each investigation the echocardiography was made to state the dimension of the left atrium and the blood samples was taken for the measurement of the atrial natriuretic peptide concentration (ANP). CONCLUSIONS: In all the investigated patients the P wave dispersion was significantly higher till 3 months after the myocardial infarction in comparison to the healthy control group, and the minimal and maximal lasting periods of both the P wave and PQ interval as well as the PQ interval dispersion hadn't significant difference comparing to the control group. In all the patients the P wave dispersion was significantly lower in the following examinations made in 3rd, 6th and 12th month of recovery comparing to the initial examination. ALL the examinations proved, that the maximal and minimal lasting period of PQ interval was significantly higher in the 6th week and 3rd, 6th and 12th month of recovery comparing to the examination made in the 10th day after the myocardial infarction. There were no differences between the P wave and the PQ interval dispersion in males and females, in the patients with the inferior myocardial infarction in comparison to the patients with the anterior myocardial infarction as well as in the patients treated fibrinolytically compared to these treated otherwise. It was no correlation between the left atrium dimensions and the P wave and PQ interval dispersion and the ANP concentration was positively correlated to the minimal lasting period of the P wave and the PQ interval in time 12 months after the myocardial infarction.

[Urotensin II--new peptide which regulates function of cardiovascular system]. / Urotensyna II--nowy peptyd regulujacy czynnosc ukladu krazenia.

Human urotensin II is one of the new peptide which regulates function of cardiovascular system. It stimulates cardiomyocytes and vascular smooth muscle hypertrophy and also shows inotropic properties. Urotensin II has the potential pathophysiological role in cardiovascular, lung and kidney diseases. The vascular function of this peptide in humans, however, has yet to be determined. Human urotensin II is an endocrine hormone with range vasoactive properties dependent on the anatomic site and the species. Preliminary results showed strong expression of urotensin II in the cardiomyocytes, and to a lesser extent in the vascular smooth muscle cells, endothelial cells, and inflammatory cells of patients with end-stage chronic heart failure. The development of selective human urotensin II antagonists may be of utility in the management of cardiovascular disorders.

[Homocysteine as the factor of atherosclerosis risk]. / Homocysteina jako czynnik zagrozenia miazdzyca.

A great number of epidemiologic and experimental results of scientific research led to the conclusion, that hyperhomocysteinemia could be possible risk factor for the cardiovascular diseases development in patients suffering from the homocysteinuria and in all the population, because of homocysteine's ability to the activation of the thrombogenesis processes and to the creation of the atherosclerotic changes. Furthermore, the elevated homocysteine concentration exacerbates the effects of the other atherosclerogenous factors, such as tobacco smoking or arterial hypertension. The increased mortality caused by the cardiovascular diseases was observed in patients with the homocysteine concentration elevated above 15 micromol/l on an empty stomach and 38 micromol/l after the methionine intake (the mortality was twice higher). The concentration aimed 10 to 15 micromol/l is assumed to be the normal high concentration. There were no screening researches led on the population for the showing the number of people with the increased homocysteine concentration, however such kind of investigation could be recommended in patients with diabetes, kidney diseases, family history with reported cardiovascular diseases, heart and other organs transplantation, and in patients with the constant intake medicaments increasing the homocysteine concentration. We have no results of prospective research conducted on the numerous patient group, which could document the profits resulted by the treatment of the hyperhomocysteinemia in the primary and secondary prophylactic of the cardiovascular disease.

[Dysmetabolic syndrome]. / Zespól dysmetaboliczny.

This paper present definition, prevalence and inheritance of the metabolic syndrome. The dysmetabolic syndrome most likely results from interplay between several genes and affluent environment. The prevalence of the syndrome is also very age-dependent and higher in males than in females. In subjects with dysmetabolic syndrome the survival is reduced, particulary because of increased cardiovascular mortality. The dysmetabolic syndrome requires non-drug and drug treatment.

[Effect of heavy metal ions on function of vascular endothelium in patients with ischemic heart disease]. / Wplyw jonów wybranych metali ciezkich na czynnosc sródblonka u pacjentów z choroba niedokrwienna serca.

UNLABELLED: Endothelium dysfunction is one of the first signs of atherosclerotic process. There are many factors known, which provoke such a dysfunction; many are still to be revealed. One of them may be a heavy metal ion. The aim of the study was to establish the link between heavy metal ions concentrations in blood and the endothelium dysfunction measured with the nitric oxide blood concentration in a population of patients with ischemic heart disease, not exposed occupationally to high concentrations of heavy metal ions. The study included 42 patients (24 men and 18 women, age 63.7 +/- 9.9 years) with angiography confirmed coronary artery disease. The study group was subdivided according to coronary artery atherosclerosis extent. Control included 18 patients (10 men and 8 women, age 58.7 +/- 9.4 years), where coronarography revealed no significant lesions in coronary arteries. In all persons blood for nitric oxide and heavy metal ions was collected. Heavy metal ions studied included: lead, copper, manganese, zinc, selenium, and cadmium. Heavy metal ions concentrations in studied and control group was within normal range for not exposed population and did not differ significantly with each other. No significant difference was observed between groups for nitric oxide concentration. Nitric oxide concentration correlated positively with zinc concentration in control group (p<0.001, Pearson r=0.70). Such a correlations was not present in studied group. After regression analysis there was still strong correlation between zinc and nitric oxide in control group (beta=0.43, p<0.01), the phenomenon not present in studied group. CONCLUSIONS: 1. In the group of patients with angiography confirmed ischemic heart disease heavy metal ions concentrations are within normal range for not exposed population and is not connected with coronary atherosclerosis extent. 2. From all heavy metal ions studied only zinc seams to have protective influence on endothelial function measured by nitric oxide production 3. No such a protective effect is observed in the group of patients with ischemic heart disease, which may be due to the relative zinc deficiency.

[Pulse pressure as a prognostic indicator of organ damage in patients with essential hypertension]. / Cisnienie tetna jako wskaznik prognostyczny powiklan narzadowych u chorych na pierwotne nadcisnienie tetnicze.

Pulse pressure (PP), defined as systolic blood pressure minus diastolic blood pressure, plays an important role as a risk factor for cardiovascular events. Pulse pressure is pulsatile component of blood pressure. A widened pulse pressure reflects increased stiffness of the large arteries. The aim of the study was to evaluate the association between pulse pressure and organ damage in essential hypertension. We examined 60 subjects, 34 women aged 59 +/- 13 years and 26 men aged 48 +/- 17 years with primary hypertension. In every subject we performed 24-hour automatic blood pressure measurement and echocardiography, abdominal ultrasonography, funduscopy, chest x-ray. We measured sodium potassium, creatinine level in serum and in urine, creatinine clearance and microalbuminuria. Pulse pressure is proportional to the stage of hypertension. A dimension of the aorta parallels with measures of blood pressure. The strong correlation between pulse pressure and damage in funduscopy can indicate, that complication in fundus of the eye are dependent more than the level of a pressure. The significantly higher sodium level in serum and the positive correlation between natremia, natriuresis and pulse pressure proves the role of natrium in pathophysiology of hypertension.

Relation between heavy metals and left ventricular diastolic function in patients with coronary artery disease.

One of the earliest detectable abnormalities in patients with coronary artery disease is left ventricular diastolic dysfunction. Its main cause is myocardial ischaemia, but still many of other mechanisms are possible. The aim of this study was to investigate the relation of cadmium, lead, copper, zinc, and selenium with left ventricular diastolic function indices in patients with coronary artery disease. The study included 33 patients (14 with single-vessel disease and 19 with multivessel disease on angiography) who were not exposed occupationally to heavy metals. Control group consisted of 18 patients with normal coronary arteries. The blood cadmium and lead concentrations and serum zinc, selenium and copper concentrations were determined using atomic absorption spectrophotometry. Left ventricular diastolic function parameters were estimated by echo-Doppler and colour M-mode. All heavy metal concentrations were within the standard ranges in all studied groups. Patients with single-vessel disease, multivessel disease and control group did not differ in concentrations of studied metals. On univariate and multivariate analysis only cadmium significantly correlated with echocardiographic parameters of left ventricular diastolic function: peak early to peak late mitral inflow velocity ratio (r = -0.36, p < 0.05) and deceleration time of early mitral inflow (r = 0.43, p < 0.01) in patients with CAD. No significant correlations between concentrations of heavy metals and indices of left ventricular diastolic function were found in control group. The present data suggest that cadmium in concentrations even below the threshold limit value for unexposed population may contribute to development of left ventricular diastolic dysfunction in patients with CAD, potentializing the effect of myocardial ischaemia.

[One-year observation of QT and corrected QT interval dispersion in patients with myocardial infarction]. / Roczna obserwacja dyspersji odstepu QT calkowitej i skorygowanej u chorych z przebytym zawalem miesnia serca.

The aim of the study was to evaluate, if the QT and corrected QT interval dispersion (QTd and QTcd) is a predictor of ventricular arrhythmia during one-year observation in patients with myocardial infarction (MI). Investigations were performed in 36 patients with MI, including 22 men and 14 women, aged 40-84 years. Considered criteria was: sex, MI location, applied/non applied thrombolytic treatment, after which patients were classified into 6 groups. I group--14 women aged 45-84. II group--22 men aged 40-71. III group--22 patients aged 43-68 with inferior wall MI (IMI). IV group--14 patients aged 40-84 with anterior wall MI (AMI). V group--29 patients aged 40-72 with MI treated thrombolytically. VI group--7 patients aged 43-84 with MI, not treated thrombolytically. Control group consisted of 15 healthy persons, aged 27-64. Standard 12-outputs ECG was performed on the 10nd day after admission to the hospital. For further observation ECG is provided within the 6th week, 3rd month, 6th month and 12th month after admission to the hospital were used. Holter monitoring was also performed on the 10nd day and 12th month after admission to the hospital. In patients with MI, independently of its sex, location and treatment, QTd and QTcd was initially increased. In patients treated thrombolytically QTcd was significantly decreasing during following months of observation, what hasn't been observed in patients not treated thrombolytically. There was no correlation between QTd, QTcd and non-sustained ventricular tachycardia in patients with MI.

[Cytokines and remodeling of the heart in patients with congestive heart failure]. / Cytokiny a przebudowa miesnia serca u chorych na zastoinowa niewydolnosc serca.

Proinflammatory cytokines are capable of modulating cardiovascular function by a various mechanisms. The aim of the study was to evaluate the influence of the selected cytokines: tumor necrosis factor alpha (TNF-alpha), interleukin 1 (IL-1), interleukin 2 (IL-2), interleukin 6 (L-6), endothelin 1 (ET-1) on the remodeling of the heart in patients with congestive heart failure (1-year follow-up). The study was made in 45 patients with congestive heart failure treated in the Department of Cardiology. Of these, 31 were men aged from 44 to 77 and 14 were women aged from 48 to 79. Ischaemic heart disease was diagnosed in 22 patients and ischaemic heart disease and hypertension in 10 patients, dilated cardiomyopathy was diagnosed in 6 patients and postinflammatory cardiomyopathy in 7 patients. Blood samples for determination of TNF-alpha, IL-1, IL-2, IL-6, ET-1, aldosterone, catecholamines, brain natriuretic peptide (BNP) and atrial natriuretic peptide (ANP) levels were obtained prior to the treatment and in 3 and 6 and 12 month follow-up. At the same time were estimated: NYHA functional class, structure, systolic and diastolic left ventricle function of the heart using echocardiography and 24-hour ECG Holter monitoring (HR, supraventricular and ventricular arrhythmias). TNF-alpha, IL-1, IL-2, IL-6, ET-1, aldosterone, catecholamines, BNP and ANP plasma levels were determined with radioimmunological assay. In patients with progression of congestive heart failure (worsening of NYHA class and ejection fraction of left ventricle) the plasma concentrations of TNF-alpha and ET-1 significantly increased in following observations. In this group patients we determined a correlation between ejection fraction of the left ventricle and serum concentration of TNF-alpha and ET-1. In patients with improving of NYHA functional class and ejection fraction of left ventricle the plasma concentrations of cytokines were not altering. In all patients the plasma concentration of TNF-alpha correlated with ANP and BNP concentrations.

[Serum level of beta-chemokine RANTES in patients with coronary artery disease]. / Stezenie beta-chemokiny RANTES w surowicy u chorych na chorobe niedokrwienna serca.

Chronic inflammatory process plays an important, as still not clear, role in pathophysiology of coronary artery disease (CAD), especially in acute coronary syndromes. Chemokines are present in atherosclerotic plaques and are essential factors in the recruitment of leukocytes and stabilization of atherosclerotic lesions. The aim of the study was the evaluation of RANTES serum level in patients with stabile CAD and seeking for correlations between RANTES serum level and progression of atherosclerotic lesions. The study included 83 patients from 22 to 87 years old, 41 women (mean age 61,2 +/- 12,5) and 42 men (mean age 58,8 +/- 15,4), who were admitted to the Cardiology Department for coronarography. After coronarography the patients were separated in 4 groups according to the presence of atherosclerotic lesions. Patients with atherosclerotic lesions were also divided depending on the severity of anginal pains to CCS II or CCS III classes. Blood samples for the measurement of RANTES serum level were taken at baseline conditions on the day after the admittance to the hospital. RANTES serum level was measured by enzyme-linked immunoabsorbent assay (ELISA) kit system (Endogen, MA, USA). There was not statistically significant differance in RANTES serum level between patients with CAD and subjects without atherosclerotic lesions in coronary arteries with or without arterial hypertension. Significantly higher levels of RANTES were observed in patients with atherosclerotic lesions in coronary arteries and anginal pains in CCS II class, than in patients with atherosclerotic lesions in coronary arteries and anginal pains in CCS II class, as well as in subjects without atherosclerotic lesions (respectively 58.5 vs 42.1 pg/ml and 54.5 vs 41.9 pg/ml, p<0.01). Significant positive corellations were found in patients with CAD between RANTES serum level and systolic blood pressure (r Pearson 0,291, p<0.05), and cholesterol (R Spearman 0.289, p<0.05). In all patients analysis of regression found significant correlation between RANTES serum level and systolic blood pressure (p 0.296, B 0.391, p<0.007). These results may indicate the active implication of chemokines in the pathophysiology of atherosclerotic lesions.