[The study of markers of herpes virus infections in myocardial ischemia].

A group of patients with ischemic heart disease (IHD), who underwent surgical aorta-coronary vascular shunting, was examined in this investigation. Low titers of HSV-1 specific IgG were detected in all patients, the obtained values being consistent with similar data obtained in healthy subjects of the same age. Negative PCR of HSV-I DNA in blood and biopsy results were obtained. None of the patients demonstrated typical clinical pattern of infectious disease caused by herpes simplex virus. These data are evidence of the absence of the HSV-1 correlation with coronary atherosclerosis in patients with the IHD diagnosis. The significance of HCMV specific IgG titers and HCMV DNA detected in blood plasma in 87.7% cases is probably attributed to existence of connection of HCMV infection markers revealing in patient' blood with IHD diagnosis and coronary atherosclerosis. Besides, the HCMV DNA presence in biopsy taken from myocardium or vascular wall with lesion is revealed in 100% cases. The cytomegalovirus markers in tissue lesions with the help of specific antiserums marked to HSMV recombinant proteins are also revealed in 100% cases. This fact indicates the connection between pathological atherosclerotical process in IHD and cytomegalovirus infection.

[Study of herpes viruses in the blood of patients with cardiovascular pathology]. / Issledovanie gerpesvirusov v krovi bol'nykh s serdechno-sosudistoi patologiei.

The association between Cytomegalovirus (CMV) and Herpes simplex (HSV-1), on the one hand, and the coronary heart disease and chronic venous insufficiency (CVI), on the other hand, was studied; besides the infection rate by the above viruses in different age groups of donors was examined. The following methods--immune-enzyme analysis and detection of viral DNA by means of the polymerase chain reaction (PCR) as well as immune-fluorescence scanning of atherosclerotic plaques--were made use in the study. The pathogenesis of coronary heart disease was shown to be related with the viral contamination caused by CMV, while there was no such correlation between the former and the CVI patients. Finally, it was established that, with age, the frequency rate of seropositive reactions to CMV and HSV-1 was increasing in virtually healthy people.

[Effectiveness of plasmapheresis and its modifications in the treatment of cardiosurgical patients]. / Effektivnost' plazmafereza i ego modifikatsii v lechenii kardiokhirurgicheskikh bol'nykh.

The efficiency of plasmapheresis in the treatment of infectious complications and multiple organ dysfunctions was evaluated in 66 patients after heart surgery. Early plasmapheresis attenuated the cytokine-related systemic inflammatory response and organ damage. The optimal use of plasmapheresis modifications (membrane plasma filtration, plasma carboperfusion, cryoapheresis) improved the clinical outcomes.

Corticosteroid and immune responses to cardiac surgery.

Serum corticosteroid-binding globulin (CBG) and cortisol levels as well as subsets of circulating immunocompetent cells (ICCs) were measured during cardiac surgery. Closed heart surgery (closed mitral commissurotomy) resulted in an elevation of cortisol levels (up to 32 +/- 5 micrograms/dL by the end of the surgery) with no changes in CBG and ICC levels observed. Open heart surgery (open reconstruction of the mitral valve) in surface-induced hypothermia (without extracorporeal bypass) caused a dramatic drop in CBG activity (from 250 +/- 17 microM before the beginning of anesthesia to 198 +/- 15 microM by the end of cooling (just before cardiac arrest) and 158 +/- 13 microM after 30 min of reperfusion), whereas cortisol levels were only slightly elevated by the end of cooling, and a significant increase (up to 17 +/- 2 micrograms/dL) was observed only at the end of the surgery (60 min of reperfusion and warming). Similar to CBG, a significant decline in circulating ICC contents occurred in response to cooling and circulatory arrest.

Serum corticosteroid-binding globulin levels in children undergoing heart surgery.

Serum corticosteroid-binding globulin (CBG) levels were measured in children (mean age 4 years) during heart surgery. Considerable decrease in CBG level occurred between baseline examination (416 +/- 39 nM) and the day of surgery (314 +/- 30 nM). Relatively simple closed heart surgery did not influence CBG level with maximal cortisol level being 20 +/- 4 micrograms/dl. Open heart surgery under conditions of profound hypothermia (26 C, without extracorporeal circulation) caused dramatic lowering of CBG level, particularly striking after resuscitation (180 +/- 20 nM). At the same time cortisol level reached extremely high values (78 +/- 8 micrograms/dl). These data suggest that CBG is likely to play an important role in pituitary-adrenal response to surgery under severe conditions of hypothermia and cardiac arrest.