[Myocardial infarction in a patient with a single ventricle of the heart].

A clinical case of myocardial infarction in a patient with single ventricle heart defect is described.

[RELATIONSHIP BETWEEN SMOKING AND INDICATORS OF SYSTEMIC INFLAMMATION IN PATIENTS WITH CORONARY HEART DISEASE].

Aim: To estimate the severity of systemic inflammation in subjects with coronary artery disease (CAD) without bronchopulmonary system comorbidity depending on smoking factor. Materials and methods: The subjects were divided into groups depending on smoking factor. We estimated the following laboratory markers of nonspecific inflammation: interleukine (IL)-12, -1ß, tumour necrosis factor-α, matrix metalloproteinase-9, C-reactive protein. The examination of lungs respiratory function included spirometry, body plethysmography and assessment of diffusing lung capacity. Results: 29.9% of the subjects with CAD smoked, 40% reported discontinuation of smoking in their histories. Smoking in CAD subjects without the history of bronchopulmonary system comorbidity was associated with a higher level of inflammatory markers (IL-12, IL-1ß, TNF-α, ММР-9 and CRP) than in subjects who ceased to smoke and those who have never smoked. No differences in the levels of inflammatory markers were revealed in subjects who had smoked before and never smoked. Conclusion: Smoking is widespread among CAD subjects. It is associated with a higher level of markers of nonspecific inflammation as compared to subjects who have never smoked before or ceased smoking.

[Pulmonary function in patients with type 2 diabetes and coronary artery disease].

Currently, there is no convincing evidence of respiratory failure in patients with diabetes mellitus (DM) and coronary artery disease (CAD). Aim: To evaluate the differences in the main parameters of pulmonary function in patients with isolated type 2 diabetes and diabetic patients with CAD. Materials and methods: Patients with diabetes were allocated to two groups depending to the presence of CAD. The assessment of carbohydrate and lipid metabolism, as well as the measurement of inflammatory markers were performed using standard methods of clinical and biochemical analysis. Respiratory function and diffusion capacity of the lungs (DLCO) were assessed using a body plethysmograph Elite Dl-220v. Results: Main pulmonary functional test parameters were within normal values, except residual volume in diabetic patients. Patients with concomitant CAD demonstrated lower values of the studied parameters compared to non-diabetic ones. A number of volume and flow rate parameters as well as DLCO correlated with systemic inflammation, decompensation of carbohydrate and lipid metabolism, and duration of diabetes. Conclusion: Diabetic patients with CAD suffered from respiratory failure, manifested as decline in pulmonary function and DLCO. Blood glucose levels, inflammation symptoms, dyslipidemia and myocardial dysfunction are among suspected causes contributing to the development and acceleration of this decline.

[Rate of Detection of Atherosclerosis in Patients With ST Elevation Myocardial Infarction and Concomitant Chronic Obstructive Pulmonary Disease of Light or Moderate Degree of Severity].

PURPOSE: to study frequency of detection of atherosclerosis among patients with ST elevation myocardial infarction (STEMI) and concomitant chronic obstructive pulmonary disease (COPD) of light or moderate degree of severity, and to elucidate its relation to lung function and level of C-reactive protein (CRP). MATERIAL AND METHODS: STEMI patients (n = 154) were enrolled into 2 groups: with (n = 58, group 1) and without (n = 96, group 2) COPD of light or moderate degree of severity. Examination of all patients included pulmonary function tests, color duplex scanning of arteries, determination of C-reactive protein using high sensitive assay (hs CRP) on days 10-14 from STEMI onset. RESULTS: Group 1 patients often had multivessel coronary lesions and signs of multifocal atherosclerosis (MFA).The extent of peripheral artery disease negatively correlated with parameters of lung expiratory function. Patients of this group had higher levels of hs CRP. At the same time STEMI and COPD patients demonstrated higher CRP levels, which reflected the activity of inflammation--one of mechanisms of atherosclerosis development. CONCLUSION: In patients with STEMI and COPD of light or moderate severity impairment of expiratory lung function and elevated level of hs CRP are associated with the presence of multifocal atherosclerosis and hemodynamically significant lesions in arteries.

[Impact of chronic obstructive pulmonary disease on one-year prognosis in patients with ST-segment elevation myocardial infarction].

AIM: To assess the role of chronic obstructive pulmonary disease (COPD) in the development of unfavorable outcomes of long-term (one-year) prognosis of ST-elevation myocardial infarction (STEMI). SUBJECTS AND METHODS: A total of 529 patients diagnosed with STEMI and no age limits were examined. Group 1 included 65 (12.3%) patients with previously diagnosed COPD; Group 2 consisted of 464 (87.7%) patients without COPD. One-year prognosis was studied in 384 (81.5%) patients. The investigators evaluated the following endpoints: evolving recurrent myocardial infarction (MI), progressive angina pectoris, decompensated chronic heart failure (CHF), repeat percutaneous coronary interventions, stroke, and death. RESULTS: The prevalence of COPD was 12.3% in the patients with STEM]. Unfavorable one-year prognosis was significantly more often registered in the comorbidity group regardless of age, gender, and smoking status. COPD increased the risk of combined endpoints by 1.9 times within a year after MI and that of decompensated CHD by 2.6 times during a year after STEM. CONCLUSION: COPD may be an independent risk factor for unfavorable outcomes during a year after MI.

[Relationship Between Respiratory Function and Myocardial Structure and Function in Patients With Type 2 Diabetes Mellitus and Ischemic Heart Disease].

PURPOSE: to analyze main parameters of respiratory dysfunction in patients with type 2 diabetes mellitus (DM) with and without concomitant ischemic heart disease (IHD). MATERIAL AND METHODS: We examined 104 patients with DM without (n= 64, 61.5%) and with (n=40, 38.5%) concomitant IHD. Examination included taking medical history, registration of parameters of myocardial and respiratory function and lung diffusion capacity. Resuts. Respiratory dysfunction in patients with DM was related to disease duration and glycose level. Presence of IHD and chronic heart failure of high functional class was associated with more pronounced reduction of forced expiratory volume in 1 sec and lung diffusion capacity. CONCLUSION: Revealed association between respiratory parameters and characteristics of the state of myocardium evidence for possible contribution of the latter in development of respiratory dysfunction in patients with DM.