Levels of middle and low molecular weight substances in patients with Q-wave and without Q-wave myocardial infarction associated with chronic obstructive pulmonary disease

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Abstract

In recent decades, enough data has accumulated that in cases of both cardiovascular and bronchopulmonary systems, endogenous intoxication syndrome is developing. The aim: to study and analyze the level of substances of medium and low molecular weight (SMLMW) and oligopeptides (OP) in patients with myocardial infarction (MI) associated with COPD, depending on the Q-wave presence. Material and methods. 225 patients with MI were examined, including 195 persons with MI in combination with COPD. In the main group (MI + COPD), 49 persons had MI without Q-wave (non-Q-MI), and 146 had MI with Q-wave (Q-MI). In the comparison group (MI without COPD), the division was as following: 29 persons with non-Q-MI, 101 with Q-MI. The control group was represented by 110 somatically healthy individuals. The level of SMLMW and OP was determined by the method of M.Ya. Malakhova (1995) by means of direct spectrometry. Results. Among patients with myocardial infarction as a mononosology with Q-MI, higher SMLMW and OD were fixed both in plasma and in erythrocytes comparatively with non-Q-MI patients. In patients with myocardial infarction associated with COPD, the levels of SMLMW and OP were significantly higher and did not depend on the size of the necrosis focus. Index of endogenous intoxication and coefficient of intoxication showed the same laws. The levels of SMLMW and OP in the urine, both in patients with MI without COPD and in patients with MI associated with COPD, did not show dependence on the presence of the Q-wave. Among patients with MI as a mononosology in the presence of a Q-wave, more expressed phases of endogenous intoxication were recorded; among patients with MI associated with COPD, this law was not observed. Conclusion. The results of our study demonstrated that the volume of the necrosis zone affects the level of endotoxemia in the development of MI as a mononosology. In patients with combined cardiorespiratory comorbidity, COPD is the dominant cause of chronic endotoxemia, and the development of acute coronary pathology against this background only exacerbates the existing endogenous intoxication. Dysfunction of the excretory organs, which occurred in the group of patients with MI associated with COPD, is not connected with the depth of myocardial damage.

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About the authors

Tatyana V. Prokofieva

Astrakhan State Medical University of the Ministry of Healthcare of Russia

Email: prokofeva-73@inbox.ru
PhD in Medicine, associate professor of the Department of internal medicine of the Faculty of pediatrics

Olga S. Polunina

Astrakhan State Medical University of the Ministry of Healthcare of Russia

Email: admed@yandex.ru
Dr. med. habil., professor, head of the Department of internal medicine of the Faculty of pediatrics

Irina V. Sevostianova

Astrakhan State Medical University of the Ministry of Healthcare of Russia

Email: irina-nurzhanova@yandex.ru
PhD in Medicine, associate professor of the Department of internal medicine of the Faculty of pediatrics

Ekaterina A. Polunina

Astrakhan State Medical University of the Ministry of Healthcare of Russia

Email: gilti2@yandex.ru
Dr. med. habil., associate professor of the Department of internal medicine of the Faculty of pediatrics

Irina S. Belyakova

Astrakhan State Medical University of the Ministry of Healthcare of Russia

Email: irinka150911@rambler.ru
PhD in Medicine, assistant at the Department of internal medicine of the Faculty of pediatrics

Nadezhda Yu. Perova

Astrakhan State Medical University of the Ministry of Healthcare of Russia

Email: perovanu@mail.ru
PhD in Medicine, assistant at the Department of internal medicine of the Faculty of pediatrics

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