Medical academic journalMedical academic journal1608-41012687-1378Eco-Vector951510.17816/MAJ16335-40Research ArticleDISORDERS OF THE VEGETATIVE REGULATION OF VASCULAR ENDOTHELIUM FUNCTIONS IN THE PATHOGENESIS OF ACUTE CORONARY SYNDROMEWeberV RCorresponding member of the RASViktor.Veber@novsu.ruMakhanovD I-KaribayevK R-Yaroslav-the-Wise Novgorod State UniversityCentral Clinical Hospital of Medical Center of President’s Affairs Administrations of the of the Republic of Kazakhstan15092016163354003092018Copyright © 2016, Weber V.R., Makhanov D.I., Karibayev K.R.2016Changes in the regulation and functions of vascular endothelium were studied in 169 acute coronary syndrome (ACS) patients. Based on coronary angiography results, the patients were divided into two groups: with or without verified hemodynamically significant constriction of coronary arteries (HSCCA). Judgments about vegetative nervous functions were derived from cardiac rhythm variation analyzed according to P. M. Bayevskiy under basal conditions and upon cold stress. The parameters of vascular endothelial functions assessed in the study included circulating endothelial cell counts, blood nitric oxide metabolites, blood Willebrand factor, and endothelium-dependent vasodilation. It was found that, in patients having no HSCCA, vegetative dysfunctions manifested as signs of increased sympathetic and parasympathetic tone were more pronounced. We suggest that one of the mechanisms of ACS development in such patients may involve interactions between the vegetative nervous system and the endothelium, which result in sustained vasospasm.acute coronary syndromevegetative statuscardiac rhythm variationострый коронарный синдромвегетативный статусвариационная интервалометрияэндотелиальная дисфункция[Yuan M. J., Pan Y. S., Hu W. G. et al. A pilot study of prognostic value of non-invasive cardiac parameters for major adverse cardiac events in patients with acute coronary syndrome treated with percutaneous coronary intervention // Int. J. Clin. Exp. Med.- 2015.- Vol. 8 (12).- P. 22440-22449.][Işcen S. Prognostic factors in patients with acute coronary syndrome without ST-segment elevation // Arq. Bras. Cardiol.- 2013.- Vol. 101 (4).- P. 373-374.][Schäfer D., Nil M., Herzig D., Eser P. et al. Good reproducibility of heart rate variability after orthostatic challenge in patients with a history of acute coronary syndrome // J. Electrocardiol.- 2015.- Vol. 48 (4).- P. 696-702.][Баевский Р. М. Кибернетический анализ процессов управления сердечным ритмом // Актуальные проблемы физиологии и патологии кровообращения.- М.: Медицина, 1976.- С. 161-175.][Ибатов А. Д., Сыркин А. Л., Вейн А. М. и др. Особенности вегетативной регуляции и эмоционального статуса у больных ишемической болезнью сердца с различной выраженностью болевого синдрома // Клиническая медицина.- 2003.- Т. 81, № 12.- С. 36-40.][Люсов В. А., Волов Н. А., Гордеев И. Г. и др. Динамика показателей вариабельности ритма сердца в клинике острого периода инфаркта миокарда // Российский кардиологический журнал.- 2007.- № 3 (65).- С. 31-35.][Суворова И. А., Говорин А. В., Зайцев Д. Н. Вегетативные нарушения и дисфункция эндотелия у больных постинфарктным кардиосклерозом // Кардиология.- 2008.- Т. 48, № 10.- С. 10-12.][Harris P. R., Sommargren C. E., Stein P. K. et al. Heart rate variability measurement and clinical depression in acute coronary syndrome patients: narrative review of recent literature // Neuropsychiatr Dis Treat.- 2014.- Vol. 10.- P. 1335-1347.][Cieslik-Guerra U. I., Fila M. et al. Correlation between the activity of the autonomic nervous system and endothelial function in patients with acute coronary syndrome // Pol. Arch. Med. Wewn.- 2014.- Vol. 124 (10).- P. 509-515.]