Vol 16, No 1 (2016)

Objective: Examination of the current concept of development of inflammatory reactions in atherosclerosis as presented in the available literature. Materials and methods: Dedicated query tools were used to search for publications addressing the problem of atherogenesis from the modern standpoints. The publications found were subjected to content analysis and reviewed in the historical and analytical perspectives. Results: the primary triggers of the development of atherosclerosis are believed to be the responses of inborn and adaptive immunity to the antigenic activity of oxidized low density lipoproteins and related species, cell death, heat shock proteins, infectious agents, chronic autoimmune diseases in anamnesis, inflammation of the adventitia, hemorrhages in vascular intima, and decreased antiatherogenic antibodies production. Atherosclerosis may be caused by genetically determined inflammatory reactions. Conclusion: Numerous data suggest that chronic inflammatory reactions are at the base of the development of atherosclerosis.

Objective: To study the effect of Enalapril on structural changes in the extracellular matrix of the media of the thoracic and abdominal segments of rat aorta under conditions that model different variants of chronic stress. Materials and methods: Wistar rats were used in experiments. Chronic adrenergic or cholinergic stresses were modeled by intraperitoneal administrations of adrenaline or Proserpine, respectively, during two weeks. The effects of Enalapril on modeled stresses were assessed by determination of the volume density of the extracellular space and collagen and elastin fibers of the media of the thoracic and abdominal segments of aorta. Results: The effects of Enalapril on extracellular matrix remodeling were most expressed in the thoracic aorta where the drug, upon the chronic adrenergic stress, prevented fibrosis and decreased collagen degradation and, upon the chronic cholinergic stress, decreased extracellular space remodeling and inhibited progression of fibrosis, in spite of a decrease in the density of elastin. In the abdominal aorta, elastin degradation increased under the effects of either, Enalapril and both variants of chronic stress. Upon chronic cholinergic stress, progressing changes in elastin network were associated with progressing fibrosis. Conclusion: Enalapryl is protective against extracellular matrix remodeling differently, depending on the conditions of stress and on the segment of aorta. Enalapryl effects were most pronounced in the thoracic segment of Wistar rat aorta upon chronic adrenergic stress and less pronounced upon chronic cholinergic stress. No protective effects of Enalapril were found in the abdominal segment of aorta upon any of stress variants.

Hypothalamic orexin-B-containing neurons reaction was investigated during several hours after administration of thymus-dependent (bovine serum albumin - BSA) and thymus-independent (lipopolysaccharide - LPS) antigen. Using immunohistochemical method we revealed changes in quantity of visualized orexin-B positive neurons and their relative optical density (ROD) only 1 hour after LPS injection. Four patterns of changes were distinguished: increase of neurons quantity; increase of neurons ROD; increase of both cells quantity and ROD; simultaneously neurons quantity increase and ROD decrease. Thus injection of T-independent antigen (LPS) causes multidirectional reaction of orexin-B-positive neurons, that could be explained with morphofunctional heterogeneity of these neurons. Administration of T-dependent antigen (BSA) does not change immunoreactivity of orexin-B-positive neurons during several hours after antigen application.

Negative stress echocardiography (SE) results suggest a favorable prognosis. However, this is true only if a submaximum heartbeat rate (HBR) is achieved in a patient. The objective of the present study was to assess the prognostic significance of coronary blood flow parameters of the anterior interventricular artery (AIVA) upon SE under physical load stress in patients who did not achieve a submaximum HBR. Materials and methods: Physical load SE data obtained for 268 patients aged 54±10 years, among whom 156 were men, were analyzed. SE data were supplemented with the results of measuring AIVA blood flow parameters using Doppler sonography. The coronary reserve value of AIVA (CRAIVA) was calculated. The patients were divided into the following groups: 1) 35 patients who did not achieve a submaximum HBR and whose CRAIVA was <2; 2) 54 patients who did not achieve a submaximum HBR and whose CRAIVA was >2; and 3) 179 patients who achieved a submaximum HBR. Adverse events were analyzed three years thereafter. Results: In 8 patients, adverse events included 2 nonfatal myocardial infarctions and 6 revascularization events. No differences in adverse event rates between Groups 3 and 2 were found (1,75% vs. 3,7%, p=0,37). A significant increase in adverse event rate was found in Group 1 compared with Group 3 (8,6% vs. 1,75%, p<0,03), including the most severe outcomes, i. e., MI/coronary artery bypass (5,7% vs. 0%, p<0,002). Conclusion: ES upon physical load should be supplemented with coronary blood flow determination in AIVA.

The aim of the present study was to assess the prognostic value of tests for pregnancy-associated plasma protein-A (PAPP-A) and insulin-like growth factor-1 (IGF-1) and of case history analysis in acute coronary syndrome (ACS) patients. Materials and methods. PAPP-a and IGF-1 levels were determined 71 ACS patients and in reference and control groups. In the ACS group, data about the duration of ischemic heart disease and arterial hypertension were extracted form case histories. Results and discussion. PAPP-A is higher in ACS than in reference and control groups. IGF-1 upon myocardial infarction is lower than in the reference group. IGF-1 increase associated with unstable angina compared with the reference and control groups is not significant. The highest IGF-1 levels were observed in the reference group, whereas the lowest, in lethal cases. Outcomes were stratified according to durations of IHD and hypertension. Anamnesis compromised with both conditions lasting for 11 to 32 years makes a basis for MI risk. However, MI is not excluded within the first year after IHD diagnosis. Conclusions. The novel biochemical markers of vascular inflammation and damage, PAPP-A and IGF-1, may be used as indicators of atherosclerotic plague instability. They have prognostic value and in ACS patients should be used in combination with anamnesis data.

The power of love desire as a harmonizing and creative drive, which awakes the sense of sympathy and mutual acceptation, plays an invaluable healing and socializing role in the life of an invalid. The erotic drive is fundamental for human and natural relationships and for human yearning for the divine and for self-sacrifice and self-determination in the divine via love and, sometimes, via the acceptation of suffering. The depth of these sensations may be superficial when it comes to hurt pride or, by contrast, may be immense and even able to transform suffering into bliss when it comes to sympathy for the neighbor or the Protoplast. The power of love and erotic drive allows a human to perceive and accept the fullness of his/her own being and of the one he/she loves being, as well as the mystic fullness of the Divine existence.