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Hypertensive disease today is one of the most common cardiovascular diseases, as well as the most common disease associated with obesity. Evaluation of the level of adipokines, namely adiponutrin and galanin, depending on the degree and duration of hypertension, the degree of obesity and their correction against the background of combined antihypertensive therapy is relevant for further understanding of this comorbidity and improvement of the early diagnostics. 127 people were examined, including 107 patients with hypertension of degree 1–3 and 20 healthy persons. Of the patients included in the study, the adiponutrin and the galanin levels were determined in 58 patients, out of which 22 were prescribed different regimens of combined antihypertensive therapy. To determine the level of adiponutrin and galanin, an enzyme-linked immunosorbent assay was used. A significant increase was found in the blood serum of the examined adipokines in comparison with the control group: the galanin level was 4.8 times higher than in the control group, the adiponutrin level in patients with this comorbid pathology was 3.3 times higher than that in the control group. The galanin level is most pronounced in patients with hypertension of degree 3 and obesity of degree 3, which is confirmed by the presence of a direct correlation with systolic, diastolic and pulse blood pressure, very low density lipoprotein cholesterol. The adiponutrin level in the blood serum increased correspondingly to the increase in body mass index: in patients with obesity of degree 3 it was 15.8 times higher than this indicator in patients with normal body weight, 8.8 times higher than in patients with overweight, 6.1 times higher than in patients with obesity of degree 1 and 2.5 times higher than in patients with obesity of degree 2. The levels of the studied adipokines in patients differed also relative to the duration of hypertension. There was a 1.8-, 5.1-, 5.2-fold increase (respectively, ≤5, 6–10, >10 years) of the galanin content in the blood serum compared to the control group. Also an increase of the serum adiponutrin level was noted in comparison with the control group. Against the background of combined antihypertensive therapy, we observed favourable dynamics of galanin and adiponutrin. It is important to conduct further studies to assess the activity of galanin and adiponutrin with a longer follow-up period in wider populations.

Hypertension is a leading risk factor for coronary heart disease, stroke, peripheral arterial disease, kidney disease, vascular cognitive impairment, and mortality worldwide. Obesity in combination with hypertension continues to attract considerable attention from scientists. Despite the presence of experimental and clinical evidence of mutual burdening of hypertension and obesity, the mechanisms of formation of pathophysiological consequences of such a combination remain insufficiently defined. That is why in recent years an important role is given to the adiponutrin protein. The purpose of the study is to assess the nature of the relationship between adiponutrin levels and lipid and carbohydrate metabolism depending on the duration and degree of hypertension and the degree of obesity in patients with this comorbid pathology. Material and methods. The study included 107 patients with hypertension who were hospitalized in the cardiology department of Municipal noncommercial enterprise "Kharkiv City Clinical Hospital No.27" of Kharkiv municipal council. The age of patients ranged from 32 to 79 years (mean age was 58.6±9.88), who had not previously received regular antihypertensive therapy. The control group consisted of 20 age- and sex-appropriate healthy individuals. The level of adiponutrin was determined in 58 patients with hypertension of the 1st - 3rd degrees, aged from 32 to 79 years (mean age was 57.5±10.11 years), while hypertension of the 1st degree was diagnosed in 12 (20.7%) patients, hypertension of the 2nd degree - in 16 (27.6%), and hypertension of the 3rd degree - in 30 (51.7%) of the examined patients. Blood pressure was measured in patients in a sitting position after 5 minutes of rest, anthropometric measurements were performed, lipid profile and indicators of carbohydrate metabolism were evaluated, adiponutrin levels (pg/mL) were determined by enzyme immunoassay method using The RayBio® Adiponutrin Enzyme Immunoassay (EIA) Kit, (USA). Results and discussion. In all groups of patients with hypertension with overweight and obesity, adiponutrin levels were significantly elevated, and lipid and carbohydrate profiles tended to increase. Significant direct correlations were found between adiponutrine and triglycerides, with very low-density lipoprotein cholesterol of a moderate nature, and draws attention with a very high body mass index. In considering the differences in adiponutrin levels depending on gender, it was found that men have higher adiponutrin levels than women. Conclusion. Thus, we have the opportunity to consider adiponutrin as a marker of metabolic disorders

Introduction. Well-known the fact that obesity, especially its abdominal (visceral) form, is one of the most important risk factors for hypertension. The purpose: to determine the level of adiponutrin in patients with hypertension and obesity. Assess how the degree of hypertension and obesity affects the level of adiponutrin in our patients with this comorbid pathology. Materials and methods. The study included 58 patients with hypertension. Grade 1 was diagnosed in 12 (20.69%), grade 2 - in 16 (27.59%), grade 3 - in 30 (51.72%) examined patients. Of these, 32 women and 26 men aged 32 to 79 years (mean age 57.5 ± 10.11 years). Patients underwent anthropometric measurements, assessed lipid profile and changes in carbohydrate metabolism, adiponutrin levels. Results. The level of adiponutrin in all groups of hypertensive patients with overweight and obesity was significantly increased compared to the control group, but the degree of hypertension did not affect the level of adiponutrin. However, the concentration of the latter in the serum gradually increases according to the duration of hypertension. In addition, the level of adiponutrin increased depending on the degree of obesity, which, in turn, was confirmed by a reliable direct linear relationship between adiponutrin and body mass index. Conclusions. Based on the data obtained, adiponutrin can be considered as a marker of metabolic syndrome.

Acute myocardial infarction is necrosis of any myocardial mass due to ischemia. COVID-19 can be complicated by thrombosis and myocardial damage, which can lead to the deployment of a clinical picture similar to acute myocardial infarction. The material of this article is presented on the example of a clinical case. A woman aged 37 was diagnosed with an acute myocardial infarction, which later turned out to be a manifestation of a complicated course of coronavirus COVID-19 infection. This case drew attention to the absence of a clinical picture specific to this infection in the form of a damage to the respiratory system or intoxication. The case is also distinguished by the presence of a single uncharacteristic clinical manifestation of COVID-19 in the form of a cardiovascular event with elevations of the ST segment on the cardiogram and other objective data and additional research methods characteristic of acute myocardial infarction. The work also analyzed the pathogenetic mechanisms of acute myocardial infarction and cardiovascular complications of COVID-19, examined the general links of pathogenesis of these two pathological units and analyzed the causes of difficulties in their differential diagnosis. In this regard, there are unquestionably complications of differential diagnosis and the prescription of timely correct therapy. A deeper understanding of these data may improve the algorithms for diagnosing acute myocardial infarction and cardiovascular complications of COVID-19.

The aim: To examine the association between polymorphisms of the IL-6 gene promoter and HF in patients with CAD and obesity. Material and methods: 222 patients with coronary artery disease and obesity were identified. Comparison group consisted of 115 patients with coronary artery disease with normal body weight. The groups were comparable in age and sex. The exclusion group consisted of patients with severe concomitant diseases of the respiratory and digestive organs, kidneys and people with cancer. One single nucleotide polymorphisms in the interleukin-6 promoter region was analyzed. Odds ratio (OR) and 95 % confident interval (95 % CI) were calculated. Results: The combined course of coronary artery disease and obesity was characterized by the detection of allele C in 62 patients (27.93 %), allele G – in 160 patients (72.07 %), and genotypes CC, CG and GG – at 24 (10.81 %), 67 (30.18 %) and 131 (59.01 %) patients respectively. The results showed that the −174G allele and GG genotype in patients with coronary artery disease and obesity were associated with heart failure (OR = 2.55, 95% CI = [1.72-3.79], χ2 = 22.8; pC polymorphism in the interleukin-6 gene is significantly associated with increased risk of heart failure in patients with coronary artery disease and obesity.

Summary. Great attention is paid recently to studying of coronary artery disease (CAD) pathogenesis on the background of diabetes mellitus (DM). One of the pathogenetic mechanisms of atherosclerosis is generalized or chronic inflammation. In particular, the question of the role of an inflammatory component role in development of atherosclerosis in patients with DM 2 types is studied. One of new perspective markers of immune inflammation is pentraxin-3 (PTX-3). The purpose of the study –to evaluate the diagnostic value of pentraxin-3 and to study the relationship with the clinical types of coronary heart disease in patients with concomitant type 2 diabetes mellitus. Material and methods. The comprehensive examination of 110 patients with CAD was conducted. Patients were divided into groups depending on presence of DM type 2: the first group included 75 patients with stable CAD and DM type 2, the group of comparison consisted of 35 patients with CAD without DM type 2.Also patients were distributed in groups depending on the IHD clinical form: stable stenocardia, post-infarct cardiosclerosis (PIC) and diffusive cardiosclerosis. Results. In patients with CAD with concomitant DM type 2 there was defined pentraxinemia level depending on clinical types of CAD: in patients with PIC the PTX-3 level in blood serum was 5.68±0.51 ng/ml (r

Aim of study – to estimate leptin gene (Arg223Gln) genotypes polymorphism in patients with coronary heart disease and obesity. Materials and Methods. 222 patients with the coronary heart disease (CHD) and obesity have been comprehensively examined. All patients were on treatment in cardiologic unit of KUZ of the Kharkiv city hospital № 27, which is the basic clinic of Department of Internal Medicine № 2 and Clinical Immunology and Allergology of the Kharkiv National Medical University of MH of Ukraine. The comparison group consisted of 115 ischemic heart disease patients with normal body weight. 35 practically healthy persons formed the control group. Groups were comparable in age and sex. The study didn't include the patients with the serious accompanying pathology of respiratory organs, digestion, kidneys and persons with oncological diseases. Results. In the control group there was the following distribution of leptin gene (Arg223Gln) alleles and genotypes polymorphism frequency: 15 people were allele A that made 42.86 %, allele G – 20 people (57.14 %); genotypes G/G, A/A and G/G had 15 (42.86 %), 7 (20 %) and 13 (37.14 %) persons respectively. 42 patients with CHD were allele A, which made 36.52 %, allele G – 73 patients (63.48 %). Genotypes G/G, A/A and G/G had 47 (40.87 %), 20 (17.39 %) and 48 (41.74%) patients with CHD respectively. In group of patients with combination of CHD and obesity 71 patients (31.98 %) were allele A, allele G – 151 people (68.02 %); genotypes G/G, A/A and G/G – 81 (36.49 %), 33 (14.87 %) and 108 (48.64 %) respectively. Comparison of leptin gene (Arg223Gln) alleles and genotypes polymorphism frequency of detection between groups showed the reliable differences of alleles A, G and a genotype G/G. In patients with CHD and obesity allele G was 10.88 % more and genotype G/G was 11.5 % more, than in the control group. Allele A was 10.88 % more in the control group, than in patients with CHD and obesity (p < 0.05). Reliable differences between group of CHD patients and the control group in distribution of detected alleles and genotypes frequency of leptin gene (Arg223Gln) polymorphism were not found (p < 0.05). Conclusions. By results of the study allele G and a genotype G/G of leptin gene (Arg223Gln) polymorphism in patients with CHD has been associated with obesity. genetic polymorphism; leptin; coronary heart disease; obesity

In this article elucidated the influence of allelic polymorphism of Gln27Glu of β2-adrenoceptors gene on patients that have coronary heart disease and obesity on the expansion and progression of congestive heart failure and left ventricular systolic dysfunction by surveying 222 patients. Presence of C allel of polymorphous locus Gln27Glu of β2-adrenoreceptors gene in patients with ischemic heart disease and concomitant obesity was associated with decreased risk of development of congestive heart failure (p < 0.05). The obtained data shown the absence of influence of polymorphous variants of β2-adrenoreceptors gene on progression of congestive heart failure in patients with ischemic heart disease and obesity (p > 0.05).

The aim was to evaluate the structural and functional changes of the left ventricular myocardium according to the data of echocardiography in patients with arterial hypertension combined with obesity by the level of irisin. Materials and methods. 105 patients were divided into 2 groups for participation in the study: the 1 group consisted of patients with arterial hypertension with concomitant obesity with concomitant obesity (n = 70), the group 2 – patients with arterial hypertension and normal body weight (n = 35). The control group consisted of 25 practically healthy persons. All participants of the study underwent irisin level measurement by an enzyme-linked immuno-sorbent assay and an echocardiographic examination with subsequent computer processing of the results using the software package “Statistica 6.0” (StatSoft Inc.,USA). Results . In patients with arterial hypertension and obesity, hypoirisinemia (irisin level

У статтi проведено порiвняльний аналiз застосування рiзних схем лiкування хворих iз постiнфарктним кардiосклерозом та цукровим дiабетом 2 типу шляхом обстеження 68 хворих iз зазначеною патологiєю. У результатi рандомiзацiї було сформовано двi пiдгрупи спостереження: пiдгрупа 1 — 35 пацiєнтiв iз постiнфарктним кардiосклерозом та цукровим дiабетом 2 типу, якi отримували рамiприл у дозi 10 мг на добу; пiдгрупа 2 — 33 пацiєнти з постiнфарктним кардiосклерозом та цукровим дiабетом 2 типу, якi отримували телмiсартан у дозi 40 мг на добу. Лiкування постiнфарктного кардiосклерозу у хворих з супутнiм цукровим дiабетом 2 типу з використанням рамiприлу та телмiсартану показало позитивний вплив на структурно-функцiональнi параметри лiвого шлуночка, фракцiю викиду, адипокiни, фракталкiн та кластерiн. Порiвняльний аналiз застосування рамiприлу та телмiсартану у хворих з постiнфарктним кардiосклерозом i цукровим дiабетом 2 типу достовiрних вiдмiнностей мiж дослiдженими показниками не виявив, що також було пiдтверджено результатами пропорцiйного регресiйного аналiзу Кокса.

The features and central cardiohemodynamics indexes were estimated in patients with acute myocardial infarction, type 2 diabetes and obesity before and after reperfusion therapy. It was examined 58 patients with acute myocardial infarction, type 2 diabetes and obesity. Restoration of coronary blood flow by reperfusion therapy in patients with acute myocardial infarction, type 2 diabetes and obesity positive impacted on the clinical condition of the patient, increases the contractile function of the myocardium and promotes adaptive left ventricular remodeling. In patients with acute myocardial infarction, type 2 diabetes and obesity was found a significant reduction in the incidence of hospitalizations, improve the clinical course of chronic heart failure, coronary reserve increase of the heart after percutaneous coronary intervention compared with thrombolytic therapy.

Мета роботи – оцінити значення поліморфного локусу С-174G гена інтерлейкіна-6 у розвитку ожиріння у хворих з ішемічною хворобою серця.Матеріали та методи. Комплексно обстежили 222 пацієнти з ішемічною хворобою серця та ожирінням. Групу порівняння становили 115 хворих на ІХС із нормальною масою тіла. До контрольної групи увійшло 35 практично здорових осіб. Групи порівняні за віком і статтю. Діагноз встановлювався згідно з чинними наказами МОЗ України. Дослідження алельного поліморфізму C-174G гена інтерлейкіна-6 здійснили методом полімеразної ланцюгової реакції з електрофоретичною детекцією результатів із використанням наборів реактивів «SNP-ЕКСПРЕС» («Синтол», Російська Федерація).Результати. Розвиток ожиріння у хворих на ІХС був пов'язаний з алеллю G (відношення шансів = 1,58, 95 % довірливий інтервал = [1,12–2,24], χ2 = 6,9; р < 0,05) та G/G генотипом (відношення шансів = 1,98, 95 % довірливий інтервал = [1,25–3,16], χ2 = 8,4; р < 0,05) поліморфного локусу C-174G гена інтерлейкіна-6. Генотип G/G виявлявся вірогідно частіше у хворих з ішемічною хворобою серця та ожирінням ІІІ стадії на 15,26 % і 8,45 %, ніж у хворих із супутнім ожирінням І та ІІ стадій (р < 0,05). Генотип C/G у хворих з ішемічною хворобою серця та ожирінням ІІІ стаді, своєю чергою, виявлявся рідше на 11,21 %, ніж у хворих з ожирінням І стадії (р < 0,05). Алелі С, G і генотип С/С мали невірогідний розподіл у хворих на ішемічну хворобу серця залежно від ступеня ожиріння (р > 0,05).Висновки. Алель G і G/G генотип поліморфного локусу С-174G гена інтерлейкіна-6 пов'язані з розвитком і прогресуванням ожиріння у хворих на ішемічну хворобу серця., The aim of this study was to estimate value of a polymorphic locus C-174G of interleukin-6 gene in obesity development in patients with coronary artery disease.Materials and methods. 222 patients with coronary artery disease and obesity were included in this study. The research of an allelic C-174G polymorphism of interleukin-6 gene was conducted by PCR method with electrophoretic detection of results with use of reactants SNP-EKSPRESS ("Sintol", Russian Federation).Results. Development of obesity in patients with coronary artery disease has been connected with G gene (odds ratio = 1.58, 95 % confidence interval = [1.12–2.24], χ2 = 6.9; р < 0.05) and G/G genotype (odd ratio = 1.98, 95 % confidence interval = [1.25–3.16], χ2 = 8.4; р < 0.05) polymorphic locus of C-174G of interleukin-6 gene. The genotype G/G was reliably more frequent in patients with coronary artery disease and stage III of obesity by 15.26 % and 8.45 %, than in patients with the accompanying I and II stages of obesity (р < 0.05). In it's turn, C/G genotype in patients with coronary artery disease and the III stage of obesity occurred 11.21 % less, than in patients with the I stages of obesity (р < 0.05). Allele C, G and genotype C/C had unreliable distribution in patients with coronary artery disease depending on obesity degree (р < 0.05).Conclusions. This study has shown that the allele of G and G/G genotype of polymorphic locus C-174G of interleukin-6 gene is associated with development and progression of obesity in patients with coronary artery disease., Цель работы – оценить значение полиморфного локуса С-174G гена интерлейкина-6 в развитии ожирения у больных с ишемической болезнью сердца.Материалы и методы. С целью исследования проведено комплексное обследование 222 больных с ишемической болезнью сердца и ожирением. Группу сравнения составили 115 больных ишемической болезнью сердца с нормальной массой тела. В контрольную группу вошло 35 практически здоровых лиц. Группы были сопоставимы по возрасту и полу. Диагноз устанавливался в соответствии с действующими приказами Минздрава Украины. Исследование аллельного полиморфизма C-174G гена интерлейкина-6 проводили методом полимеразной цепной реакции с электрофоретической детекцией результатов с использованием наборов реактивов «SNP-ЭКСПРЕСС» («Синтол», Российская Федерация).Результаты. Развитие ожирения у больных ишемической болезнью сердца было связано с геном G (отношение шансов = 1,58, 95 % доверительный интервал = [1,12–2,24], χ2 = 6,9; р < 0,05) и G/G генотипом (отношение шансов = 1,98, 95 % доверительный интервал = [1,25–3,16], χ2 = 8,4; р < 0,05) полиморфного локуса C-174G гена интерлейкина-6. Генотип G/G встречался достоверно чаще у больных с ишемической болезнью сердца и ожирением III стадии на 15,26 % и 8,45 %, чем у больных с сопутствующим ожирением I и II стадий (р < 0,05). В свою очередь, генотип C/G у больных с ишемической болезнью сердца и ожирением III стадии встречался реже на 11,21 %, чем у больных с ожирением I стадии (р < 0,05). Аллели С, G и генотип С/С имели недостоверное распределение у больных ишемической болезнью сердца в зависимости от степени ожирения (р > 0,05).Выводы. Аллель G и G/G генотип полиморфного локуса С-174G гена интерлейкина-6 связаны с развитием и прогрессированием ожирения у больных ишемической болезнью сердца.

The purpose of this study was to evaluate the relationship between indicators of cardiac hemodynamics and types of dyslipidemia in patients with coronary heart disease and type 2 diabetes mellitus. Materials and Methods. A comprehensive examination of 85 patients with CHD and type 2 diabetes mellitus who were treated in the Cardiology Department of the Kharkiv City Clinical Hospital № 27 as a basic medical institution of the Department of Internal Medicine № 2 and Clinical Smmunology and Allergology of Kharkiv National Medical University MOH of Ukraine was made. Types of dyslipidemia were determined using the hyperlipidemia classification by WHO, based on the classification by Fredrickson (D. Fredrickson). The echocardiography study was performed according to standard methods (H. Feigenbaum, 1999) by the ultrasound unit RADMIR (Ultima PRO 30) (Kharkiv,Ukraine). Results. As a result of our research it has been found a significant increase in such indicators of cardiac hemodynamics as EDV by 29.32%, CSR by 35,39%, ESV by 13.79%, EDS by 16.17% in the group of patients with coronary heart disease and type 2 diabetes mellitus with type IIb dyslipidemia compared with patients with coronary heart disease and type 2 diabetes mellitus with type IIa dyslipidemia. We have determined the cardio hemodynamics indexes in patients with coronary heart disease and type 2 diabetes mellitus with type I and type IV dyslipidemia and detected a significant increase in such indices as DBP by 15.49%, EDV by 26.99%, EDS by 13.49%, ESV by 16.57% and the diameter of the aorta by 9.85% compared with patients with coronary artery disease and type 2 diabetes mellitus with I type dyslipidemia. Conclusions. According to the results of our study significant changes in the indices of cardiac hemodynamics occurred more often in patients with IIb and type IV dyslipidemia, suggesting a more adverse impact of these types on left ventricular remodeling in patients with coronary heart disease and type 2 diabetes mellitus.

With the use of ambulatory blood pressure monitoring were examined 105 patients with hypertension and type 2 diabetes. It was found that these patients is characterized by: lack of reduction in diastolic blood pressure at night-time, increase in the index of hypertension at night, increased variability of diastolic blood pressure at night, increase in blood pressure morning peak. Marked features should be considered when appointing of antihypertensive therapy for this group of patients and for control effectiveness.

The material was presented on the example of the clinical case. In woman of 64 years myeloma disease was diagnosed. This case has attracted attention due to the manifestation of myeloma disease heart failure and diabetic nephropathy arising on a background of ischemic heart disease, hypertension and type 2 diabetes. Non-specific character of clinical symptoms harshly worsened the diagnostic search.

OBJECTIVE Introduction: Recently great attention is paid to studying of coronary artery disease (CAD) pathogenesis against the background of the diabetes mellitus (DM). First of all, the question of an inflammatory component role in development of atherosclerosis in patients with DM 2 types is studied. One of new perspective markers of immune inflammation is pentraxin-3 (PTX-3). The aim of the study was to evaluate the nature of changes in the level of pentraxin-3 in patients with coronary artery disease, depending on the presence of type 2 diabetes mellitus and to investigate the nature of the relationship with metabolic parameters. PATIENTS AND METHODS Materials and methods: Comprehensive examination of 110 patients with CAD was conducted. Patients were divided into groups depending on presence of type 2 DM: to the first group (n = 75) entered patients with CAD and type 2 DM , the group of comparison was made by 35 patients with CAD without type 2 DM. 25 almost healthy persons entered into control group. RESULTS Results: As a result of a research it is established the reliable increase in PTX-3 level in all patients with CAD in comparison with group of control for 65.40% . And in the conditions of the combined current of CAD and type 2 DM, PTX-3 level is for 80.14% higher, than in persons of control group. Also interrelation between PTX-3 and indicators of dcarbohydrate and lipidic exchanges were defines. According to the carried-out correlation analysis there was revealed existence of direct integral probable connections between PTX-3 level and levels of glucose (r = 0.41; p