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"Flexibility” is a physical quality of a person, which is characterized by the ability to perform movements with a large amplitude. Flexibility is important for success in such activities as sports (artistic and rhythmic gymnastics, figure skating, etc.), as well in classical choreography, for example, ballet. Extracellular matrix producing cells and structural proteins of connective tissues take an active part in the formation of mobility of the elements of the musculoskeletal system. Connective tissues are a complex structural and functional system, the components of which are encoded by many genes. Mutations in them lead to various hereditary diseases that increase or decrease "flexibility”. The role of genes in the formation of conditions encoded in the ICD-11 LD28.Z remains unclear - "Syndromes involving connective tissue as the main feature, unspecified”, and their prognostic significance for people experiencing intense physical exertion. The purpose of this review is to generalize modern ideas about the role of genes, extracellular matrix and cells producing it in the formation of such a physical quality as flexibility.

The aim: To determine predictors and develop the model of prognosis of comorbidity of ischemic heart disease and type 2 diabetes mellitus. Materials and methods: 126 patients were involved in the study and divided into three groups. Main group involved 70 patients with comorbid T2DM and IHD; comparison group included 36 IHD-only patients; 20 patients were included into control group. Results: Predictors of comorbid T2DM and IHD included titin (OR = 0.001 [95.0 % CI 0.001–0.105], р = 0.021); I and II grade hypertension (respectively OR = 28.993 [95.0 % CІ 1.595–526.940], р = 0.023 and OR = 19.050 [95.0 % CІ 1.078–336.620], р = 0.044); left ventricle hypertrophy (OR = 3.169 [95.0 % CІ 1.103–3.108], р = 0.032); very low density cholesterol level (OR = 49.032 [95.0 % CІ 4.155–578.644], р = 0.022); and stenocardia symptoms in significant physical load (OR = 6.199 [95.0 % CІ 1.129–34.039], р = 0.036). Conclusions: developed model can be used in prediction of comorbid course of T2DM in patients with IHD for early diagnosis of cardiovascular complications in such patients.

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.

The aim: To study the level of Galanin concentration in hypertensive patients with obesity, and to identify how the degree of hypertension and the degree of obesity affect the level of Galanin in 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 – 16 (27.59%), grade 3 – 30 (51.72%) examined patients. Of the patients enrolled to study, 32 were women and 26 were men, 32 to 79 years old (mean age – 57,5±10.11 years). Results: The level of Galanin in all groups of hypertensive patients was significantly increased compared to the control group (p < 0.001). The concentration of the latter in the blood serum gradually increases according to the degree of hypertension, while (p

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 purpose of the article is to build a conceptual model of strategic project management through the prism of a multidisciplinary approach. Project management methodologies for the place of strategic management of complex nonlinear system development are analyzed. Standardized, adaptive and combined project and program management methodologies (PMBoK, P2M, PRINCE2, MSP, Agile) are considered. The authors pay special atten-tion to the study of the influence of the external environment on a complex nonlinear system in the context of a synergetic approach. The main part describes the process of expanding the scope of project management and inte-gration of project management with modern methods and tools of other management disciplines. Elements of the theory of synergetics and the classical theory of the design approach to the management of the development of a complex nonlinear system are synthesized. The necessity of clear definition by the team of the project of the struc-tural attractor, ie the direction of strategic development of the system is substantiated. The tool for determining compliance with the contextual requirements of SMART-goals of alternative scenarios for strategic development projects is considered. The tool of the Ishikawa diagram is used to determine the most influential factors on possi-ble deviations of the project from the strategic development of a complex nonlinear system. The conducted theoret-ical research allowed the authors to build a conceptual model of system development strategy management from the standpoint of the project approach. The conceptual model of strategic project management is constructed, the principles of its work and its use in discrete systems for actualization of administrative decisions in the conditions of risk and uncertainty are resulted. The expediency of using this conceptual model in managing the integration of strategic development projects is substantiated. Keywords: strategy, project management, program, project, synergetic, bifurcation.

The aim: To study the level of Galanin concentration in hypertensive patients with obesity, and to identify how the degree of hypertension and the degree of obesity affect the level of Galanin in 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 - 16 (27.59%), grade 3 - 30 (51.72%) examined patients. Of the patients enrolled to study, 32 were women and 26 were men, 32 to 79 years old (mean age - 57,5±10.11 years).Results: The level of Galanin in all groups of hypertensive patients was significantly increased compared to the control group (p0.001). The concentration of the latter in the blood serum gradually increases according to the degree of hypertension, while (p0.01), and the maximum level of Galanin was observed in group of patients with grade 3 hypertension (Me 164.47 pg/mL). The level of Galanin concentration in all subgroups of patients, depending on the presence and degree of obesity, was significantly increased compared to the control group (p0.001), the maximum level of Galanin was in the group with hypertension and obesity of 3 degrees (Me = 166.48 pg/mL).Conclusions: In hypertensive patients with obesity, a significant increase in the concentration of Galanin was detected; most pronounced in arterial hypertension grade 3 and obesity grade 3. Galanin is possibly a biomarker of cardiovascular risk in a cohort of patients with abdominal obesity.

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

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; p0.05) and (OR = 11.95, 95% CI = [3.41-41.91], χ2 = 22.5; p0.05), whereas allele C-174 was associated with a decrease in the risk of heart failure (OR = 0.39, 95% CI = [0.26-0.58 ], χ2 = 22.75, p0.05).Conclusions: The obtained results testify that the -174GC polymorphism in the interleukin-6 gene is significantly associated with increased risk of heart failure in patients with coronary artery disease and obesity.

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

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.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: 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; p0,05), insulin (r = 0.36; p0,05), index of HOMA (r = 0.89; p0,05), TG level (r = 0.74; p0,05) and the return with the HDL (r = - 0.54; p0,05).Conclusions: In patients with CAD with the accompanying type 2 DM it is established higher PTX-3 level, than in patients without type 2 DM and control group that demonstrates autoimune link activation. In the examined patients PTX-3 level increase was associated with violation of lipid and carbohydrate exchanges.

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).

Introduction: Obesity-associated arterial hypertension (AH) is characterized by common pathogenetic mechanisms. In this data, the following facet of the obesity/hypertension nexus will be discussed: the potential mechanisms by which nesfatin-1 can lead to the left ventricle (LV) myocardium remodeling. The aim: - to estimate a nesfatin-1 role in the remodeling of the LV myocardium in patients with AH in combination with obesity and to establish existence and a charatker of communications with cardiohaemodynamics indexes.Materials and methods: In 2016-2018 a single screening study in representative sample of 105 individuals aged 59,7±3,27 - 66,43±1,26 years was performed. AH was detected with history stratified by ESH17 criteria. Body mass index (BMI) was calculated for all individuals. Obesity was diagnosed in BMI30 kg/m2. The level of nesfatin-1 has been determined to participants of a research with the use of test system of Human NES ELISA KIT (China). Echocardiography was performed for all patients.Results: In patients with AH with normal body weight the level of nesfatin-1 was 8,07±0,06 ng/ml that is probable higher, than in persons from control group where the value of this indicator was 4,61±0,07 ng/ml (р0,001), but lower, than in patients without obesity. Also we have obtained data about existence of direct correlation connections between the level of the nesfatin-1 and end-diastolic volume (r=0,35, р0,05), end-systolic volume (r=0,46, р0,05), end-diastolic size (r=0,54, р0,05), end-systolic size (r=0,35, р0,05) and feedback with ejection fraction of LV (r=-0,37, р0,05) in the examined patients.Conclusions: The increased content in blood serum of the nesfatin-1 leads to remodeling of a myocardium of LV in the form of reduction of ability of a myocardium to reduction and increase of chambers and the LV sizes and can play a role in pathogenesis AH in patients with obesity.

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.

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.

The value of sCD40L and presence of cardiovascular complications were examined based on the investigation of 56 patients with type 2 diabetes mellitus and arterial hypertension. The level of sCD40L was increase in patients with diabetes mellitus. The mathematical model for prediction the development of cardiovascular complications has shown the value of sCD40L as a marker of cardiovascular risk.

105 patients with arterial hypertension were studied. Type 2 diabetic patients with arterial hypertension showed increased levels of insulin, HbA1c, glucose lipids except high density lipoproteins. The biggest potentiation for insulin resistance is type 2 diabetes mellitus and arterial hypertension.

Currently identified a large number of biomarkers that are closely linked with the development of chronic heart failure, some of which are clusterin and fractalkine. Accordingly, the purpose of our study was - to evaluate the role of clusterin and fractalkine in progression of chronic heart failure in patients with postinfarction cardiosclerosis, type 2 diabetes and obesity. We investigated 71 patients with postinfarction cardiosclerosis, type 2 diabetes and obesity. All patients with postinfarction cardiosclerosis, diabetes and obesity were divided into groups according to the functional class of chronic heart failure (CHF). It was found that an increase the level of fractalkine and reduced clusterin leads due to the development of systolic dysfunction and heart failure progression in patients with postinfarction cardiosclerosis, type 2 diabetes and obesity. Fractalkine and clusterin play an important role in progression of the heart failure in patients with postinfarction cardiosclerosis, type 2 diabetes and obesity, and this gives them the right to be considered indicators of the severity of CHF.

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