The article represents literature review dedicated to molecular and cellular mechanisms underlying clinical manifestations and outcomes of acute myocardial infarction. Extracellular matrix adaptive changes are described in detail as one of the most important factors contributing to healing of damaged myocardium and post-infarction cardiac remodeling. Extracellular matrix is reviewed as dynamic constantly remodeling structure that plays a pivotal role in myocardial repair. The role of matrix metalloproteinases and their tissue inhibitors in fragmentation and degradation of extracellular matrix as well as in myocardium healing is discussed. This review provides current information about fibroblasts activity, the role of growth factors, particularly transforming growth factor β and cardiotrophin-1, colony-stimulating factors, adipokines and gastrointestinal hormones, various matricellular proteins. In conclusion considering the fact that dynamic transformation of extracellular matrix after myocardial ischemic damage plays a pivotal role in myocardial infarction outcomes and prognosis, we suggest a high importance of further investigation of mechanisms underlying extracellular matrix remodeling and cell-matrix interactions in cardiovascular diseases.
Цель. Оценить динамику уровня альдостерона в сыворотке крови и структурно-функциональных параметров сердца у больных инфарктом миокарда, развив-шемся на фоне недифференцированной дисплазии соединительной ткани. Материал и методы. В исследование было включено 90 пациентов с инфарк-том миокарда с зубцом Q с наличием недифференцированной дисплазии сое-динительной ткани и без таковой. Группа контроля -практически здоровые пациенты без сердечно-сосудистой патологии, группа сравнения -пациенты с недифференцированной дисплазией соединительной ткани без сердечно-сосудистой патологии. Проведено клиническое и фенотипическое обследова-ние, эхокардиографическое исследование сердца, определение уровня альдо-стерона сыворотки крови в динамике течения инфаркта миокарда. Результаты. У больных инфарктом миокарда не зависимо от наличия либо отсутствия недифференцированной дисплазии соединительной ткани в 1-е сутки инфаркта отмечалось повышение уровня альдостерона в сыворотке крови с последующим снижением через 28 дней до уровней контрольной группы и группы сравнения. В группе больных инфарктом миокарда с недиф-ференцированной дисплазией соединительной ткани выявлено более выра-женное увеличение размеров полости левого желудочка, снижение его насос-ной функции в сочетании с тенденцией к менее выраженному увеличению индекса массы миокарда левого желудочка по сравнению с пациентами без соединительнотканной дисплазии. Заключение. Наличие недифференцированной дисплазии соединительной ткани не оказывает влияния на уровни альдостерона крови и их динамику при инфаркте миокарда, но в тоже время ассоциируется с более неблагоприятным вариантом постинфарктного ремоделирования сердца в виде дилатации левого желудочка и снижения его сократительной функции. Aim. To assess the dynamics of aldosterone in blood serum and structurefunctional parameters of the heart in myocardial infarction patients, developed on the background of non-differentiated connective tissue dysplasia. Material and methods. Totally, 90 patients included with Q-myocardial infarction with non-differentiated connective tissue dysplasia and without it. The controls were almost healthy persons without cardiovascular pathology, comparison grouppatients with connective tissue dysplasia but not having cardiovascular pathology. Clinical and phenotypic assessment was done, echocardiography, aldosterone levels measurement in serum at dynamics of the infarction course. Results. All patients, independent of existence of connective tissue dysplasia, showed aldosterone elevation at 1st day of infarction with further decrease to the level of controls or comparison in 28 days. In the group of infarction patients with non-differentiated connective tissue dysplasia there was significant enlargement of the left ventricle size, reduced pumping function with tendency to less prominent myocardial mass index increase comparing with those not having dysplasia. Conclusion.Presence of non-differentiated connective tissue dysplasia does not influence aldosterone levels and their dynamics in myocardial...
Heart failure (HF) is a global healthcare burden and a leading cause of morbidity and mortality worldwide. Type 2 diabetes mellitus (T2DM) appears to be one of the major risk factors that significantly worsens HF prognosis and increases the risk of fatal cardiovascular outcomes. Despite a great knowledge of pathophysiological mechanisms involved in HF development and progression, hospitalization rates in patients with HF and concomitant T2DM remain elevated. In this review we discuss the complex interplay between systemic neurohumoral regulation and local cardiac mechanisms participating in myocardial remodeling and HF development in T2DM with a special attention to cardiomyocyte energy metabolism, mitochondrial function and calcium metabolism, cardiomyocyte hypertrophy and death, extracellular matrix remodeling.
To study the possibility and effectiveness of using succinylated gelatin (SG) for injecting endoscopic hemostasis. Material and methods. 70 albino non-linear rats. 0.5 ml of the solution has been injected into the anterior wall of the stomach with a syringe after laparotomy. A mixture of 0.9 % NaCl solution and epinephrine hydrothartrate (1.8 mg/1 ml) has been used in a ratio of 1:20 for the control group (35 animals). A mixture of a solution of SG (40 mg/1000 ml of injection water) and epinephrine hydrothartrate (1.8 mg/1 ml) in a ratio of 1:20 for the experimental group (35 animals). Right after the injection and in 1, 3, 6, 12 hours, after laparotomy, the stomach wall has been taken for histological examination, during which the thickness of the stomach wall (TSW) has been determined. Results. As soon as the injection has been given, the TSW in animals of both groups hasn`t differed significantly. The TSW has significantly increased in both of the groups, and the parameters of indicators in the experimental group have significantly raised in 1 h after the injection. In 3, 6, and 12 hours, the TSW in both groups has been decreasing. The parameters of indicators in the experimental group of animals have been significantly higher than in the control one all the time during the study. The indicators have barely differed from the initial ones in the control group 12 hours later, whereas in the experimental one they have been significantly higher. Histological studies have shown that the structure of stomach tissues in both groups hasn`t varied. The SG injection has not caused any negative effects on the tissues of the stomach wall. The thickness of the submucosa hasn`t been much modified right after the injection. The thickness (26.95±5.34 microns) has increased in the experimental group 12 hours later than in the control one (15.45±4.38 microns, p<0.01). Most of the vessels of the experimental group have remained compressed 12 hours later, whereas the diameter of the vessels of the control group has been growing. Conclusions. 1. The TSW hasn`t differed right after the injection (a mixture of 0.9 % NaCl and epinephrine solution and a mixture of SG and epinephrine solution) into the stomach wall. 2. 1 h later after the injection, the TSW has increased and its parameters after injection of a mixture with SG have been significantly higher. 3. In 3,6,12 h and later on, the TSW has been gradually reducing and its parameters after injection of a mixture with SG have been significantly higher each time. The thickness of the submucosa and the degree of compression of the vessels have also been considerably higher. 4. No negative changes in the structure of stomach tissues after injection of the mixture with SG have been detected. This allows it to be used for performing endoscopic hemostasis by injection therapy in clinical conditions.
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