The occurrence of type 2 diabetes mellitus (T2DM) in developed countries is currently becoming epidemic primarily due to the changes in quality of life. This disease typically makes progress for a long time, and its clinical pattern is mostly related to various micro- and macrovascular complications. In addition to said complications the pancreas itself often undergoes damage associated with amyloid formation in islets of Langerhans which results in a toxic effect on the hormone-producing islet cells. Ultimately, hormone overproduction in T2DM shifts to hormone deficiency. The crucial causative factor of the development of pancreatic amyloidosis in T2DM is а short peptide hormone, amylin (IAPP), which is cosecreted with insulin and considered to be a kind of insulin antagonist. The present review reports structure, functions and amyloidogenic properties of human IAPP. The basic concepts of molecular and cellular aspects concerning pathogenesis of pancreatic amyloidosis have been provided. Patterns of the development of pancreatic amyloid lesions and possible approaches for early diagnosis and treatment of this significant complication of T2DM have been discussed.
Aim. To study the levels of circulating microRNA-21 in patients with hypertrophic cardiomyopathy (HCM) of different ages.
Materials and methods. The study included 49 patients with HCM. The proportion of females was 55.1%, males 44.9%. The average age was 50 [32; 65] (from 19 to 86 years). The control group for microRNA-21 included 44 healthy individuals, respectively, matched by the age and sex with the studied patients. Patients was made in accordance with the recommendations of the European society of cardiology. Plasma microRNA expression was determined by PCR with reverse transcription and real-time detection of results. The relative level of gene expression was calculated in accordance with the standard procedure 2-Ct.
Results. Septal wall thickness at end diastole has a significant negative correlation with age in patients with HCM (r=-0.56; р0.001). PWTd (posterior wall thickness at end diastole) has a significant positive correlation with age in patients with HCM (r=0.67, р0.001).
The level of circulating microRNA-21 in plasma is higher in patients with HCM compared to healthy individuals (5.28 [2.64; 13.96] and 0.84 [0.55; 1.23], respectively; p0.001). Significantly higher levels of microRNA-21 were found in young patients aged from 19 to 45 years with the symptomatic course of HCM (36.76 [5.66; 42.22]) compared to patients with asymptomatic course 45 years of age (2.81 [1.45; 5.28]; p0.002) and symptomatic patients 45 years (3.88 [2.16; 8.63]; p0.002).) The calculated risk of SCD was significantly higher in young symptomatic patients with HCM (6.01 [3.64; 9.67]) compared to patients with asymptomatic course 45 years (2.41 [1.21; 3.89]; p0.001) and symptomatic patients 45 years (2.56 [1.67; 4.41]; p0.001).
Conclusion. The level of circulating microRNA-21 is significantly in patients with HCM compared to control group. The maximum level of circulating microRNA-21 was detected in patients with symptomatic course of HCM at the age of 45 years.
This article discusses recent advances in understanding genetic basis and classification of hypertrophic cardiomyopathy. Here, we review pharmacologic treatment strategies and new developments in disease - specific management of HCM.
There are presented the literature data and a description of the clinical course of the disease in isolated/predominant cardiac amyloidosis. Amyloid cardiomyopathy is the most common phenocopy of hypertrophic cardiomyopathy. The modern possibilities of non-invasive diagnostics using osteoscintigraphy for the differential diagnosis between amyloid cardiomyopathy caused by AL- and transthyretin amyloidosis are described in detail.
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