Clinical Features, Course and Indicators of Endothelial Function and Systemic Immune-Inflammatory Response in Patients with Chronic Coronary Artery Disease Depending on Affected Coronary Artery Number

Abstract

In Ukraine, cardiovascular diseases are the leading cause of morbidity and rank second among primary diseases. Nowadays the most common cardiovascular disease is coronary artery disease that accounts for 33.7% of total cardiovascular pathology cases. The objective of the research was to study clinical manifestations and indicators of endothelial function and immune-inflammatory response in the patients with coronary artery disease, heart failure with preserved left ventricular ejection fraction depending on affected coronary artery number. Materials and methods. The study included 62 patients with chronic coronary artery disease, heart failure with preserved left ventricular ejection fraction who underwent coronary artery stenting. Among the examined patients, males prevailed – 52 (83.9%) individuals. All the patients were randomized according to the number of the affected coronary arteries and divided into two groups. Clinical manifestations were studied; the patients’ quality of life was assessed; the functional state of the myocardium was determined according to the six-minute walk test; the indicators of endothelial dysfunction were analyzed by endothelin-l level; the indicators of immune inflammatory response were analyzed by serum levels of C-reactive protein and tumor necrosis factor. Results. In the examined patients, the clinical course did not depend on the number of the affected coronary arteries; however, to reduce the incidence of cardiac pain, the patients with multivessel coronary artery disease received 2±0.1 extra nitroglycerin tablets. Conclusions. Quality of life and physical well-being were better in the patients with single-vessel coronary artery disease (p<0.05). Myocardial functional reserves were lower in the patients with multivessel coronary artery disease (p<0.05), while the intensity of immune inflammation and endothelial dysfunction reduced in case of multivessel coronary artery disease that confirmed a strong correlation between the indicators of tumor necrosis factor and endothelin-l.