Tripolka S. Peculiarity of ishaemic heart disease (IHD) pathogenesis and current in patients with rheumatism.

Object of the study:Patients with coronary artery disease (CAD), rheumatism and patients with rheumatism accompanied by CAD. Purpose of the study:To work out the principles of diagnosis, prevention, and treatment of CAD in patients with rheumatism basing on the study of clinical and pathogenetic characteristics of the disease in this category of patients. Methods of research:To solve the tasks of the research the following methods were used: clinical method of evaluation of the patient's state, biochemical studies (lipid spectrum, lipid peroxidation products, lipoproteid (a), antiphospholipid antibodies), instrumental studies (electrocardiography, echocardiography, chest x-ray). Mathematical and statistical methods were used to evaluate the significance of the obtained results. Theoretical and practical results:The algorithms for prognosis of CAD development in patients with rheumatism depending on the degree of its activity were worked out. The suggested method allows to evaluate the character of deviation in the biochemical parameters (pathogenetic or compensatory) and to determine the pathogenetic mechanism of development and course of CAD in specific to each patient. These data were used to determine the most effective preventive and therapeutic measures which allow to improve the quality of therapeutic and preventive aid in patients with rheumatism. Novelty: The correlation between the character of the involvement of the mitral valve in patients with rheumatism and CAD development was established. The role of rheumatic inflammation in CAD developnment was determined. Pathogenetic significance of antiphospholipid and lipoproteid (a) hyperproduction in coronary artery atherosclerosis development in patients with rheumatism was shown. The correlation between hyperactivation of lipid peroxidation and weakening ща antioxidant protection and CAD development in patients with rheumatism was revealed. The characteristics of oxidant-antioxidant mechanisms of lipid peroxidation in patients with rheumatism depending on the phase of activity and CAD presence were described. Prognostic significance of clinical and biochemical parameters was determined with the purpose to predict CAD development in patients with active and nonactive rheumatism. The ranges of biochemicasl parameters which allow to evaluate pathogenetic and compansation deviations from the control were established. Degree of introduction:The results of the research are used in the work of specialized departments of Regional Clinical Hospital (Kharkiv), Institute of Therapy (Academy of Medical Science of Ukraine), Pechenigy, Kraыnokutsk, Valky Central District Hospitals. Sphere of application: medicine, cardiology.