Lysenko M. Homocysisteine and endothelial dysfunction, their correction at ischemic heart disease.

Object of the study: Coronary artery disease, stable angina. Purpose of the study: To improve the efficacy of CAD treatment, diagnosis and prognosis of its destabilization based on the study of pathogenetic significance of GC level elevation in the blood plasma and functional state of the endothelium. Methods of research: Clinical, biochemical, instrumental inves-tigations. Theoretical and practical results: To objectivize the character of angina course and determine the prognosis of the disease it is reasonable to use determining GC, ET-1, cGMP in the complex of investigation of CAD patients. Doppler mapping of the blood flow in the brachial artery during the test with reactive hyperemia and simultaneous investigation of ET-1 and cGMP in the blood plasma of the patients with CAD accompanied by hypertension can be used for evaluation of vasodilating function of the endothelium of the peripheral vessels and sufficiency of the administered therapy. The use of combination of folic acid at a dose of 1.5 mg, vitamin В6 at a daily dose of 1.5 mg and vitamin В12 at a daily dose of 3 ?g corrected GGC in CAD patients. Administration of calcium antagonist amlodipine is a reasonable method of correction of endothelial dysfunction at CAD accompanied by HD. Novelty: For the first time, correlation between GC level, vasoconstrictive and vasodilating factors of endothelial dysfunction (ET-1 and cGMP), cholesterol level in various forms of CAD. Increased GC level in patients with stable angina of afford of FC III-I vs class II angina had a character of tendency (р=0.051). Correlation analysis revealed a positive correlation between GC and ET-1 in patients with increased GC level (>15 ?mol/l) (г= 0.42; р < 0.01). Increased concentration of GC in the plasma of younger patients (41.3±6.5 years) vs an older group (58.6±6.2 years) was revealed. Possible mechanism of atherogenic effect of ET-1 associated with endothelium damage at reactive hyperemia of the brachial artery was established. It was shown that in patients with atherosclerosis EDVD was lower than in the healthy subjects. High efficacy of folic acid, vitamins В6 and В12 incorporated into BIOVITAL in correction of GGC at CAD treatment was demonstrated. Degree of introduction: The findings of the research were introduced to the work of department of clinical pharmacology and pharmacotherapy of Institute of Therapy (Academy of Medical Sciences of Ukraine), departments of therapy and cardiology of city clinical hospital No. 28, department of cardiology and therapy of regional hospital of Nikolayev Region. Sphere of application: medicine, cardiology, therapy.