Zaika M. Proinflammatory cytokines and oxidative stress in the patients with chronic heart failure in dynamics of treatment with angiogenesis П receptors antagonists.

Object of the research: chronic heart failure (CHF). Purpose of the research: increase of the diagnosis efficacy for myocardial dysfunction progression and development of differentiated approaches to CHF therapy on the basis of the assessment of markers of nonspecific inflammation (NSI) and oxidative stress. Methods of the research: immunoenzyme method for de-termining levels of tumor necrosis factor alpha (TNF-?), soluble receptor (SR) of TNF-? I, C-reactive protein (CRP), 8-isoprostane; spectrophotometric method for determining the activity of catalase (Cat) by Fried’s method (1975) and superoxide dismutase (SOD) by a modified method of Chevari et al. (1991); echocardiography. Theoretical and practical results: the use of the methods for a complex assessment of NSI activation and disturbances in the prooxidant-antioxidant balance, suggested in the research, by doctors of practical medical establishments of Ukraine will facilitate diagnosis of CHF at early stages of its formation and optimization of the therapeutic influence. The revealed reliable negative correlations between the levels of TNF-? I SR, TNF-? and CRP demonstrate the antagonistic part played by TNF-? I SR in the processes of NSI in the organism and its possible use as a marker of the local activity of TNF-?. The studied anti-inflammatory and antioxidant properties of the investigated therapeutic modes make it possible to recommend Kandesartan for patients with a significant increase of plasma TNF-? and a reduced activity of SOD, whereas the combination of Phosinopril and Bisoprolol for a high level of CRP and TNF-? I SR, a lower activity of Cat and a higher cardiac index, thereby contributing to the achievement of the “cardioprotective” effect in the treatment of patients with CHF. Novelty: for the first time, a complex analysis of clinical manifestations, intracardiac haemodynamics and changes in the indices of the prooxidant-antioxidant balance and NSI mediators in the organism of patients was made during the formation of different functional classes of CHF with a preserved systolic function of the heart. The examined people revealed a strong positive dependence of the plasma level of 8-isoprostane on the functional class of CHF. Reliable relationships were found out between the plasma content of 8-isoprostane, TNF-? and CRP versus the indices of intracardiac haemodynamics. It was demon-strated that the blood serum content of SR to TNF-? type I could serve as a marker, which reflects the local activity of TNF-?. The revealed correlations between the level of TNF-?, TNF-? I SR, SRP, 8-isoprostane, Cat and SOD depending upon the severity of CHF course show presence of some relationships between disturbances in the prooxidant-antioxidant balance and NSI activation in the pathogenesis of the myocardial dysfunction formation. Degree of introduction: results of the research were introduced into the pedagogical process of Department of Propedeutics of In-ternal Medicine No. 1 of Kharkiv National Medical University of the Ministry of Health of Ukraine, into the work of Medical De-partments of Kharkiv City Clinical Hospital No. 11, Cardiology Departments of Ukrainian Railways Central Clinical Hospital, Kharkiv City Clinical Hospital No. 9, as it is confirmed by acts on introduction. Sphere of application: medicine, cardiology departments.