Shalmina M. The relationship of vascular endothelial dysfunction and immune disorders in elderly and senile patients with coronary heart disease, the possibility of pharmacological correction

This thesis investigates the immune-inflammatory and endothelium-dependent disorders in elderly and senile patients with stable angina, their relationship with impaired of cardio-hemodynamics and ischemic symptoms. The use of L-arginine in the basic treatment of the disease is statistically, laboratory and clinically proved. The results of the survey on 108 elderly and senile patients with stable angina and 33 patients in the control group are shown. It is proved that in the studied group of patients with worsening severity of ischemic events and endothelial dysfunction increases the level of formation of vascular inflammation. As evidence of this we can see the increase in the level of expression of sSD40L. This factor significantly determines the violation of the functional state of vascular endothelium, as well as it is associated with the formation of the sympathetic-vagal imbalance and deterioration of the quality of life. It was also found that there is a significant disorder of metabolism of natriuretic peptides in elderly and senile patients with stable angina with increased production of atrial and brain natriuretic peptides. The remodeling of the left ventricle is connected with these changes in the metabolic processes.