Manusha Y. Features of systemic inflammation in coronary heart disease concurrent with non-alcoholic fatty liver disease and methods of their treatment.

The thesis was aimed at improving the diagnostics of stable coronary heart disease under conditions of its course exposure to non-alcoholic fatty liver disease on the basis of studying the markers of the activity of systemic inflammation of low intensity - levels of cytokines, the index of inflammatory endothelial activation, the level of expression of kappa inhibitor В ? of nuclear kappa transcription factor B, determination of their effect on the liver blood flow indices, cardiohemodynamics, index with antioxidant potential and optimization of treatment of patients with this comorbid disease through the use of combined therapy with the addition betargin and quercetin. The obtained results indicate that in stable coronary heart disease, there is a close pathogenetic relationship between chronic systemic inflammation, dyslipidemia and inflammatory activation of the endothelium, while under conditions of its course exposure to non-alcoholic fatty liver disease, the degree of chronic systemic inflammation of low intensity is more likely . It was found that the increased velocity characteristics of the blood flow in the hepatic veins constitute a marker of chronic inflammatory changes and endothelial dysfunction in the liver in the stage of steatohepatosis. The anti-inflammatory effect of betargin and quercetin on the mechanisms of chronic systemic inflammation with the participation of kappa B nuclear factor in patients with coronary heart disease concurrent with non-alcoholic fatty liver disease was determined. We substantiated the expediency of using the combination of betargin and quercetin in patients with this comorbidity due to proven endothelial resistance and positive effect on the clinical status of patients as a result of reduced number of circulating endothelial microparticles CD32+ CD40+, decreased blood flow velocity in portal and hepatic veins and improved cardiohemodynamics indices. An increase in antioxidant defense of the organism as a result of the addition of betargin in patients with stable coronary heart disease concurrent with NAFLD was revealed. The efficiency of the using betargin and quercetin in the comprehensive therapy of patients with stable coronary heart disease concurrent with non-alcoholic fatty liver disease due to proven anti-inflammatory, endothelial-protective, cardioprotective, hepatoprotective and antioxidant effects was substantiated