Object of the study: pathological anatomy of ischemic heart disease (IHD). Purpose of the study: detection of characteristic features in the morphofunctional changes of the autonomic nervous system (ANS) of the heart in coronary insufficiency and revealing of their part in the pathogenesis of angiogenic lesions of the myocardium. Methods of the study: in order to achieve the above purpose and solve problems, the microscopic, organometric, histological, histochemical, morphometric, immunohistochemical, biochemical and statistic methods were employed. Practical significance: the obtained results will enable doctors-pathologists to assess pathological changes in the human ANS in different forms of IHD. The established criteria of morphological changes in heart innervation are diagnostically important for sub-stantiating pathogenetic mechanisms of myocardial lesions without any significant stenosis of the coronary arteries. The most rational techniques for investigating the autonomic heart innervation, applicable to the work in the pathoanatomical department, were established and suggested. The revealed pathogenetic mechanisms of myocardial ischemia will enable cardiologists to take into ac-count the functional state of ANS in such patients with the aim to prevent ischemic changes and, on their basis, to establish principles of the adaptive protection of the myocardium, to reveal risk factors of the development of pathologic changes in ANS and cardiovas-cular system at large. The suggested way of modelling IHD with use of twenty-four-hour lighting is easy in application and reproduces in the myocardium the pathological changes typical for IHD, thereby making it possible to use it for needs of reseaches. Novelty of the obtained results: as a result of the research conducted it was possible for the first time to assess morphological changes of the intracardiac nervous system in a complex in cases of death caused by different forms of IHD. Differential-diagnostic criteria of changes in the intramural nervous system of the heart for their assessing in cases of death caused by myocardial ischemia were established. For the first time, peculiarities of myocardial lesions under the effect of pathologic changes in the sympathetic and parasympathetic heart innervation were revealed. It was found out that in myocardial ischemia the sympathetic part of ANS of the heart underwent earlier alterative and reactive changes versus the parasympathetic one, thereby affecting the myocardial sympathetic system and causing a change in the sensitivity of cardiomyocytes to catecholamines with formation of additional areas of necrobiotic changes. It was revealed for the first time that dysfunction of the intracardiac nervous system in IHD created preconditions for the development of angiospasm of coronary vessels, it being explained, firstly, by the progressing imbalance of the cholinergic and adrenergic innervation with prevalence of vasoconstrictor effects, and, secondly, by endothelial dysfunction with a disorder in the control over thevascular wall reactivity. On the basis of the obtained data, new links in the etiology and pathogenesis of myocardial ischemia were revealed, it creating a new direction in the etiopathogenetic prophylaxis and treatment of this kind of cardiovascular pathology. Introduction: the obtained data were introduced into the teaching process of the departments of pathologic anatomy of higher medi-cal schools of Ukraine (Kharkiv, Zaporizh’a State Medical Univer-sities, Shupik National Academy of Postgraduate Training), as well as into practical activity of pathoanatomical departments of medi-cal establishments (Malaya Research Institute of Therapy of the Academy of Medical Sciences of Ukraine, Kharkiv Regional Hos-pital), Ternopil, Odesa and Zaporizh’a pathoanatomical offices. Sphere of application: medicine, pathologic anatomy.
