Serik S. Immunoinflammatory activation in patients with heart failure caused by ischemic heart disease and its combination with diabetes mellitus

The investigation was dedicated to the problem of the immunoinflammatory activation in heart failure (HF) patients with ischemic heart disease (IHD) and type 2 diabetes mellitus. The results of the evaluation of lipoprotein-containing immune complexes (LDL IC), pro- and anti-inflammatory cytokines, soluble CD14, chymase, metabolic factors and the analysis of its interactions in patients with different severity of HF caused by IHD with and without diabetes show particular significance and specificity of diabetes associated immunoinflammatory processes in the pathogenesis of HF. In the thesis the advantages of ?-1, ?-adrenoblocker carvedilol over ?1-selective adrenoblocker bisoprolol were proved. These benefits are due to positive influence on inflammatory activity, oxidative stress and glucometabolic disorders in HF patients with diabetes. It was shown, that immunomodulatory effects of statins in HF patients with diabetes are developed more slowly and in less degree than in patients without diabetes. It was established, that clinical efficiency of statins in HF patients with diabetes depends on initial immunoinflammatory activity, exactly on the levels of LDL-IC with IgA antibodies, which reasonably should be considered as therapeutic target. It was demonstrated, that in HF patients with diabetes the addition of quercetin to standard therapy resulted in the decrease of oxidative stress, tumor necrosis factor-? level and contributed to left ventricular ejection fraction elevation, patients clinical and functional status improvement.