A systematic review of publications from the PubMed and eLibrary. ru databases, Biobanking and Biomolecular Resources Research Infrastructure — European Research Infrastructure Consortium (BBMRI-ERIC) and ClinicalTrials.gov studies was carried out for 15 years. The aim was to find priority areas for the use of biobanks in cardiology. The key areas of research on blood and heart tissue biobanks are the study of pathogenetic mechanisms, creation of innovative methods for diagnosis, treatment and prevention of cardiovascular diseases (CVDs). The use of modern technologies such as genomics, transcriptomics, proteomics and metabolomics allows identifying candidate markers, revealing new molecular targets for drug therapy, diagnostic and therapeutic approaches for CVD. One of the promising areas is the search and study of polygenic scores of CVD risk and predictors of adverse cardiovascular events. Analysis of the registry revealed another important area of biobank application — clinical trials, in which biobanks are a key resource of blood and tissue samples, as well as clinical, paraclinical, and socio-demographic data. Therefore, studies using biobank resources are necessary to study the pathogenetic mechanisms of CVD, identify new proteomic biomarkers and genetic factors, as well as to improve diagnostics, prevention and treatment.

Aim. To compare the changes in serum concentrations of matrix metalloproteinases (MMPs) and their tissue inhibitor (TIMP) to the dynamics of blood pressure (BP) and parameters of left ventricular hypertrophy (LVH) 6 months after renal denervation (RD) in patients with resistant arterial hypertension (RAH) and complicated coronary atherosclerosis.Material and methods. In 22 RAH patients with complicated coronary atherosclerosis (revascularization and/or history of myocardial infarction (MI)), 24-hour BP monitoring, echocardiography, and measurement of blood MMPs and TIMP were performed at baseline and six months after RD. The comparison group consisted of 48 RAH patients without a history of coronary revascularization or MI.Results. In 6 months after RD, BP was decreased comparably in both groups. In the group of complicated atherosclerosis, there were no significant changes in profibrotic markers or LVH parameters. Thus, at baseline and after 6 months, the values of the studied indicators were the following: left ventricular myocardial mass (LVMM) 233.1±48.1 and 243.0±52.0 g, LVMM index 60.6±14.5 and 62.8±10 .9 g/m2.7, proMMP-1 4.9 [2.1; 7.7] and 3.6 [2.0; 9.4] ng/ml, MMP-2 290.4 [233.1; 352.5] and 352.2 [277.4; 402.9] ng/ml, MMP-9 220.6 [126.9; 476.7] and 263.5 [82.9; 726.2] ng/ml, TIMP-1 395.7 [124.7; 591.4] and 424.2 [118.2; 572.0] ng/ml, respectively. In the comparison group, on the contrary, there was a significant decrease in LVMM from 273.6±83.3 g to 254.1±70.4 g, LVMM index from 67.1±12.3 to 64.0±14.4 g/m2.7, proMMP-1 from 7.2 [3.6; 11.7] to 5.9 [3.5; 10.9] ng/ml, MMP-2 from 328.9 [257.1; 378.1] to 272.8 [230.2; 343.2] ng/ml, MMP-9 from 277.9 [137.0; 524.0] to 85.5 [34.2; 225.9] ng/ml, and the MMP-9/TIMP-1 ratio from 0.80 [0.31; 1.30] to 0.24 [0.07; 0.76]. The BP dynamics in this group was inversely correlated with MMP-2 at 6 months (r=-0.38), and the MMP-9/TIMP-1 ratio was correlated with LVMM and the LVMM index at baseline (r=0.39 and r=0.39) and at 6 months (r=0.37 and r=0.32). The change in TIMP-1 from 543.9 [277.5; 674.1] to 469.8 [289.7; 643.6] ng/ml was not significant (p=0.060).Conclusion. In RAH patients with complicated coronary atherosclerosis, the dynamics of profibrotic biomarkers and LVH parameters after RD was absent despite the pronounced antihypertensive effect, probably due to the low reversibility of cardiovascular remodeling processes or more complex regulatory mechanisms of the MMP system.

Aim. To study the features of regression of left ventricular hypertrophy and magnetic resonance changes of cardiac fibrosis in patients with resistant hypertension (RH) 1 year after renal denervation (RDN) in relation to changes in blood pressure (BP), the level of high-sensitivity C-reactive protein (hsCRP), matrix metalloproteinases 2, 9 (MMP-2, MMP-9), tissue inhibitor of metalloproteinase type 1 (TIMP-1). Material and methods. The study included 42 patients with true RH. The mean age of the patients was 59 (51; 62) years, while half were men. All patients took 3 or more antihypertensive drugs. At baseline and after 12 months, creatinine, hsCRP, MMP-2, MMP-9, TIMP-1 were determined, as well as 24-hour blood pressure monitoring, assessment of left ventricular mass (LVM) and contrast agent accumulation according to cardiac MRI. RDN was performed using Symplicity Fleх (n=18) and Symplicity Spyral (n=24) catheters in accordance with the manufacturer's instructions. Results. A year after RDN, a significant antihypertensive effect and a decrease in heart rate were noted. Sixteen patients (38,1%) reached the target office BP level. After 1 year, a significant decrease in the levels of hsCRP from 2,05 (1,04; 3,28) to 1,64 (0,96; 2,25) mg/l (p=0,045) and MMP-2 from 278,2 (240,9; 353,4) to 265,2 (221,2; 293,2) ng/ml (p=0,018) was detected. There was a trend towards an increase in TIMP-1 and a decrease in MMP-9. According to MRI 1 year after RDN, there was a tendency to increase the contrast agent volume, and there was a pronounced LVM decrease from 228 (180; 295,2) to 204 (169,8; 277) g (p=0,029). Correlation analysis revealed a direct connection between a decrease in LVM and a decrease in SBP and DBP levels, MMP-2 and MMP-9 levels. There was a relationship between a decrease in the contrast agent volume and an increase in TIMP-1 level (r=-0,64; p=0,04). Conclusion. A year after RDN, patients with RH show regression of left ventricular hypertrophy with a pronounced antihypertensive effect and a decrease in collagen production, which could also be significant for suppressing the myocardial fibrosis.

Aim. To study the relationship of coronary microvascular dysfunction (CMD) with the levels of pro- and anti-inflammatory biomarkers in patients with preserved ejection fraction (LVEF) and non-obstructive coronary artery disease (CAD). Material and methods . The study included 118 patients (70 men, mean age, 62,0 [58,0; 69,0] years) with preserved LVEF (62 [59; 64] %) and non-obstructive CAD. Serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hsCRP), interleukin-1β, 6, and 10 were assessed initially by enzyme immunoassay. Coronary flow reserve (CFR) was assessed by dynamic single photon emission computed tomography. CFR ≤2 was a CMD marker. Results. Patients were divided into groups depending on CMD presence: group 1 included patients with CMD (n=45), and group 2 was the control group and included patients without CMD (n=73). HsCRP concentrations were 1,8 times higher (p=0,011) in group 1 compared to group 2. Interleukin-6 levels did not differ significantly between groups (p=0,842), while interleukin-10 concentrations were lower by 21,7 % (p=0,048), and interleukin-1β was 2,7 times higher (p=0,046) in group 1 compared to group 2. According to ROC analysis, hsCRP concentration ≥4,8 g/l (AUC=0,655; p=0,012), and NT-proBNP ≥950,6 pg/ml (AUC=0,792; p<0,001) were identified as markers associated with CMD in patients with non-obstructive CAD, while levels of interleukin-1β, 6 and 10 showed no diagnostic significance. Multivariate regression analysis showed that diastolic dysfunction (odds ratio, 3,27; 95% confidence interval, 2,26-5,64; p<0,001) and NT-proBNP ≥950,6 pg/ml (odds ratio, 2,07; 95% confidence interval, 1,56-4,12; p=0,023) were independent factors associated with CMD. Conclusion . We established that in patients with non-obstructive CAD, the pre­sence of CMD is associated with a higher expression of pro-inflammatory markers and a decrease in the expression of an anti-inflammatory marker, which may confirm the fact that chronic inflammation is one of CMD pathogenesis links.

Atrial fibrillation (AF) is one of the most common cardiac arrhythmias. Numerous data indicate a significant contribution of myocardial inflammatory changes in the development and progression of AF. The search for new laboratory biomarkers to assess the activity of myocardial inflammatory processes, and the study of their diagnostic significance for noninvasive diagnosis in patients with AF is relevant. Therefore, the aim was to study the features of the serum level of the biomarker Gal-3 and to identify its relationship with inflammatory changes in the myocardium in patients with AF. Depending on the results of histological studies, the patients were divided into 2 groups: group 1 – with morphologically verified active lymphocytic myocarditis (ALM), group 2 – with lymphocytic infiltration (LI). Analysis of the frequency of detection and severity of the inflammatory process in the myocardium showed that activity of 4-5 scores was detected only in group 1. In 2nd group, activity of the inflammatory process in most patients was 1 score. All patients with LI mild interstitial inflammation were showed. In the ALM group moderate and severe interstitial inflammation was detected. A high number of CD3+ and CD45+ cells were found in 1st group compared to group 2 (p < 0.001).There were no significant intergroup differences in the serum level of Gal-3. At the same time, in 1st group showed a significant decrease in Gal-3 in 6 months after treatment (p = 0.028). Positive correlations of Gal-3 with the severity of the inflammatory process and endocardial involvement were revealed in patients with ALM. The association of serum Gal-3 levels with CD68+ levels in 1st group was detected (R = 0.48, p = 0.030). In 2nd group, a correlation between the level of Gal-3 in 6 months after ablation with infiltration of CD45+ cells was found (R = 0.69, p = 0.003). Thus, in patients with AF and active lymphocytic myocarditis, significant associations were established between biomarkers of Gal-3 and inflammatory changes in the myocardium. This confirms the important role of Gal-3 as a participant in the inflammatory process.

Background and Aims: To study the role of autonomic regulation of cardiac activity in patients with non-obstructive coronary artery disease (CAD) depending on the presence of heart failure with preserved ejection fraction (HFpEF). Methods: Group 1 included 48 patients with newly diagnosed HFpEF, group 2-17 patients without HFpEF. Non-obstructive CAD was confirmed by computed coronary angiography. NT-proBNP concentrations were determined by ELISA. Heart rate variability was assessed by 24-hour ECG monitoring. LV function parameters were assessed using echocardiography. Results: SDANN correlated with myocardial stress in diastole (r=0.345; p=0.006), and SDNNidx correlated with cardiovascular resistance (r=0.301; r=0.045) and E/e' (r=0.256; r=0.032) (Fig.1). In group 1, SDANN values (p=0.006) were 13.1% lower than in group 2. In group 1, SDNNidx values (p=0.012) were 14.8% higher than in patients of group 2. At night, group 1 showed a decrease in rMSSD by 42.5% (p=0.007) compared with group 2. In group 1 pNN50% values were 2.6 (1.7; 11.5), and in group 2 - 14.6 (6.2; 67.5) ms (p=0.009) (Fig.2). Based on ROC analysis, SDNNidx ≤49 ms (AUS=0.768; p=0.012) and pNN50 ≤5 ms (AUS=0.777; p=0.007) were defined as threshold values associated with the presence of HFpEF in patients with non-obstructive coronary artery disease (Fig.3). Conclusions: Patients with non-obstructive CAD and HFpEF showed a decrease in parasympathetic effects on the heart at night with a parallel increase in the activity of the sympathoadrenal nervous system. SDNNidx and pNN50 values can be used as a marker for diagnosing HFpEF. Funding: Russian Science Foundation No. 22-25-20019 https://rscf.ru/project/22-25-20019/ and funds from the Administration of Tomsk Region”

Objective. To study possible correlations between the quantitative characteristics of fat depots in the abdominal and perirenal regions according to magnetic resonance imaging (MRI) data with metabolic and immunoinflammatory parameters, renal function, blood pressure (BP), as well as anthropometric data in patients with resistant hypertension (RH). Design and methods. Sixty-three patients (26 men) with RH aged 60 [54; 64] years who were receiving individual treatment with antihypertensive medication (mean, 4,3 ± 1,1 drug per day) were included in the study. Systolic/diastolic/pulse BP (SBP/DBP/PBP) was 157,7 ± 15,4 / 86,3 ± 13,6 / 71,3 ± 14,5 mm Hg. Mean body mass index (BMI) 34,1 [31,0; 38,5] kg/m2, waist circumference (WC) 108 [102; 113] cm (95,2 % with abdominal obesity). Diabetes mellitus type 2 suffered 51,6 %, chronic kidney disease C3–30,6 %. Clinical and laboratory examinations were performed. Creatinine level with estimated glomerular filtration rate (CKD-EPI), biomarker levels were assessed by ELISA. MRI was performed in a high-field tomograph with a magnetic field induction on 1,5 T. Mean parameter values in apparently healthy volunteers were considered normal. The area of visceral adipose tissue (S VAT) and subcutaneous adipose tissue (S SAT) was determined at the L4-L5 level (normal 123,5 [101,0; 169,0] and 216,5 [167,0; 287,0] cm2, respectively); kidney diameter — the anterior-posterior size of the kidney at the level of the renal vein (normal 5,0 [4,4; 5,4] cm); the thickness of perirenal adipose tissue (PRAT) as the difference between the distance between the sheets of Gerota’s fascia at the level of the renal vein and the diameter of the kidney (normal 1,2 [0,9; 2,4] cm); thickness of anterior subcutaneous adipose tissue (SATT) at the level of the umbilicus (normal 2,7 [1,8; 3,8] cm), the ratio of PRAT/SATT (normal 0,72 ± 0,61). Results. An increase was observed in all fat depots: S VAT 271,2 ± 104,4 cm2, S SAT 309,5 [236,0; 400,0] cm2, PRAT 2,7 [1,8; 3,9] cm, SATT 3,0 [2,3; 3,7] cm. Anthropometric parameters were associated with S VAT and S SAT. The thickness of PRAT correlated only with weight (r = 0,44) and WC (r = 0,41), whereas SATT correlated with BMI (r = 0,49). The PRAT/SATT ratio was not dependent on BMI. S VAT was associated with the level of PBP (r = 0,30). The following associations were observed with metainflammatory markers: TNF-α with S VAT (r = 0,31) and S SAT (r = 0,43) and with BMI (r = 0,32) and WC (r = 0,38); hsCRP with S SAT (r = 0,30), PRAT thickness (r = 0,34), and SATT (r = 0,34); leptin level correlated only with subcutaneous adipose tissue (S SAT, r = 0,60 and SATT, r = 0,69) and BMI (r = 0,51). Kidney size was 5,5 [5,0; 6,0] cm and was not associated with BMI. A decrease in kidney size was associated with a decrease in estimated glomerular filtration rate (r = 0,36). Glomerular filtration rate was associated with PRAT, as was creatinine (r = 0,43), which was also correlated with S VAT (r = 0,32). No correlations were found between renal function and anthropometric data. Conclusions. In patients with RH, there is an increase in the size of fat depots in the abdominal and perirenal regions according to MRI, which are closely related to anthropometric parameters and markers of inflammation. A direct correlation between the serum concentration of leptin and the size of subcutaneous adipose tissue has been established. An increase in the ratio of PRAT/SATT indicates an increase in the predominantly visceral component of adipose tissue and is associated with an increase in PBP, which reflects vascular stiffness. The decrease in the filtration function of the kidneys is correlated with an increase in the size of perirenal fat depots in the absence of direct links with dimensions of subcutaneous adipose tissue and anthropometric characteristics.

The aim: to determine the phenotype of kidney damage characteristic of resistant arterial hypertension by MRI, including the volume of renal parenchyma, and its association with biomarkers of renal dysfunction. Patients and methods. The main group included 35 patients with resistant arterial hypertension (RAH), average age 57.6±8.4 years. The comparison group consisted of 20 men and women without cardiovascular pathology, comparable in gender and age. To determine the qualitative and quantitative changes in the kidneys, MRI was performed (1.5 Tesla, Titan vantage, Toshiba). Kidney volumes (TKV, TCV) were calculated using the ellipsoid formula. Kidney volumes indexed for height, BMI and body surface area were calculated. Renal dysfunction was assessed by the level of serum creatinine and cystatin C, as well as by the value of eGFR (CKD-EPI). Results. The MR phenotype of kidney changes in resistant hypertension is described – renal cortex surface roughness, renal cortex thinning, decreased kidney sizes, and rounded kidney shape. The relationship of the renal parenchyma volume indexed for height with the level of cystatin C (r=-0.36), creatinine (r=-0.48) and eGFR (r=0.49) was revealed. Conclusion. The hypertensive renal MRI-phenotype includes a decreased in kidney size, thinning of the renal cortex, renal cortex surface roughness and rounded shape of the kidneys. The total volume of the renal cortex indexed for height has a close relationship with serum biomarkers of renal dysfunction, and is recommended for use as a non-invasive marker reflecting the state of the kidneys in resistant arterial hypertension.

Background: It remains difficult to understand the association between the local mechanical properties of ascending thoracic aorta aneurysm (asTAA), its tissue, and its cellular and molecular changes. The purpose of our study was to investigate the relationship between biomechanical properties, histopathological findings, and tissue biomarkers of asTAA. Methods: Intraoperative asTAA samples from 30 patients were studied. All samples were examined histologically and underwent a tensile test. We determined the tensile strength (σв, MPa), the strain (ε, mm/mm˟%), and the area under the strength-strain curve (S) along with the concentrations of tissue matrix metalloproteinases (MMP-1 et al.) and their inhibitors, their interleukins (IL) -6 -10, and their tumor necrosis factor (TNF) -α. Results: It was found that 43.3 % of asTAA patients had atherosclerosis, 3.3 % had aortitis, and 53.3 % of patients had connective tissue dysplasia. Differences in the studied parameters between these subgroups were not found. Age correlated with ε (r = −0.49) and S (r = −0.54). ε was also associated with media fibrosis degree (r = −0.5), collagen/elastin ratio (r = −0.61), and IL-10 (r = 0.52). IL-10 correlated with collagen/elastin ratio (r = −0.58), TNF-α (r = 0.77), and MMP-1 (r = 0.71). Conclusion: Tissue IL-10 has a protective effect on the elastic structures of the aortic wall and is positively associated with the activity of MMP-1 and pro-inflammatory cytokines. IL-6 is associated with media fibrosis degree, and negatively affects strength-strain parameters of asTAA samples.

Aim. To compare two methods for the determination of N-terminal pro-brain natriuretic peptide (NT-proBNP) and soluble ST2 (sST2): rapid immunochemical methods and standard enzyme immunoassay (ELISA), as well as to determine the possibility of rapid tests for determining these biomarkers in acute myocardial infarction (AMI). Material and methods . This open, non-randomized, single-center observational study included 41 patients: 20 with non-ST-elevation myocardial infarction (non-STEMI) and 21 with ST-elevation myocardial infarction (STEMI), without cardiogenic shock and active inflammatory process. During hospitalization, all patients underwent the level of NT-proBNP using an immunological fluorometric analyzer AQT90 FLEX (Radiometer, Germany) and sST2 immunological method for assessing lateral flow using an ASPECT Reader™ T2 analyzer (Critical diagnostics, USA). Then, studies of these biomarkers by standard ELISA were delayed. Results. The Spearman correlation coefficient for rapid NT-proBNP and NT-proBNP-ELISA was 0,5937 (p=0,00000087). At the same time, the proportion of patients with an NT-proBNP level >300 pg/ml in the rapid test was significantly higher than in the ELISA: 90% vs 44% (p<0,05). In a comparative analysis of two methods for sST2, the Spearman correlation coefficient for rapid sST2 and sST2-ELISA is 0,9561 (p=0,0000007). The proportions of patients with sST2 >35 ng/ml with rapid and ELISA methods did not differ significantly and amounted to 53 and 55%. Rapid NT-proBNP were significantly different between Killip I and Killip III (p=0,043): Me=1375,00 (669,00; 3140,00) vs Me=3660,00 (1815,00; 6890,00). There were no significant changes in the rapid sST2 level depending on Killip class. Conclusion. Correlations were found between rapid and ELISA methods in patients with AMI: medium in strength for NT-proBNP and strong for sST2. The proportion of patients with NT-proBNP levels >300 pg/mL in the rapid test was significantly higher than in the ELISA. Therefore, a conversion formula is needed, for which the available data are insufficient. The proportion of patients with sST2 >35 ng/ml in the rapid and ELISA methods did not differ significantly. A direct relationship between the level of rapid NT-proBNP and Killip class was found. No dependence of the level of rapid sST2 on Killip class was found.

Aim . To evaluate the role of heart rate variability in the pathogenesis of chronic heart failure with preserved ejection fraction (HFpEF) in patients with non-obstructive coronary artery disease (CAD). Materials and methods . The cross-sectional study included 65 patients (55.4% were males) with non-obstructive CAD. Non-obstructive CAD (stenosis < 50%) was confirmed by coronary computed tomography angiography. Heart rate variability (HRV) was evaluated by 24-hour Holter monitoring; parameters of time series and spectral analysis were analyzed. Results . Depending on the presence of HFpEF, the patients were divided into 2 groups: group 1 (n = 48) included patients with HFpEF, and group 2 (n = 17) encompassed patients without it. In patients with HFpEF, a statistically significant decrease in the total HRV and parasympathetic effects on the heart rate, mainly at night, as well as increased activity of cerebral ergotropic systems were revealed. In group 1, the values of the time series analysis of HRV and QT dispersion based on the study of RR interval duration (SDANN and SDNNidx) had a significant direct relationship with the level of myocardial stress in diastole, the value of vascular resistance, and the E / e’ ratio. The cut-off values of SDNNidx and pNN50 were identified, that may be used as markers for early diagnosis of HFpEF. Conclusion . In patients with non-obstructive CAD and HFpEF, it is advisable to perform 24-hour Holter monitoring and assess HRV parameters by the time series analysis, which, compared with the spectral analysis, has a closer relationship with the characteristics of left ventricular diastolic function and afterload.

Aim. To evaluate manifestations of systemic inflammatory response (SIR) and the effect of the colchicine therapy on SIR severity in patients with ischemic heart disease (IHD) after coronary artery bypass grafting (CABG) with extracorporeal circulation (EC).Material and methods. This study included 100 patients aged 62+6.3 years with stable IHD and multivessel coronary atherosclerosis scheduled for CABG with EC. Patients of group 1 (n=50) were administered with a single dose of colchicine (Colchicum-Dispert) 500 µg 4 hours before surgery followed by 500 µg twice a day for 10 days after surgery. Patients of group 2 (n=50) received a standard treatment, including nonsteroid anti-inflammatory drugs after surgery. Severity of the inflammatory response was evaluated by measuring blood cytokines.Results. In the postoperative period, patient of group 1 showed a tendency toward a lower incidence of pleurisy and heart rhythm disorders in the form of paroxysmal atrial fibrillation (AF) (p=0.18). Levels of the anti-inflammatory cytokines, interleukin-10 (IL-10) and interleukin-6 (IL-6), were significantly increased in both groups at 6 hours after surgery (p<0.05); at the same time, in group 1, IL-10 remained increased also at 10 days after surgery (р=0.0002). No significant time-related changes in the proinflammatory cytokines, tumor necrosis factor α (TNF-α) and interleukin 1β (IL-1β), were observed. At 3 days post-CABG, there were significant increases in tissue inhibitors of matrix metalloprotease 1 (TIMP-1) (р<0.0001) and matrix metalloproteinase 9 (MMP-9) (р<0.001); at the same time, patients of group 1 had lower MMP-9 concentrations than patients of group 2 (p<0.05). At 10 days of postoperative period, these values were comparable with the background values. Increases in neopterin compared to preoperative values were found in both groups on days 3 and 10 after surgery (р <0.0001).Conclusion. CABG with EC is associated with the activation of SIR. The colchicine therapy at a dose of 500 µg 4 hours prior to surgery and 500 µg twice a day for 10 days after surgery reduces manifestations of SIR, which is clinically evident as a tendency to reduced incidence of pleurisy and arrhythmias, and does not result in the development of serious complications. The dynamics of matrix metalloproteinases indicates that the colchicine treatment is promising for decreasing the risk of CHF progression and myocardial remodeling in patients with IHD.

Aim. In patients with non-obstructive coronary artery disease (CAD), to evaluate the pathophysiological significance and diagnostic effectiveness of catestatin in detecting heart failure with preserved ejection fraction (HFpEF), as well as to assess the relationship of the levels of this biomarker with heart rate variability (HRV) parameters and the severity of diastolic dysfunction. Material and methods. The study included 83 patients (44 men, mean age, 62,0 [57,0; 68,5] years) with non-obstructive CAD and preserved left ventricular (LV) ejection fraction of 63 [60; 64]%). Echocardiography was performed according to a standard protocol. HRV was assessed using 24-hour electrocardiographic monitoring. Serum biomarker levels were determined using enzyme-linked immunosorbent assay. Results. Patients were divided into groups depending on HFpEF presence: group 1 (n=63) included patients with newly diagnosed HFpEF, and group 2 included patients without heart failure (n=20). Serum catestatin concentrations were 43,1% lower (p<0,001) in patients with HFpEF than in patients without it. Catestatin had a negative correlation with levels of N-terminal pro-brain natriuretic peptide and C-reactive protein. Moreover, serum catestatin values were inversely correlated with LV remodeling parameters, whereas no relationship was found with HRV values. According to ROC analysis, catestatin £132,83 μg/ml (AUC=0,884; p<0,001) were defined as threshold values associated with HFpEF. Conclusion. Decreased serum catestatin concentrations were associated with HFpEF and overexpression of heart failure and inflammation biomarkers. Moreover, serum catestatin values had a negative relationship with LV remodeling parameters, while no relationship was found with HRV values.

Aim . To study the role of molecular biomarkers potentially influencing the formation and progression of heart failure (HF) with preserved ejection fraction (HFpEF) in non-obstructive coronary artery disease (CAD). Material and methods . We examined 48 patients with newly diagnosed HFpEF against the background of non-obstructive CAD. Group 1 (n=31) included patients with class I-II HF and group 2 (n=17) included patients with class III HF; the control group consisted of patients without heart failure (n=17). The content of NT-proBNP and sST2, diastolic dysfunction and coronary flow reserve parameters were assessed. Results . The content of NT-proBNP in patients of group 1 was 45% higher than in group 2 (p<0,001). The mean levels of sST2 did not exceed the reference values and significantly exceeded the control group (p<0,001). Coronary flow reserve (CFR) decreased (p<0,001) depending on the severity of HF. Negative associations of sST2 levels with LVEF, septal e’ and CFR were revealed, as well as NT-proBNP with CFR. Conclusion . HFpEF in non-obstructive CAD is triggered due to progressive impairment of endothelial function, which affects the decrease in coronary and myocardial flow reserves, diastolic function, hyperproduction of humoral factors that initiate perivascular fibrosis and apoptosis of cardiomyocytes.

Aim. To test the hypothesis that early detection of clinically significant patients with high risk of developing intra-abdominal hypertension in cardiac surgery may be based on an increase in the level of fatty acid-binding protein. Material and Methods . Concentrations of fatty acid-binding protein (I-FABP) were measured in urine samples taken from 82 patients after cardiac surgery with cardiopulmonary bypass. The data were compared with clinical manifestations of the perioperative period, as well as changes in pH and lactate levels in arterial blood. Results. Statistically significant differences were revealed between the study groups in the cases of increased intra-abdominal pressure, duration of ventilation, and the number of cases of intestinal failure. The level of I-FABP increased in the patients of both groups after removal of the aortic clamp in 2 hours, 12 hours, 24 hours after surgery. Conclusions. The I-FABP level can be a valuable marker for early detection of patients with the development intra-abdominal hypertension of after cardiac surgery. The measurement of I-FABP can serve as a guideline not only for the identification of patients with intra-abdominal hypertension, but also for the initiation of therapeutic measures aimed at minimizing further deterioration of intestinal function.

Aim To study renal hemodynamics in patients with resistant arterial hypertension (RAH) in combination with type 2 diabetes mellitus (DM2) and to identify factors involved in the increase in intrarenal vascular resistance.Material and methods This study included 59 patients (25 men) with RAH in combination with DM2. Mean age of patients was 60.3±7.9 years; 24-h blood pressure (24-BP) (systolic, diastolic, SBP/DBP) was 158.0±16.3 / 82.5±12.7 mm Hg during the treatment with 4.3 [4.0;5.0] antihypertensive drugs; glycated hemoglobin (HbA1c) was 7.5±1.5 %; estimated glomerular filtration rate (eGFR) was 73.1±21.8 ml/min / 1.73 m2 (CKD-EPI equation). Measurement of office BP, 24-h BP monitoring, renal artery (RA) Doppler, routine lab tests including determination of GFR (CKD-EPI), 24-h urine albumin excretion, and ELISA measurement of blood lipocalin-2, cystatin C, high-sensitive C-reactive protein (hsCRP), and asymmetric dimethylarginine (ADMA) were performed for all patients.Results Incidence of increased RA resistive index (RI) was 39% despite the high rate of vasodilator treatment (93% for renin-angiotensin-aldosterone system inhibitors, 78% for calcium antagonists). According to a correlation and regression analysis, RA RI values were correlated with the kidney function (r=-0.46, p<0.001 for eGFR, r=0.56; p=0.006 for lipocalin-2), age (r=0.54, p<0.001), increases in concentrations of hsCRP (r=0.35, p<0.001) and ADMA (r=0.39, p=0.028), the increase in vascular stiffness (r=0.59, p<0.001 for pulse BP (PBP) as well as DM2 duration, and HbA1c (r=0.33, p<0.001 for both). The independent association of RA RI with the age, PBP, and duration of DM2 was confirmed by the results of multivariate regression analysis. According to the ROC analysis, the threshold level of RA RI corresponding to a decrease in GFR <60 ml / min / 1.73 m2 was ≥0.693 conv. units.Conclusion In more than one third of patients with RAH in combination with DM2, increased renal vascular resistance was documented, which was closely associated with impaired kidney function, age, DM2 duration and severity, and markers of low-grade inflammation, endothelial dysfunction, and vascular stiffness. The value of RA RI ≥0.693 conv. units was a threshold for the development of chronic kidney disease (CKD).

We analyzed the associations of the mechanical strength of dilated ascending aorta wall (intraoperative samples from 30 patients with non-syndromic aneurysms) with tissue MMPs and the cytokine system. Some samples were stretched to break on an Instron 3343 testing machine and the tensile strength was calculated; others were homogenized and the concentrations of MMP-1, MMP-2, MMP-7, their inhibitors (TIMP-1 and TIMP-2), and pro- and anti-inflammatory cytokines were determined by ELISA. Direct correlations between aortic tensile strength and concentrations of IL-10 (r=0.46), TNFα (r=0.60), and vessel diameter (r=0.67) and an inverse correlation with patient's age (r=-0.59) were revealed. Compensatory mechanisms supporting the strength of the ascending aortic aneurysm are possible. No associations of MMP-1, MMP-7, TIMP-1, and TIMP-2 with tensile strength and aortic diameter were found.

Background: The study of laboratory biomarkers that reflect the development of adverse cardiovascular events in the postinfarction period is of current relevance. The aim of the present study was evaluation of oncostatin M (OSM) concentration changes in the early and late stages of myocardial infarction and evaluation of the possibility of its use in prediction of adverse left ventricular (LV) remodeling in patients with myocardial infarction with ST-elevated segment (STEMI). Methods: The study involved 31 patients with STEMI admitted in the first 24 hours after the onset of MI and 30 patients with chronic coronary artery disease as a control group. Echocardiographic study was performed on day 3 and in 6 months after STEMI. The serum levels of biomarkers were evaluated on the day of hospital admission and 6 months after MI using multiplex immunoassay. Results: OSM level increased during the first 24 h after the onset of the disease, with the following decrease in 6 months. OSM concentration at admission had correlated with echocardiography parameters and Nt-proBNP, troponin I, CK-MB levels. Our study has demonstrated association of the increased levels of OSM at the early stages of STEMI with development of the adverse LV remodeling in 6 months after the event. Conclusions: Elevation of OSM levels in the first 24 h after STEMI is associated with the development of the adverse LV remodeling in the long-term post-infarction period.