There is evidence that behavioral risk factors, such diets rich in refined carbohydrates, sugar trans-fat and saturated fat and salt, the lack of mastication during eating, sedentary behavior, tobacco intake, alcoholism, and mental stress, are important risk factors of cardio-metabolic diseases including heart failure (HF).These health behaviors are known to predispose risk factors for HF: obesity, hypertension, metabolic syndrome, diabetes mellitus, and coronary artery disease. The exact mechanisms of how sugar and tobacco damage the cardiac cells are not known. However, it seems that oxidative stress, resulting in inflammation and immune deficiency, is common in the pathogenesis of HF. Free radicals are known to damage the cell membranes causing development of intracellular Ca2+ overload, activation of proteases and phospholipases, and alterations in cardiac gene expression. These biochemical alterations result in the changes in the molecular structure, and function of different subcellular organelles of the heart, with pathological subcellular remodeling, leading to HF. Since cardiac hypertrophy impairs the relationship between ATP demand and production, mitochondrial bioenergetics must keep up with the cardiac hypertrophic phenotype. The roles of mitochondrial proteomic and energetic remodeling in cardiac hypertrophy are of significant importance. The temporal and causal relationships between mitochondrial failure with increased energy demand can facilitate progression to cardiac decompensation. It is possible that the maladaptive effect of sustained neuroendocrine signals on mitochondria may lead to bioenergetic fading, which contributes to the progression from cardiac hypertrophy to HF. It seems that persistent and continuous pathological signals in the cardiac cells induce cardiac hypertrophy, which is associated with increased risk for sudden death or progression to HF, irrespective of the initial cause of hypertrophy. These cardiac alterations, although considered adaptive, become maladaptive, leading to cardiac failure if prolonged for a long duration. Since cardiac imaging can identify early cardiac hypertrophy, there is an unmet need to examine the significance of behavioral risk factors in the early diagnosis of HF.

Aim. To develop based on the indicators of clinical blood tests, some biochemical markers, iron metabolism and cytokines a mathematical model that allows with high sensitivity and specificity to conduct differential diagnosis of anemia of chronic diseases (AHD) and iron deficiency anemia (IDA) in patients with inflammatory joint diseases (rheumatoid arthritis (RA), psoriatic arthritis (PSA), ankylosing spondylitis (AS)). Material and methods. The study included 104 patients with inflammatory joint diseases and anemic syndrome (37 males/67 females, age 48.4±5.42 years old), of which 54 patients with RA, 27 patients with PSA and 23 patients with AS. The control group consisted of 22 patients with inflammatory diseases of the joints without anemia (13 males/9 females, age 47.8±3.55 years old), of which 7 patients with RA, 10 with PSA, 5 with AS. For all patients, in addition to hemogram parameters, the concentrations of interleukin-6, interleukin-10, interleukin-1β, interferon-gamma, tumor necrosis factor alpha, ferritin, C-reactive protein, hepcidin, transferrin, soluble transferrin receptor were determined. For quantitative indicators, the median, standard error of the mean, and interquartile range was calculated. The significance of differences between several unrelated groups was determined using the Kruskal-Wallis test. The calculation of a mathematical model for the differential diagnosis of ACD and IDA was carried out using discriminant analysis. Results. As a result of the study, a canonical linear discriminant function (CLDF) was obtained: CLDF = 1.612171-0.002725× Hepcidin -0.005429× Ferritin The coordinates of the centroids are calculated, for ACD it is -1.44222008, and for IDA it is 1.52705656. A patient whose CLDF value is determined based on ferritin and hepcidin concentrations should be classified into the ACD or IDA group based on the minimum distance to the corresponding centroid. The resulting mathematical model has 100% sensitivity and 80% specificity. Conclusions. The equation based on hepcidin and ferritin (obtained from the results of discriminant analysis) allows, with high sensitivity, specificity and information ability, to carry out differential diagnosis of ACD and IDA in patients with inflammatory joints diseases instantly at the stage of initial contact with the doctor. Using of the equation will make it possible to more effectively diagnose and correct these types of anemia in this pathology, including for the purpose of more effective treatment.

Pulmonary hypertension (PH) is an understudied but significant complication of myocardial infarction (MI). Currently, there are no diagnostic algorithms that can predict the development of PH in the setting of myocardial infarction, which requires the development of prediction models based on the results of routine examination, for example, lipid profile. The purpose of the research was to study the parameters of lipid metabolism in men with PH that developed against the background of MI and their impact on the risk of developing PH. The results of examination of men aged 32-60 years with verified MI were studied. According to the level of mean pulmonary artery pressure (MPAP) determined by echocardiography, patients were divided into two groups: the study group (with a MPAP level of more than 20 mm Hg at the end of the third week of MI) and the comparison group (with a normal MPAP level at the end of the third week of MI). The studied indicators were compared based on the Mann-Whitney, Wilcoxon, and Chi-square tests; correlations were performed using the Spearman method. It was found that patients in the study group had lower levels of the atherogenic coefficient (AC) and the total cholesterol/high-density lipoprotein (TC/HDL) index at the end of the third week of MI. Levels of triglycerides (TG) < 1.3 mmol/l and very low density lipoprotein (VLDL) ≥ 1.2 mmol/l, TC/HDL indices < 6.0 and LDL/HDL < 3.2 in the first 48 hours, LDL <2.4 mmol/l, AC value <5.0, TC/HDL indices <6.0 and LDL/HDL <3.2 at the end of the third week of MI influence the risk of developing PH in the subacute period of MI. Correlations have also been established between the level of MPAP and lipid profile parameters. It is advisable to use the obtained results when developing a model for predicting the development of PH against the background of MI. Keywords: pulmonary hypertension, myocardial infarction, lipid metabolism, mean pulmonary artery pressure, heart failure, men, young and middle age.

Heart failure (HF) is rapidly increasing in both developing and developed countries and the exact pathophysiology is not known. The cardiac cells use fatty acids and glucose for the metabolic functions depending upon physiological and metabolic requirements. Western diet characterized with high sugar, high fat, red meat and processed meat, eggs, fried foods, and sweetened beverages may have adverse effects on cardiomyocyte ultrastructure. However, micronutrients such as vitamins, minerals, antioxidants, flavonoids, and polyphenolics as well as essential and nonessential amino acids and fatty acids that are rich in Mediterranean type of diets may have protective roles in maintaining physiological functions of the cardiomyocyte. Apart from glucotoxicity, lipotoxicity is also damaging to cardiac cells. There is increased production of ceramide, advanced glycation end products, and triamino-methyl-N-oxide due to high sugar and high-fat diets. High-fat diet in combination with inducible nitric oxide synthase via N-arginine methyl ester has been found to preserve ejection fraction in a mouse model of HF. It is possible that increased supplementation of monounsaturated fatty acids, arginine, and w-3 fatty acids with flavonoids such as resveratrol and cessation of red meat and egg may further improve the function of cardiac cells, resulting in the prevention of HF with reduced ejection fraction. Cohort studies and randomized, controlled trials would be necessary for the demonstration of the role of nutritional factors in the prevention of HF.

Aim. To identify predictors of the development of pulmonary hypertension (PH) in the subacute period of myocardial infarction (MI) in young and middle-aged males to improve preventive measures.Materials and methods. We studied the results of treatment of male patients aged 32–60 years with a verified diagnosis of MI. Based on echocardiography findings and detection of PH at the end of the third week of MI, the patients were divided into the study group (patients with PH) and the comparison group (patients with a normal pressure in the pulmonary artery). In the studied groups, a comparative assessment of various parameters was performed, and an analysis of the risks of developing PH using the Pearson’s chi-squared test was conducted.Results. We found that the risk of developing PH in the subacute period of MI was significantly affected by certain parameters of peripheral hemodynamics, the presence of bradycardia, and the calculated value of total pulmonary resistance. The main parameters of the lipid profile were found to be significant predictors of PH in the subacute period of MI, along with some parameters of electrolyte metabolism (sodium and magnesium in the first 48 hours of MI, potassium and calcium at the end of the third week of the disease). We established the presence of a reliable relationship between several parameters of the structural and functional state of the myocardium both in the first 48 hours of MI and the end of the third week of the disease with the risk of developing PH in the subacute period of MI.Conclusion. The identified predictors make it possible to determine patients with MI who are at an increased risk of PH to timely diagnose and treat the disease and improve the prognosis.

Relevance. Cardiogenic shock remains the most common cause of death in myocardial infarction. Aim. To evaluate the myocardial infarction complicated by cardiogenic shock clinical course features in males under 50 years old (y.o.) to clarify their significance for the development of this complication to improve prevention and outcomes. Material and methods. The study included males aged 19-49 y.o. with type I myocardial infarction. The patients were divided into age-matched groups. The study group consisted of seven patients with cardiogenic shock, the control group - without cardiogenic shock - 223 patients. Comparative analysis of the clinical course variants, complications in selected groups was performed. The influence of the studied parameters on the probability of cardiogenic shock development in the examined patients was assessed by the method of risk analysis using the Pearson Chi-square test. Results. In the study group, there was a predominance of kidney dysfunction (100 in the study group and 10.3% in the control group; p=0.004), chronic heart failure in history less than one year old (50.0 and 15.3%, respectively; p=0, 04), non-anginal variants (abdominal (16.7 and 1.5%; p = 0.0497), arrhythmic (16.7 and 2.5% p = 0.0497) and according to the type of increase in heart failure (16.7 and 1.5%; p=0.0497)) of the clinical course of myocardial infarction, the presence of two or more complications (100 and 38.1%; p=0.005) and combinations of all groups of myocardial lesions (57.1 and 6.3% ; р˂0.0001). The risk of developing cardiogenic shock increased in addition to the above situations with diastolic blood pressure ˂70 mm Hg (Absolute risk: 18.8%; relative: 13.3; p˂0.0001), systolic˂110 mmHg (14.3%; 9.9, respectively; p=0.0004), total peripheral resistance (37.5%; 35.8; p˂0.0001). Conclusions. These factors should be used in the formation of high-risk groups for the cardiogenic shock in myocardial infarction development for monitoring and timely implementation of the necessary treatment. It is also expedient to take them into account in the prognostic modeling of this complication.

Relevance. Cardiogenic shock remains one of the most common causes of death in myocardial infarction. Aim. To evaluate the features of cardiac rhythm and conduction disturbances in myocardial infarction complicated by cardiogenic shock, as well as their significance for the development of this complication in males under 50 years old to improve prevention and outcomes. Material and methods. The study included males aged 19-49 years old with type I myocardial infarction. The patients were divided into age- comparable groups. The study group consisted of seven patients with cardiogenic shock, the control group - without cardiogenic shock - 223 patients. A comparative analysis of arrhythmias among the variants of the clinical course, complications, as well as their structure in selected groups were performed. The influence of the studied parameters on the risk of cardiogenic shock development in the examined patients was assessed by the method of risk analysis using the Pearson Chi-square test. Results. In the study group, a higher incidence of arrhythmias in the structure of MI complications (85.7%) was revealed than in the control group (24.2%; p=0.003). They were observed in combination with complications of the group of contractile myocardial insufficiency and its mechanical failure (57.1% and 6.3%, respectively; р˂0.0001) and only contractile insufficiency (28.6% and 11.2%; р˂0,0001). In the structure of arrhythmias in the study group, the frequency of observation of atrial fibrillation and flutter (66.7%) prevailed over the control group (4.9%; р˂0.0001), ventricular fibrillation (50.0 and 2.4%, respectively; р˂ 0.0001), supraventricular tachycardias (33.3% and 1.5%; р˂0.0001), supraventricular (33.3% and 8.3%; р=0.03) and polytopic extrasystoles (33.3% and 3 .9%; p=0.0003), ventricular tachycardias (16.7% and 2.0%; p=0.02), complete atrioventricular blockades (16.7% and 2.0%; p=0.02) and asystole (16.7% and 1.5%; p=0.007). The risk of cardiogenic shock development increased with these arrhythmias. Conclusions. The listed types of arrhythmias should be used in the formation of high-risk groups for the cardiogenic shock development in myocardial infarction for monitoring and timely implementation of the necessary treatment. It is also expedient to take them in the prognostic modeling of this complication.

The study was conducted at the Department and Clinic of Hospital Therapy of the Military Medical Academy. CM. Kirov. The work studied the relationship of motor disorders of the stomach with morphological changes in the gastric mucosa in 90 patients with chronic atrophic gastritis and 93 patients with chronic non-atrophic gastritis aged 20 to 73 years (the average age of patients was 52.7+1.7 years and 48.5+ 3.6 respectively). Motor disorders were characteristic of 87% of patients with chronic atrophic gastritis and 79.6% of patients with chronic non-atrophic gastritis. It was found that in patients with chronic atrophic gastritis significantly more often (p<0.01) than in patients with chronic non-atrophic gastritis, there was an insufficiency of the lower esophageal sphincter. At the same time, insufficiency of the pylorus in comparison with its spasm was significantly more often (p<0.01) detected in chronic atrophic gastritis. Duodenogastric reflux in combination with insufficiency of the lower esophageal sphincter in patients with chronic atrophic gastritis significantly more often (p<0.01) atrophy was observed in the body and antrum of the stomach. When atrophy was localized only in the antrum, pyloric insufficiency was observed significantly more often than spasm (p<0.01). Duodenogastric reflux in combination with insufficiency of lower esophageal sphincter in patients with chronic atrophic gastritis significantly more often (p<0,01) atrophy in the body and antral part of the stomach was observed. Thus, the relationship between insufficiency of the lower esophageal and pyloric sphincters with a diffuse atrophic process has been established.

Relevance. Myocardial ruptures during myocardial infarction remain one of its most dangerous complications. Aim. To evaluate the features of risk factors for the development of myocardial infarction complicated by rupture in young and middle-aged men for predictive modeling of this complication to improve its prevention. Material and methods. The results of examination and treatment of men aged 19-60 years with myocardial infarction were studied. Patients were divided into two age-comparable groups: I – study group, with myocardial rupture – seven patients; II - control, without it - 558 patients. A comparative analysis of clinical, instrumental and laboratory parameters was performed, as well as an analysis of their influence (Pearson's Chi-square) on the risk of myocardial ruptures. Using binary and stepwise logistic regression, a model for predicting the risk of myocardial rupture was created. Results. The study group differed from the control group in terms of a more severe condition of patients (recurrent extensive lesions with multiple complications), the most significant of which were: electrocardiographic signs of right ventricular enlargement (absolute risk: 21.4%; relative: 27.0; p˂0.0001), the presence of thromboembolism (17.9%; 17.5, respectively; p˂0.0001) and pulmonary edema (9.0%; 44.6; p˂0.0001) among the complications myocardial infarction, history of coronary artery bypass surgery (6.6%; 11.0; р˂0.0001), III and IV severity class of acute heart failure according to T. Killip (12.1%; 21.3; р˂ 0.0001), the presence of asystole (18.8%; 23.5; p˂0.0001) and complete atrioventricular block (15.8%; 19.7; p˂0.0001). Conclusions. These factors were used to build a model for predicting the risk of myocardial rupture with good predictive characteristics, suitable for practical use.

Relevance. Changes in lipid metabolism during myocardial infarction (MI) complicated by acute kidney injury (AKI) are potentially important for evaluating the effects of therapy and expanding the possibilities of prevention. Aim. To evaluate the changes in lipid metabolism during acute and subacute MI periods and their role in the complication’s development in men under 60 years old (y.o.) with AKI to im-prove prevention and outcomes. Material and methods. The results of inpatient examination and treatment of men aged 20-60 y.o. with MI were studied. Patients were divided into two age-comparable groups: the study group, with AKI - 22 patients and the control group, without it - 141 patients. The parameters of lipid metabolism and their dynamics were compared in the first hours (1) and at the end of the third week of MI (2) in selected groups, their influence was assessed (risk analysis by Pearson's Chi-square test) on the risk of AKI development and complications MI in the study group. Results. In the study group, the following were observed: higher levels of low-density lipo-protein2 (LDL2) (5.53±2.50 mmol/l) compared to the control group (3.33±2.45 mmol/l; p=0.02); an increase in the levels of very low-density lipoproteins, a coefficient and an atherogenic index, a decrease in triglycerides (TG) at the end of the third week of the disease. The risk of AKI development was associated with the concentration of TG1≥1.88 mmol/l (p=0.007). Complicated course of MI in the study group is characterized by levels of LDL1≥4.0 (p=0.02), high-density lipoprotein1 (HDL1)˂1.1 (mmol/l; p=0.02), and their ratio (LDL1/HDL1) ≥4.5 (p =0.02). Conclusions. In AKI, persistent atherogenic changes in lipids are noted both in the acute and at the end of the subacute period of MI. The risk of developing AKI increases at levels of TG1≥1.88 mmol/l, and the complicated course of MI in the study group is associated with lev-els of LDL1≥4.0, HDL1˂1.1 (mmol/l) and LDL1/HDL1≥4.5. It is expedient to use them in predictive modeling.

Abstract. Relevance. Acute kidney injury (AKI) in myocardial infarction worsens the prognosis and increases the duration of treatment of patients. Aim. To evaluate predictors of acute kidney injury in myocardial infarction in men younger than 60 years of age with gout to assess opportunities to improve prevention. Material and methods. The study included men 42-59 years old (y.o.) with type I MI and gout. Patients were divided into two age-comparable groups: I - study group, with AKI - two pa-tients; II - control, without it - 24 patients. Comparative evaluation of data on cardiovascular risk factors, parameters of the disease course in selected groups was performed. Quantitative parameters were determined twice, in the first 48 hours (1) and at the end of the third week (2) of MI. Pearson's chi-square method was used to assess the absolute (AR) and relative (RR) risks of developing AKI under the influence of the listed factors. Results. A significant effect on the possibility of developing AKI in the examined patients was obtained for: a history of urolithiasis (AR 50.0%; p=0.01), MI in the winter period (AR 40.0%; p=0.03 ); levels of low-density lipoproteins1<2.5 mmol/l (AR 50.0%; p=0.04), ratios of total cholesterol1/high-density lipoproteins1<3.7 (AR 50.0%; p=0.04), glucose1 ≥8.9 mmol/l (AR 100.0%; RR 14.0; p=0.008); potassium1 ˂3.8 mmol/l (AR 100.0%; RR 13.0; p=0.01), glomerular filtration rate (СKD-EPI)1≥123.0 ml/min/1.73 m2 (AR 100.0%; RR 14.0, p=0.008); polytopic extrasystole (AR 100.0%; RR 14.0; p=0.008), thromboembolism (AR 100.0%; RR 14.0; p=0.08) in the structure of MI complications; levels of systolic blood pres-sure (BPsyst)1≥200 mm Hg. (AR 66.7%; p=0.002), mean BP1≥133.0 (AR 66.7%; p=0.002), stroke index1≥39.8 ml/m2 (AR 66.7%; p=0.002), transverse dimension of the right atrium (RA)1 ˃52 mm (AR 50.0%; p=0.01). Conclusions. The most important for the risk of AKI development during MI in men under 60 y.o. with gout were arterial hypertension (BPsyst≥200 mHg), hyperglycemia (≥8.9 mmol/l), RA dilation (˃52 mm), history of urolithiasis. Combinations of the above parameters should be used to form high-risk groups for AKI development in this category of patients to improve preventive measures, as well as for predictive modeling.

The influence of seasonal and infectious factors on the risk of an unfavorable outcome in the first 56 days of myocardial infarction, a complicated course of the disease, the development of chronic heart failure of the second functional class and higher during this period was studied. The results of examination and treatment of 556 men 1960 years old with verified type I myocardial infarction were evaluated. The analysis of the risks of an unfavorable outcome, a complicated course of the disease, and the development of chronic heart failure was carried out by the method of multivariate analysis of variance. Chronic foci of infections of the abdominal cavity and kidneys, myocardial infarction in winter, spring and autumn have a moderate negative effect on the prognosis of the disease in the examined. Predictors of unfavorable prognosis are heterogeneous across the seasons. Frequent respiratory infections and chronic inflammatory lung diseases reduce the risk of death in those examined in the first months of myocardial infarction, however, they significantly increase the risk of developing chronic heart failure (bibl.: 19 refs).

Relevance. The role of the coronary arteries angiographic changes severity in myocardial infarction complicated by acute kidney injury is assessed in different ways. Aim. To evaluate the features of the coronary arteries state in men under 60 years old with myocardial infarction complicated by acute kidney injury to improve prevention and outcomes. Material and methods. The study included men 19-60 years old with type I myocardial infarction. The patients were divided into two age-comparable groups: I - study group, with acute kidney injury - 25 patients; II - control, without it - 168 patients. A comparative assessment of coronary angiography indicators, also acute kidney injury and heart failure development risk analysis (ANOVA) were performed. Results. There were no differences in the compared groups in angiographic data, localization, depth of the lesion, and the frequency of the complicated course of the disease. The study group were characterized by akinesia in the middle anterior (in the studied% 100; control: 15.6%; p =0.02) and antero-septal (100 and 17.7%; respectively; p=0.04) segments , as well as the frequency of registration of chronic heart failure (72.0 and 43.2%; p=0.005) by the eighth week of myocardial infarction. Bypass surgery (absolute risk: 46.2%; relative - 4.37; p=0.0002) and unstable angina (absolute risk: 19.8%; relative - 2,46; p=0.02) in the medical history, as well as the presence of peripheral angiopathies (absolute risk: 18.9%; relative - 3.21; p=0.0008). Conclusions. Men under 60 years old with acute kidney injury in myocardial infarction were not differ in the number and extent of large coronary artery lesions from the general group. They are characterized by large in area and severity of dysfunction lesions of the anterior middle segments of the left ventricle with a higher frequency of chronic heart failure than in the general group. The anamnestic data listed above associated with coronary arteries is advisable to use in the formation of groups at high risk for the acute kidney injury development formation, as well as prognostic modeling.

The aim . Evaluation of renal function variations during different year seasons in men under 60 years old within acute and subacute phases of myocardial infarction (MI) to prevent dysfunction and enhance forecasting. Patients and methods . Examination and treatment results analyses of 412 men with MI under 60 y.o. for the period of 2000-2015 who had 30-59 mL/ min/1,73 m 2 calculated glomerular filtration rate (GFR, CKD-EPI 2009, modification 2011) at the end of the third week from the disease onset (61 patients) and more than 60 mL/min/1,73 m 2 respective-ly (315 patients) had been conducted. Renal function changes were assessed during treatment in the first 48 hours and at the end of the third week from the MI onset in patients groups that were combined aligning to the climatic seasons of the year founded on average daily air tem-perature of St. Petersburg, Russia changes. Variations of renal dysfunction (RD) development simulation in different year seasons corresponding to the end of the third week of the disease were conducted with the use of classification trees methodology. Results. Reliable evidence of creatinine and GFR level changes depending on the seasonal variances have been identified for the early periods of the MI development. An ef-fective prognostic algorithm with efficiency as high as 62 % for patients risk groups separation among men under 60 y.o. with MI potent to RD development at the end of the third week of disease was created. Conclusions . Higher creatinine levels and low levels of GFR in men under 60 y.o. with MI are being observed in spring and winter. The risk group for RD development at the end of the MI subacute period represents smokers in summer and autumn; chronic heart failure history patients in winter; patients with diastolic arterial blood pressure in the MI acute period of 90 mm Hg and more in spring. Prescription of medicinal products with nephroprotective features starting from the first hours of MI development in this group of pa-tients is beneficial.

Relevance. The development of chronic heart failure in chronic inflammatory pulmonary disease (CIPD) after myocardial infarction (MI) remains insufficiently studied. Aim. To evaluate changes in intracardiac hemodynamic parameters in men under 60 years old with CIPD in the acute and subacute MI periods to clarify their significance in the development of chronic heart failure. Material and methods. The study included men aged 19-60 years old with type I MI. Patients are divided into two age-comparable groups: I - the study group, with CIPD - 166 patients; II - control, without it - 490 patients. A comparative assessment of intracardiac hemodynamic in selected groups was performed in first 48 hours (1) and the end of third MI week (2). Results. There was a left ventricle (LV) large dilatation in the study group, as in the first hours of MI (end-systolic volume index (ESVI1) 43.5±21.5 and 36.6±20.7 (ml/m2); p=0.001 ), and at the end of the third week of MI (ESVI2 35.6±16.9 and 32.2±18.4 (ml/m2); p=0.03). There was a left atrium (LA) dilatation (I (1): 40.3±5.3; I (2): 40.9±5.2 (mm) and II (1): 40.7±5.1; II (2): 40.4±5.2 (mm); p≥0.05), right ventricle (RV) dilatation in the first hours of MI (28.3±6.7 and 25.2±6.7 (mm); p = 0.01). There was a significant decrease in the LV ejection fraction in the study group compared to the control at both measurement points (1: 42.6±13.4 and 47.8±13.3 (%), respectively; p=0.0004; 2: 54.9±11.5 and 57.2±12.6 (%); p=0.04). When assessing the dynamics over the observation period, an expansion of the LP was noted in the study group (by 1.4%), in contrast to its decrease in the control group (by 0.6%; p˂0.0001). Also revealed: negative dynamics of the ratio of the velocity of late and early LV filling in the study group (decrease by 6.0%) in comparison with the control (increase by 5.8%; p˂0.0001). Conclusions. Thus, in CIPD, we observed more pronounced dilatation of the RV and LV, systolic and diastolic LV dysfunction in the acute and subacute MI periods. This confirms the negative value of CIPD for the prognosis of MI.

The features of erythropoietin secretion in patients with a rheumatic pathology and anemia of the chronic diseases in comparison with patients having iron deficiency anemia, as well as the relationship between erythropoietin, hepcidin, proinflammatory, and antiinflammatory cytokines, have been investigated. 126 patients suffering from the rheumatic pathology were examined, including 34 men aged 3655 years and 92 women aged 3860 years. At the same time, 104 (82.5%) patients suffered from anemia, 22 (17.5%) patients did not have it. Patients suffering from anemia, depending on the leading pathogenetic factor, were divided into three groups such as: the 1st group patients suffering from anemia of chronic diseases; 2nd grouppatients suffering from a combination of anemia of chronic diseases and iron deficiency anemia; 3rd grouppatients suffering from iron deficiency anemia. In patients suffering from anemia of chronic diseases, the maximum concentration of interleukin-6, hepcidin, and the minimum concentration of erythropoietin were detected in comparison with the patients suffering from iron deficiency anemia and patients suffering from anemia of chronic diseases, and iron deficiency anemia (p 0.05). The maximum concentration of the erythropoietin has been established in patients suffering from iron deficiency anemia. About the concentrations of interleukin-10 and interleukin-1, tumor necrosis factor-, interferon-, no differences were found in the study groups. A direct correlation was found between the erythropoietin and erythrocytes (r = 0.57), hemoglobin (r = 0.41), hepcidin (r = 0.65). There was a strong negative correlation between the erythropoietin and interleukin-6 (r = 0.75), and a weak relationship with interferon gamma, tumor necrosis factor alpha, interleukin-10, and interleukin-1 (r 0.3). Thus, for patients with a rheumatic profile, a specific molecular profile should be identified, leading to the development of anemia of the chronic diseases, which consists in increased concentrations of hepcidin and interleukin-6 in combination with the insufficient secretion of erythropoietin. The found changes fit into the structure of the previously proposed working version of the classification of anemia of chronic diseases (with a predominant iron deficiency, with disturbances in the regulatory mechanisms of the erythropoiesis, with an insufficient production of erythropoietin). Isolation of the leading factor in the development of anemia of chronic diseases in the future will allow for a more optimal approach to its correction, including with the targeted therapy drugs.

Relevance. The pulmonary hypertension (PH) and heart failure (HF) development during myocardial infarction (MI) in men with recurrent ischemic events (RIE) has not been adequately studied. Aim. To evaluate changes in pulmonary circulation parameters (PCP) in men under 60 years old (y.o.) in acute and subacute MI periods with RIS to improve understanding of PH and HF developmental options and to search for possible ways to improve prevention. Material and methods. The study included men aged 19-60 years old with type I of MI. Patients are divided into two age-comparable groups: I - the study group, with RIS - 110 patients; II - control, without it - 555 patients. A comparative assessment of PCP in the first 48 hours and the end of the subacute period of MI in these groups was performed. Results. In the first hours of MI the higher values of total pulmonary resistance (TPR) and mean pulmonary artery pressure (MPAP) were noted in the study group. When considering their dynamics at the end of the third MI week the MPAP decreased in both groups (I: by 8.7%; p˂0.0001; II: by 15.0%; p˂0.0001). TPR decreased in both groups (I: by 30.6%; II: by 29.6%; p˂0.0001) too. The heart rate - I: by 6.2%; p=0.03; II: 8.4%; p˂0.0001). At the end of the third MI week, MPAP remained elevated in the study group (I: 30.6 ± 12.7; II: 27.2 ± 7.7; p = 0.03).