The work is devoted to the study of atrial natriuretic peptide (ANP) and its precursors as one of possible predictors of left ventricular repeated remodeling in patients with ischemic cardiomyopathy (ICMP) in the follow-up (postoperative period). Objects of the study are venous blood and intraoperative samples of right atrial auricle. Precursors of NUP were identified in blood serum by the immuno-fluorescence test. Ultrathin slices of auricle biopsy samples were examined with electronmicroscopy with the use of image processing ImageJ software (program). The concentration of NUP precursors in blood plasma and relation of minimal diameter of secretory granules to maximal one in right auricle cardiomyocytes reflect pathological processes taking place in the myocardium of patients with ICMP. Ratio of minimal and maximal diameters of secretory granules is a predictor of chronic heart failure progressing.

Functional morphology of LV myocardium and RA appendage in 48 patients with ICMP was studied based on intraoperative biopsies analysis. In the early postoperative period (1 year) all the patients were divided into 2 groups. Group one was comprised of the patients with positive dynamics of EDI and LV EF, group two with negative ones. Retrospective analysis of echocardiographical values did not let to reveal predictors of postoperative remodeling of heart in both patients groups. On the contrary, drawing clinical-morphological parallels of negative dynamics in the early postoperative period showed that the presence of diffuse lymphocytic- macrophage inflammatory infiltration of myocardial stroma in combination with pronounced fibrosis, low values of trophic index (TI) (<0,015) and specific volume (SV) of atrial natriuretic peptide granules in atrial cardiomyocytes as well as high values of pericappilar diffusion zone (PDZ) (>1000 mcm) and Kernogan index (KI) (>1,6) of LV myocardium are morphological predictors of postoperative heart remodeling.

The objective of this study is a morphological evaluation of compatibility of ventricular myocardium with the device of our original construction for restriction of heart chambers dilatation. In the experiment the device made from titanium nickelide was implanted into 8 outbred dogs with the previously induced experimental model of left ventricular aneurism. The animals were excluded from the experiment in 1, 3 and 6 months after implantation of an external restrictive elastic sac. Histological preparations of myocardium samples, which were in an immediate contact with titanium nickelide fibers were the subjects for studying of general tissue response to the presence of an implanted device. No data evidencing negative effect of an external restrictive elastic titanium nickelide sac on ventricular myocardium have been found. It means that an implanted sac has a satisfactory compatibility with biological tissues just as like as any other implant made from titanium nickelide.

The concentration of matrix metalloproteinase (ММР-1, 3, 9), tissue inhibitor ММР-1 (TIMP-1), atrial (proANP) and brain NT-(proВNP) natriuretic peptide have been studied by the method of enzymelinked immunosorbent assay in blood serum and plasma in 53 patients with ischemic cardiomyopathy and in 17 healthy volunteers. The groups were of the comparable age. In 37 patients from the group with ischemic cardiomyopathy there was performed identification of circulating antibodies to myocardium in blood serum by the method based on the reaction of indirect immune fluorescence. In one year after surgical treatment 27 patients (50,9%) were examined, in 6 of them there was noticed negative dynamics of the late postoperative period. Statistical analysis of the obtained data showed that concentration of ММР-3 and ММР-9 in blood serum of the patients with postoperative remodeling was significantly higher than that in patients with favourable late postoperative period (p=0,03); this fact allows ММР-3 and ММР-9 identification as molecular markers of postoperative remodeling of left ventricle.

Morphofunctional condition and features of ultrastructural organization of right atrium auricle and left ventricular myocardial cardiomyocytes were studied in 40 patients with ischemic cardiomyopathy and chronic heart failure. Results of electron-microscopic study of patients myocardium were compared with clinical results of their operative treatment for the first time. New data about pathogenous mechanisms of repeated left ventricular remodeling at ultrastructural level were obtained. Presence of plastic insufficiency of cardiomyocytes of both left ventricle and right atrium auricle was shown to play key role in heart failure advancing in late postoperative period.

The objective of the given study was to assess statistic dependence of histomorphometrical values of left ventricle (LV) and right atrium (RA) auricle myocardial condition in normal hearts (17 cases) and in hearts with chronic heart failure (CHF) (21 cases). Statistic dependence between morphometrical parameters in LV, RA auricle as well as between these heart parts in both patients without cardiovascular pathology and in patients with CHF was found. In the latter group the amount of correlations decreases in left ventricle and increases between the parts (LV and RA) in comparison with the norm.

Some cases of nanobacteria detection using ultrastructural examination of left ventricular myocardium in patients having acquired valvular disease of both rheumatic and infectious nature are described.

Morphofunctional state of left ventricle (LV) myocardium and right atrial (RA) auricle at 31 ischemic cardiomyopathy patients with chronic cardiac decompensation has been investigated in details. Histological preparations colored with hematoxylin and eosin and by Mallory method have been studied with usual light and polarization microscopy. The correlation of morphofunctional state of ventricle myocardium and atrium has been found, the factors of unfavorable farther results of operational treatment of this patient category have been revealed: presence of morphological myocarditis picture and marked LV myocardium fibrosis were pathomorphological predictors of LV dilatation in late postoperative period.