cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLCcardiovascular-1294Research ArticleОСТРЫЙ КОРОНАРНЫЙ СИНДРОМACUTE CORONARY SYNDROMEОбострение хронической бактериально-вирусной инфекции как возможный фактор риска развития острого коронарного синдрома у больных коронарной болезнью сердцаChronic bacterial and viral infection exacerbation as a possible risk factor for acute coronary syndrome development in coronary heart disease patientsКванталианиТ. Г.KvantalianiT. G.ЧумбуридзеВ. Б.ChumburidzeV. B.ЦиклауриП. А.TsiklauriP. A.Институт кардиологии им. акад. М.Д. Цинамдзгвришвили; Общество кардиологов Грузии. ТбилисиAcademician M.D. Tsinamdzgvirishvili Institute of Cardiology; Georgean Society of Cardiology. Tbilisi200620102006553640Copyright © Кванталиани Т.Г., Чумбуридзе В.Б., Циклаури П.А., 20062006Кванталиани Т.Г., Чумбуридзе В.Б., Циклаури П.А.Kvantaliani T.G., Chumburidze V.B., Tsiklauri P.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/1294

Цель. Выявить новые, нетрадиционные риск и преципитирующие факторы, которые на фоне хронического комбинированного хламидийно-вирусного инфицирования могут способствовать нарушению стабильности течения коронарного атеросклероза и развитию острых коронарных кризов. Материал и методы. Обследованы 66 больных коронарной болезнью сердца (КБС), как со стабильной стенокардией напряжения, так и острым коронарным синдромом (ОКС), серопозитивных к специфическим антителам Chl.pn и вирусам HSV-I, CMV и EBV, а также 20 серонегативных больных КБС (контрольная группа). Серологический статус больных определялся иммуноферментным методом ELISA. Результаты. Выделена триада плазменных маркеров: С-реактивный белок (СРБ), МВ фракция креатинкиназы и активность липидного гидропероксида, которые одновременно с высокоинформативными показателями серологического статуса больных могут быть использованы в качестве добавочных диагностических тестов ОКС. Заключение. Выдвинуто предположение о роли рекуррентной инфекции в качестве одного из триггеров трансформации хронической КБС в ее острую или нестабильную формы.

Aim. To identify new, non-traditional risk and precipitating factors, that, combined with chronic chlamydial and viral infection, could provoke coronary atherosclerosis destabilization and acute coronary crise development. Material and methods. In total, 66 coronary heart disease (CHD) patients were examined, who had stable effort angina or acute coronary syndrome (ACS), and were sero-positive for Chl. Pneumoniae, HSV-I, CMV and EBV viruses. Control group included 20 sero-negative CHD patients. Serological status was determined by ELISA immuno-enzyme method. Results. Triad of plasma markers: C-reactive protein (CRP), МВ-creatine kinase, and lipid hydroperoxide activity – was identified, that can be used, together with serological status data, for more effective ACS diagnostics. Conclusion. Recurrent infection might play a role as one of the triggers for chronic CHD transformation into its acute or instable forms.

острый коронарный синдромспецифические иммуноглобулинылипидный гидропероксидхроническая хламидийно-герпесвирусная инфекцияAcute coronary syndromespecific immunoglobulinslipid hydroperoxidechronic chamydial and herpetic infectionReferencesLi HL, Suzuki J, Bayna E, et al. Lipopolysaccharide induces appoptosis in adult rat vertricular myocytes via cardiac AT(1) receptores. Am J Physiol Heart Circ Phisiol 2002; 283(2): H461-7.Li HL, Suzuki J, Bayna E, et al. Lipopolysaccharide induces appoptosis in adult rat vertricular myocytes via cardiac AT(1) receptores. Am J Physiol Heart Circ Phisiol 2002; 283(2): H461-7.Бобин А.Н., Пархоменко Ю.Г., Патология системы кровообращентя у больных брюшным тифом. Эпидем инфекц бол 2005; 4: 31-4.Бобин А.Н., Пархоменко Ю.Г., Патология системы кровообращентя у больных брюшным тифом. Эпидем инфекц бол 2005; 4: 31-4.Zhu J, Quyyumi AA, Norman JE, et al. Cytomegalovirus in the pathogenesis of atherosclerosis: the role of inflammation as reflected by elevated C-reactive protein levels. JACC 1999; 34: 1738-43.Zhu J, Quyyumi AA, Norman JE, et al. Cytomegalovirus in the pathogenesis of atherosclerosis: the role of inflammation as reflected by elevated C-reactive protein levels. JACC 1999; 34: 1738-43.Danesh J, Wheeler JG, Hirschfield GM, et al. C-reactice protein and other circulating markers of inflammation in the prediction of coronary heart disease. 2004; 350(14): 1387-97.Danesh J, Wheeler JG, Hirschfield GM, et al. C-reactice protein and other circulating markers of inflammation in the prediction of coronary heart disease. 2004; 350(14): 1387-97.Bendit EP, Barrett T, McDougall JK. Viruses in the etiology of atherosclerosis. Proc Natl Acad Sci USA 1983; 80: 6386-9.Bendit EP, Barrett T, McDougall JK. Viruses in the etiology of atherosclerosis. Proc Natl Acad Sci USA 1983; 80: 6386-9.Mayr M, Metzler B, Kiechl S, et al. Endotelial cytotoxicity mediated by serum antibodies to heat shock proteins of Escherichia coli and Chlamydia pneumoniae: immune reactions to heat shock proteins as a possible link between infection and atherosclerosis. Circulation 1999; 99: 1560-6.Mayr M, Metzler B, Kiechl S, et al. Endotelial cytotoxicity mediated by serum antibodies to heat shock proteins of Escherichia coli and Chlamydia pneumoniae: immune reactions to heat shock proteins as a possible link between infection and atherosclerosis. Circulation 1999; 99: 1560-6.Kipshidze N, Kakauridze N. Helicobacter pylory infection and “Agressive Atherosclerosis”. Georgian Medical News 2003; 12(105): 13-6.Kipshidze N, Kakauridze N. Helicobacter pylory infection and “Agressive Atherosclerosis”. Georgian Medical News 2003; 12(105): 13-6.Bertrand ME, Simoons ML, Fox KA, et al. Management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J 2002; 23(23): 1809-40.Bertrand ME, Simoons ML, Fox KA, et al. Management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J 2002; 23(23): 1809-40.Lipid Hydroperoxide (LPO) Colorimetric Assay for the quantitative determination of Lipid Hydroperoxide. IBL Immuno-Biological Laboratories. Hamburg 2000; 3: 1-9.Lipid Hydroperoxide (LPO) Colorimetric Assay for the quantitative determination of Lipid Hydroperoxide. IBL Immuno-Biological Laboratories. Hamburg 2000; 3: 1-9.Porter NA, Mills KA, Coldwell SE. Mechanisms of free radical oxidation of unsaturated lipids. Lipids 1995; 30: 277-90.Porter NA, Mills KA, Coldwell SE. Mechanisms of free radical oxidation of unsaturated lipids. Lipids 1995; 30: 277-90.Akhvlediani NV, Emukhvari MG, Sharabidze NA. Diagnostic value of determination of C-reactive protein and different class lipids in patients with hypercholesterolemia. Georgian Med News 2002; 7-8: 45-7.Akhvlediani NV, Emukhvari MG, Sharabidze NA. Diagnostic value of determination of C-reactive protein and different class lipids in patients with hypercholesterolemia. Georgian Med News 2002; 7-8: 45-7.Шахнович Р.М., Басинкевич Ф.Б. Маркеры воспаления и ОКС. Кардиология СНГ 2005; 3: 56-71.Шахнович Р.М., Басинкевич Ф.Б. Маркеры воспаления и ОКС. Кардиология СНГ 2005; 3: 56-71.Biasucci LM, Liuzzo G, Angiolilo DG, Masseri A. Inflammation and acute coronary syndromes. Herz 2000; 108-12.Biasucci LM, Liuzzo G, Angiolilo DG, Masseri A. Inflammation and acute coronary syndromes. Herz 2000; 108-12.Rifai N, Ridker PM. A proposed cardiovascular risk assessment algorithm employing high-sensitivity C-reactive protein and lipid screening. Clin Chem 2001; 47: 28-30.Rifai N, Ridker PM. A proposed cardiovascular risk assessment algorithm employing high-sensitivity C-reactive protein and lipid screening. Clin Chem 2001; 47: 28-30.Ishii J, Wang J, Naruse H, et al. Serum concentration of myoglobin vs human heart-type cytoplasmic fatty acid-binding protein in early detection of acute myocardial infarction. Clin Chem 1997; 43(8): 1372-8.Ishii J, Wang J, Naruse H, et al. Serum concentration of myoglobin vs human heart-type cytoplasmic fatty acid-binding protein in early detection of acute myocardial infarction. Clin Chem 1997; 43(8): 1372-8.

The authors declare that there are no conflicts of interest present.