MYOCARDIAL STRESS AND INFLAMMATORY RESPONSE IN THE FORMATION OF POST-INFARCTION MYOCARDIAL REMODELING

The aim of the study is to evaluate the role of myocardial stress and inflammatory response in the formation of post-infarction myocardial remodeling based on a review of modern scientific literature and our own data on the investigation of serum concentrations of the amino-terminal fragment of the brain natriuretic peptide precursor and highly sensitive C-reactive protein in post-infarction patients. Material and methods. Based on a study of the literature in the databases Scopus, PubMed, Lancet, CyberLeninka, key mechanisms of the formation and biomarkers of myocardial stress and inflammatory response are considered. Our own study included 63 patients (34 women and 29 men) with anterior localization of myocardial infarction. On 1st, 3d, 7th–10th, 30th day from the onset of the disease development, patients underwent serial measurement of serum concentrations of enzymes and C-reactive protein, taking into account reference values, as well as on days 1 and 30 myocardial parameters during echocardiography. Depending on the magnitude of the increase in the end-systolic volume index, two groups are distinguished: 31 patients (1) with a volume increase of less than 20% and 32 patients (2) with an increase in the volume of 20% or more from the initial ones. Statistical analysis of the data was carried out by the method of parametric statistics. Results. Elevated levels of the amino-terminal fragment of the brain natriuretic peptide precursor and highly sensitive C-reactive protein are closely associated with the severity of myocardial remodeling both in the acute phase of myocardial infarction and in the post-infarction period and can be used to predict the development of chronic heart failure.

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