cardioКардиологияKardiologiia0022-90402412-5660Kardiomag10.18087/cardio.2018.7.10155cardio-161Research ArticleОСТРЫЙ КОРОНАРНЫЙ СИНДРОМACUTE CORONARY SYNDROMEЦитомегаловирусная инфекция и функция эндотелия у пациентов с острым инфарктом миокардаCytomegalovirus Infection and Endothelial Function in Patients With Acute Myocardial InfarctionЛебедеваА. М.LebedevaAnna M.asya.lebedev@mail.ruМарюхничЕ. В.MariukhnichE. V.noemail@neicon.ruГривельЖ. -Ш.GrievelZh. -Sh.noemail@neicon.ruНикитскаяЕ. А.NikitskayaE. A.noemail@neicon.ruАлбаковаТ. М.AlbakovaT. M.noemail@neicon.ruАлбаковаР. М.AlbakovaR. M.noemail@neicon.ruРыжковаЕ. В.RyzhkovaE. V.noemail@neicon.ruШпекторА. В.ShpektorA. V.noemail@neicon.ruМарголисЛ. Б.MargolisL. B.noemail@neicon.ruВасильеваЕ. Ю.VasilievaE. Yu.noemail@neicon.ruФГБОУ ВО «Московский государственный медико-стоматологический университет им. А. И. Евдокимова» Минздрава РоссииРоссияA. I. Yevdokimov Moscow State University of Medicine and DentistryRussian FederationНациональный Институт Детского Здоровья и Развития Человека им. Юнис Кеннеди Шрайвер Национальных Институтов ЗдоровьяРоссияEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of HealthRussian Federation2018181120185874152Copyright © Kardiomag, 20182018KardiomagKardiomaghttps://cardio.elpub.ru/jour/about/submissions#copyrightNoticehttps://cardio.elpub.ru/jour/article/view/161

Цель исследования. Изучение связи активной цитомегаловирусной (ЦМВ) инфекции с дисфункцией эндотелия у пациентов с острым инфарктом миокарда (ОИМ). Материалы и методы. В исследование вошли 42 добровольца без ишемической болезни сердца (ИБС) и 63 пациента с ОИМ. У пациентов до коронарографии и у добровольцев при поступлении брали образцы крови для анализа дезоксирибонуклеиновой кислоты (ДНК) ЦМВ в плазме методом полимеразной цепной реакции в реальном времени. Кроме того, у пациентов с ОИМ и добровольцев без ИБС анализировали функцию эндотелия с помощью теста эндотелийзависимой вазодилатации (ЭЗВД) плечевой артерии. Результаты. Мы показали, что у пациентов с ОИМ при поступлении статистически значимо повышена концентрация ДНК ЦМВ в плазме крови по сравнению с таковой у добровольцев без ИБС, что отражает активную ЦМВ-инфекцию - 1185,7 (0; 3003,0) против 0 (0;910,8) копий ДНК/мл плазмы (p=0,011). При этом по сравнению с добровольцами без ИБС у пациентов с ОИМ также выявлена дисфункция эндотелия - 11,5 (7,5; 15,2) % против 4,4 (0; 9,6) % случаев (p<0,0001), которая достоверно коррелировала с активностью продукции ЦМВ (R= -0,35; p=0,002). Обсуждение. У пациентов с ОИМ помимо нарушения функции эндотелия в острую фазу заболевания также выявляется повышенная продукция цитомегаловирусной ДНК. В настоящей работе мы впервые выявили отрицательную корреляцию между активностью цитомегаловирусной инфекции и эндотелийзависимой вазодилатацией не только у здоровых добровольцев, но и у пациентов с ОИМ. Выявленная нами взаимосвязь между активацией ЦМВ и нарушением функции эндотелия может объяснять роль цитомегаловируса в развитии осложнений атеросклероза за счет активации и повреждения инфицированных им клеток эндотелия. Выводы. В настоящей работе мы подтвердили наличие дисфункции эндотелия и активной ЦМВ-инфекции у пациентов с ОИМ. Мы выявили отрицательную корреляцию между активностью ЦМВ-инфекции и ЭЗВД у добровольцев без ИБС и пациентов с ОИМ.

Purpose: to study elucidate association of active cytomegalovirus (CMV) infection with endothelial dysfunction in patients with acute myocardial infarction (AMI). Materials and Methods. The study included 42 volunteers without ischemic heart disease (IHD) and 63 patients with AMI. Blood samples for analysis of the deoxyribonucleic acid (DNA) of CMV in plasma by real-time polymerase chain reaction were taken in patients - before coronary angiography, in volunteers - at admission. In addition, in patients with AMI and volunteers without IHD, endothelial function was analyzed using endothelium-dependent vasodilatation (EDVD) test of the brachial artery. Results. We showed that in patients with AMI, the concentration of CMV DNA in plasma was statistically significantly increased when compared with that in volunteers without IHD, which reflects active CMV infection - 1185.7 (0; 3003.0) vs. 0 (0; 910.8) copies of DNA/ml plasma (p=0.011). In comparison with volunteers without IHD, patients with AMI also more often had endothelial dysfunction - 11.5 (7.5, 15.2) % vs. 4.4 (0; 9.6) % of cases (p<0.0001), what significantly correlated with activity of CMV production (R= -0.35, p=0.002). Discussion. In patients with AMI, in addition to disturbance of endothelial function in the acute phase of the disease, increased production of cytomegalovirus DNA was also detected. In this study, for the first time found a negative correlation between the activity of cytomegalovirus infection and endothelium-dependent vasodilation, not only in healthy volunteers, but also in patients with AMI. The relationship between CMV activation and endothelial dysfunction can explain the role of cytomegalovirus in the development of complications of atherosclerosis due to the activation and damage of endothelial cells infected by it. Conclusions. In this study, we confirmed the presence of endothelial dysfunction and active CMV infection in patients with AMI. We found a negative correlation between the activity of CMV infection and EDVD in volunteers without IHD and patients with AMI.

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