[Correlations between electrophysiological myocardial remodeling and parameters of free radical oxidation in patients with various forms of ischemic heart disease].
OBJECTIVE
To investigate potentialities of a novel biochemical test assessing oxidative resistance of plasma as a marker of ischemic damage to the myocardium and to study this marker correlation with high-performance ECG parameters reflecting electrophysiological remodeling of the myocardium in patients with ischemic heart disease (IHD).


METHODS
A total of 145 IHD patients entered the trial: 32 patients free of effort angina, 67patients with stable effort angina of functional class (FC) II-III, 56 patients with acute coronary syndrome (ACS) and 32 healthy controls. ACS patients were examined according to the following protocol: stage 1--6-12 hours since the disease onset, stage 2--at the end of the first 24 hours, stage 3--day 5-7 of the disease. In ACS patients the following outcomes (end points) were evaluated: recurrent myocardial infarction (MI), hospitalization because of exacerbation of IHD, documented potentially harmful arrhythmias and death within 1 year. High-performance ECG and a novel biochemical test of plasma oxidizability were used. The latter was determined by accumulation of malonic dialdehyde after 24 hours of incubation with 20 mcM of copper sulphate.


RESULTS
A correlation was found between activity offree radical processes and electrophysiological remodeling of the myocardium by high-performance ECG. Amplitude and temporal characteristics of QRS complex and P wave can be used for follow-up of progression and severity of IHD in addition to standard electrocardiography.


CONCLUSIONS
Unidirectional changes of high-performance ECG, plasma oxidizability and severity of IHD course allow using them as novel diagnostic tests of ischemic lesion and electrophysiological remodeling of the myocardium, for estimation of IHD severity.
Drinitsina
S V
SV
Azizova
O A
OA
Piriazev
A P
AP
Korinevich
A Iu
AIu
Solov'eva
N P
NP
Ivanov
G G
GG
Lopukhin
Iu M
IuM
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory; D004562:Electrocardiography; D004594:Electrophysiology; D005260:Female; D005609:Free Radicals / Q000097:blood*; D006801:Humans; D008054:Lipid Peroxides / Q000097:blood; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood / Q000378:metabolism / Q000503:physiopathology; D010084:Oxidation-Reduction; D012720:Severity of Illness Index; D020257:Ventricular Remodeling / Q000502:physiology*
D005609:Free Radicals; D008054:Lipid Peroxides