V.K. Tashchuk, T.M. Amelina, O.S. Polianska, N.A. Turubarova-Leunova.The effect of endothelial dysfunction on the key pathogenetic mechanisms of the progression of coronary artery disease combined with chronic obstructive pulmonary disease.

The level of endothelin-1 in blood plasma, the activity of free radical processes and antioxidant defense, proteolysis and fibrinolysis have been determined in 113 patients with stable angina of II–III functional classes. It has been shown that the course of the ischemic heart disease with concomitant chronic obstructive pulmonary disease is characterized by enhancement of free radical lipid peroxydation processes with elevation of malonic aldehyde by 10.1 % (Р<0.05), diminished functioning of the antioxidant defense system, reflected by decreased activity of catalase by 11.4 % (Р<0.05) and increased level of ceruloplasmin by 14.5 % (Р<0.05). Significant decrease of the lysis of low molecular proteins and blood plasma collagenolytic activity, correlating with manifestations of the endothelial dysfunction (r=–0.62; Р<0.05) and (r=–0.56; Р<0.05) respectively, may potentiate remodeling of the vascular wall. Significant elevation of the level of endothelin-1 by 18.8 % has been established as well, proving the key role of the endothelial dysfunction in the progression of cardiovascular and pulmonary pathology.

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