INFLUENCE OF ABDOMINAL OBESITY ON ENDOTHELIAL DYSFUNCTION AND CORONARY ATHEROSCLEROSIS IN PATIENTS AFTER MYOCARDIAL INFARCTION

The aim of this study was to estimate the influence of secretory activity of adipose tissue on the functional capacity of the endothelium and the characteristics of atherosclerotic coronary artery changes in patients after myocardial infarction (MI) and abdominal obesity (AO). Methods: multislice computed tomography with contrast coronary arteries (CT-angiography); laboratory research of endothelin-1, nitric oxide (NO), leptin and adiponectin was carried out in 80 patients after MI. Results: the proportion of persons with the development of 2-3 hemodynamically significant stenosis among the patients with AO was significantly higher than among those without AO: 69.4% (n=25) against 20.0% (n=5) (χ2=14.4; p<0.001). Medium strength correlation between significant coronary lesions and the leptin was established (r=0.33; p<0.05) in patients with AO. A correlation between CT-angiography characteristics and laboratory parameters of endothelial function was detected: straight, medium-strength connection between the severity of coronary artery disease and increased endothelin-1 (r=0.39; p<0.01) and the value of the index of endothelial dysfunction «endothelin-1/NO» (r=0.59; p<0.001); inverse, medium-strength relationship between the scale of ischemic damage and the level of NO (r=-0.59; p<0.001). Conclusions: in patients with abdominal obesity myocardial infarction occurs on the background of the secretory endothelial dysfunction manifested by prognostically negative increase in endothelin-1, reduced protective effect of nitric oxide, disorders of the functional balance of endothelin-1/NO and associated with multivessel hemodynamically significant atherosclerotic stenosis of the coronary arteries and a high risk of cardio-vascular events.