[THE LEVEL OF PROTECTION FROM OXIDATIVE STRESS AND THREE-YEAR DYNAMICS OF STRUCTURAL AND FUNCTIONAL CHANGES OF THE MYOCARDIUM IN CHRONIC ISCHEMIC HEART DISEASE IN MEN].

Aim - to assess the nature and three-year dynamics of structural and functional changes in the cardiovascular system in relation to the levels of enzymatic and non-enzymatic antioxidants in chronic coronary heart disease in men. The study included 246 men aged 48 to 65 years (mean age 58 years (53,0; 63,0)) with stable form of ischemic heart disease - angina FC II-III CHF I-III FC (NYHA), observed during 2012-2015. To assess the level of oxidative stress in all patients by ELISA was determined by lipid peroxide, total antioxidant status (CCA) and levels of non-enzymatic antioxidant bilirubin (BR). Patients were divided into 2 groups according to the level of serum BR: the main group - 146 patients with the level of BR< 8.0 µmol/l; the control group-100 patients with the level of BR ≥8.0 µmol/l. Assessment of the structural and functional state of the myocardium included ECG, XM ECG, EchoCG, VEM test. A decrease in the level of protection against oxidative stress (OS) in men with stable CHD in the form of a significant increase in the level of lipid peroxides and a decrease in the OAS index was found. In the study group OxyStat, total cholesterol and LDL cholesterol were significantly higher (p<0.01)., and ImAnOx - significantly lower than in the control group (p<0.01). A high degree of direct relationship between the level of blood BR and the indicator of AOC is established. Three-year dynamic observation showed a close relationship between the processes of cardiovascular system remodeling and OS components. The high level of OS in men with stable ischemic heart disease is accompanied by adverse changes in the geometry of the left ventricle (eccentric non-dilatated hypertrophy, an increase in the number of segments with hypokinesis), which leads to the progression of chronic heart failure with the risk of ischemic and arrhythmic reactions to physical activity.