| Abstract | Cilj istraživanja: Svrha ovih istraživanja bila je utvrditi povezanost između kompleksnosti
koronarne arterijske bolesti i proupalnih čimbenika u obliku antikardiolipinskih protutijela, kao
i utvrditi povezanost između globalne sistoličke funkcije lijeve klijetke i parametara
mitohondrijske respiracije.
Materijali i metode: Provedena su opservacijska, presječna, klinička znanstvena istraživanja.
Obuhvaćeno je ukupno 65 odraslih bolesnika koji su podvrgnuti invazivnoj koronarografiji
zbog sumnje na koronarnu arterijsku bolest (prvo istraživanje) i 40 odraslih bolesnika koji su
podvrgnuti elektivnoj kardiokirurškoj revaskularizaciji miokarda zbog značajne koronarne
arterijske bolesti (drugo istraživanje). Svi ispitanici podvrgnuti su detaljnoj anamnezi,
fizikalnom pregledu i ehokardiografskim mjerenjima. Ispitanici iz drugog istraživanja su
interaoperacijski podvrgnuti biopsiji miokarda, te naknadnim eksperimentalnim procjenama
mitohondrijske funkcije u tkivu miokarda.
Rezultati: Utvrđena je neovisna statistički značajna pozitivna korelacija kompleksnosti
koronarne arterijske bolesti i antikardiolipinskog protutijela aCL-IgG (β 5,58, P=0,005), dok
nije bilo neovisne povezanosti između kompleksnosti koronarne arterijske bolesti i ostalih
odabranih varijabli (aCL-IgG, leptin, C3, C4) nakon prilagodbe za dob, indeks tjelesne mase i
koncentracije glukoze i kolesterola u krvi. Nadalje, utvrđena je statistički značajna pozitivna
korelacija između maksimalne mitohondrijske respiracije u tkivu miokarda i ejekcijske frakcije
lijeve klijetke (r=0,37, P=0,020), što je potvrđeno nakon prilagodbe za zbunjujuće varijable (β
0,11, P=0,030). Slično tome, utvrđena je statistički značajna pozitivna korelacija između
ejekcijske frakcije lijeve klijetke i izražaja glavnih enzima oksidacije masnih kiselina. S druge
strane, nije utvrđena značajna povezanost između srčane sistoličke funkcije i indikatora
mitohondrijske količine u tkivu, niti razine pojedinih respiratornih komplekasa. Također, nije
nađena značajna korelacija između srčane sistoličke funkcije i mitohondrijskog kapaciteta za
oksidaciju ugljikohidrata.
Zaključci: Razine antikardiolipinskog aCL-IgG protutijela su značajno povezane sa
kompleksnosti koronarne arterijske bolesti u obliku SYNTAX zbroja, dok ista veza ne postoji
s ostale medijatore upale poput antikardiolipinskog protutijela aCL-IgM, komponenti
komplementa C3 i C4, te leptina. Također, kod pacijenata u ranim fazama patološkog
remodeliranja miokarda i blago smanjenom sistoličkom funkcijom, postoji veza između LVEF
i mitohondrijske respiratorne sposobnosti te kapaciteta oksidacije masnih kiselina. |
| Abstract (english) | Objectives: The aim of this study was to determine the relationship between the complexity of
coronary artery disease and pro-inflammatory factors in the form of anticardiolipin antibodies,
as well as to determine the relationship between global left ventricular systolic function and
mitochondrial respiration parameters.
Materials and methods: An observational, cross-sectional, clinical research was conducted. A
total of 65 adult patients who underwent invasive coronary angiography due to suspected
coronary artery disease (first study) and 40 adult patients who underwent elective surgical
myocardial revascularization due to significant coronary artery disease (second study) were
included. All subjects underwent a detailed medical history, physical examination and
echocardiographic measurements. Subjects from the second study underwent intraoperative
myocardial biopsy, which was followed by subsequent experimental assessments of
mitochondrial function in biopsied myocardial tissue.
Results: An independent statistically significant positive correlation of the complexity of
coronary artery disease (SYNTAX score) and anticardiolipin antibody aCL-IgG was
determined (β 5.58, P=0.005), while there was no such association for other selected variables
(aCL-IgG, leptin, C3, C4) after adjusting for age, body mass index, glucose and cholesterol
levels. Furthermore, a statistically significant positive correlation was found between maximal
mitochondrial respiration in myocardial tissue and left ventricular ejection fraction (r=0.37,
P=0.020), which was confirmed after adjustment for confounding variables (β 0.11, P =0.030).
Similarly, a statistically significant positive correlation was found between the left ventricular
ejection fraction and the expression of the main fatty acid oxidation enzymes. On the other
hand, no significant correlation was found between cardiac systolic function and indicators of
mitochondrial quantity in the tissue, nor the level of individual respiratory complexes. Also, no
significant correlation was found between cardiac systolic function and mitochondrial capacity
for carbohydrate oxidation.
Conclusions: Anticardiolipin aCL-IgG antibody levels are significantly related to the
complexity of coronary artery disease in the form of SYNTAX score, while the same
relationship does not exist with other mediators of inflammation such as anticardiolipin
antibody aCL-IgM, complement components C3 and C4, and leptin. Also, in patients in the
early stages of pathological remodeling of the myocardium and slightly reduced systolic function, there is a relationship between LVEF and mitochondrial respiratory ability and fatty
acid oxidation capacity. |
