Objective: to conduct a comparative assessment of the parameters of heart rhythm and conduction in patients with Covid-19 with acute ST-segment elevation myocardial infarction (STEMI) in the hospital ...and post-hospital treatment periods. Materials and methods. The study included 140 patients with STEMI, stratified into 2 groups: I - the main (52 people) patients with STEMI who had COVID-19 for 1.5-6 months before the development of acute coronary syndrome (ACS), II - the comparison group (88 people) with STEMI without COVID-19 in the anamnesis. All patients underwent percutaneous coronary intervention with stenting of a single infarct-related artery in the first 24 hours. Daily ECG monitoring was performed with an assessment of traditional heart rate and conduction parameters for 2-3 days, 9-11 days and after 6 months from the moment of the accident. Results. In the main group, in contrast to the control group, a shortening of the QT interval (7.7% vs. 0.0%), ventricular extrasystole (VES) of Lown grade IV A (25.0% vs. 7.9%) was more often recorded on 2-3 days. Supraventricular extrasystole (SVE; 92.0% vs. 65.4%), sinus arrhythmia (37.5% vs. 0.0%), supraventricular tachycardia (SVT; 7.9% vs. 0.0%) were more often recorded in group II on 2-3 days. During the hospital follow-up period, the retention of shortened QT (7.7% vs. 0.0%), predominance SVE (90.4% vs. 76.1%), sinus arrhythmia (48.1% vs. 29.5%), migration of the rhythm driver along the atria (15.3% vs. 0.0%), VES Lown grade IV A (9.6 % vs. 0.0%). In the control group, AV blockade of 1 deg. (15.9% vs. 3.8%), AV blockade of 2 deg. (4.5% vs. 0.0%), CA blockade (3.4% vs. 0.0%), QT prolongation (12.5% vs. 0.0%) were more often determined. By 6 months after STEMI, patients in the main group were more likely to have SVT (9.6% vs. 0.0%) and VES Lown grade IV A (7.6% vs. 0.0%). In the control group, AV blockade of 1 deg. (9.0% vs. 0.0%), CA blockade (3.4% vs. 0.0%) were registered. Conclusion. Patients with STEMI who had a history of COVID-19 and without COVID-19 had a multidirectional dynamics of heart rate and conduction parameters during the hospital and post-hospital follow-up periods. In patients who underwent COVID-19, there was a predominance of ventricular arrhythmias of high Lown gradations on 2-3 days of STEMI, an increase in supraventricular arrhythmias on days 9-11, an increase in supraventricular and ventricular arrhythmias of high Lown gradations and the absence of CA and AB disorders after 6 months. In the control group, there was a predominance of supraventricular and ventricular arrhythmias of low gradations according to Lown, a predominance of CA and AB conduction disorders on days 9-11 and 6 months after STEMI.
An original representative of the patented by author family of histamine-containing peptidomimetics
l-glutamyl-histamine (
l-Glu-Hist) was synthesized and characterized as a biologically active ...compound with a role of cytokine mimic leading to cellular responses of improved specificity. The study assesses the ability of
l-Glu-Hist to affect molecular modeling, modulate free radical activity and influence immune cell signaling. The energy-minimized 3D conformations of
l-Glu-Hist derived from its chemical structure resulted in stabilization for Fe
2+ chelating complexes.
l-Glu-Hist accelerated the decrease of ferrous iron in the ferrous sulfate solution in a concentration-dependent mode and showed the ferroxidase-like activity at concentrations less than 3
mM in the phenanthroline assay, whereas in the concentration range 3–20
mM
l-Glu-Hist restricted the availability of Fe
2+ to phenanthroline due to binding of ferrous ions in chelating complexes.
l-Glu-Hist showed stimulatory effect on phosphatidylcholine liposomal peroxidation (LPO) catalyzed by the superoxide anion radical (O
2
−
)-generating system (Fe
2+
+
ascorbate) at low (less or about 1
mM)
l-Glu-Hist concentrations and both revealed the inhibitory effect on LPO in this system of high (∼10
mM)
l-Glu-Hist concentration. The stimulation of LPO by
l-Glu-Hist was related to the ability of peptidomimetic in small (∼0.05
mM) concentrations to release O
2
−
free radicals as determined by the superoxide dismutase-inhibitable cytochrome
c reduction assay. O
2
−
release by
l-Glu-Hist might result from its ferroxidase-like activity, while inhibition of LPO by
l-Glu-Hist was caused by its chelating activity to Fe
2+ ions, prevention of free radical generation and lipid hydroperoxide-degrading ability of 5–20
mM
l-Glu-Hist.
l-Glu-Hist released O
2
−
in concentrations which stimulated
3H-thymidine incorporation into DNA and proliferation of mouse spleen lymphocytes and mononuclear cells from human blood.
l-Glu-Hist modulates the ability of oxygen free radicals to act as signaling agents at low concentrations, influencing gene expression. The structural peptide-like analogues of
l-Glu-Hist such as
l-Glu-Trp, carcinine (β-alanylhistamine), but not
l-Pro-Glu-Trp were active in stimulating thymidine incorporation and in inducing proliferation of mononuclear cells as compared to mitogen concanavalin A at doses 2.5–25.0
μg/ml. Our data provide evidence that
l-Glu-Hist may act as a very fast, specific and sensitive trigger for lymphocyte proliferation and immunoregulation. The cited abilities and further obtained in vivo results make Immudilin
® ((INCI: glutamylamidoethyl imidazole, aqueous solution),
l-Glu-Hist) a useful immunoregulatory agent.
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