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Cytomegalovirus Infection and Endothelial Function in Patients With Acute Myocardial Infarction

Lebedeva A. M.1, Mariukhnich E. V.1, Grievel Zh.‑Sh.2, Nikitskaya E. A.1, Albakova T. M.1, Albakova R. M.1, Ryzhkova E. V.1, Shpektor A. V.1, Margolis L. B.2, Vasilieva E. Yu.1
1 A. I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
2 Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA

Keywords: acute myocardial infarction; herpes virus; cytomegalovirus; endothelial function

DOI: 10.18087/cardio.2018.7.10155

Purpose: to study elucidate association of active cytomegalovirus (CMV) infection with endothelial dysfunction in patients with acute myocardial infarction (AMI). Materials and Methods. The study included 42 volunteers without ischemic heart disease (IHD) and 63 patients with AMI. Blood samples for analysis of the deoxyribonucleic acid (DNA) of CMV in plasma by real-time polymerase chain reaction were taken in patients – before coronary angiography, in volunteers – at admission. In addition, in patients with AMI and volunteers without IHD, endothelial function was analyzed using endothelium-dependent vasodilatation (EDVD) test of the brachial artery. Results. We showed that in patients with AMI, the concentration of CMV DNA in plasma was statistically significantly increased when compared with that in volunteers without IHD, which reflects active CMV infection – 1185.7 (0; 3003.0) vs. 0 (0; 910.8) copies of DNA / ml plasma (p=0.011). In comparison with volunteers without IHD, patients with AMI also more often had endothelial dysfunction – 11.5 (7.5, 15.2) % vs. 4.4 (0; 9.6) % of cases (p<0.0001), what significantly correlated with activity of CMV production (R= –0.35, p=0.002). Discussion. In patients with AMI, in addition to disturbance of endothelial function in the acute phase of the disease, increased production of cytomegalovirus DNA was also detected. In this study, for the first time found a negative correlation between the activity of cytomegalovirus infection and endothelium-dependent vasodilation, not only in healthy volunteers, but also in patients with AMI. The relationship between CMV activation and endothelial dysfunction can explain the role of cytomegalovirus in the development of complications of atherosclerosis due to the activation and damage of endothelial cells infected by it. Conclusions. In this study, we confirmed the presence of endothelial dysfunction and active CMV infection in patients with AMI. We found a negative correlation between the activity of CMV infection and EDVD in volunteers without IHD and patients with AMI.
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Lebedeva A. M., Mariukhnich E. V., Grievel Zh.‑Sh., Nikitskaya E. A., Albakova T. M., Albakova R. M., Ryzhkova E. V., Shpektor A. V., Margolis L. B., Vasilieva E. Yu. Cytomegalovirus Infection and Endothelial Function in Patients With Acute Myocardial Infarction. Kardiologiia. 2018;58(7):41–52.

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