Neuro-humoral mediators in progression of coronary artery disease with concomitant obesity (review)

Abstract

Cardiovascular diseases are the main cause of death worldwide. Priority in the structure of the cardiovascular diseases belongs to coronary artery disease (CAD) and especially to its acute form - acute myocardial infarction. AMI largely determines mortality, economic losses in most countries of the world. Modern epidemiological studies have shown the relationship between obesity and cardiovascular diseases, as well as between obesity and individual cardiovascular risk factors such as hypertension and hyperlipidemia. Cardiac troponin is a biomarker of choice for the diagnosis of acute myocardial infarction. However, after reperfusion therapy the actual level of Tn may be misleading due to the phenomenon of washout and the 12-hour expectation of peak levels remains the Achilles heel of this biomarker. Activation of neurohumoral systems in the acute period of the myocardial infarction promotes the expansion of the necrosis zone, the development of myocardial ischemia, bnormal heart rhythm and acute heart failure. Despite the large number of detected and studied neurohormones, our knowledge of the role of these peptides in the development of myocardial infarction and its complications is very limited. That is why studying of new biomarkers, such as copeptin and midregional proadrenomedullin, is perspective and interesting for scientist all over the world.