Leukocyte Telomere Length as a Molecular Biomarker of Coronary Heart Disease

Background. This work is a review of preclinical and clinical studies of the role of telomeres and telomerase in the development and progression of coronary heart disease (CHD). Materials and methods. A search for full-text publications (articles, reviews, meta-analyses, Cochrane reviews, and clinical cases) in English and Russian was carried out in the databases PubMed, Oxford University Press, Scopus, Web of Science, Springer, and E-library electronic library using keywords and their combinations. The search depth is 11 years (2010–2021). Results. The review suggests that the relative leukocyte telomere length (LTL) is associated with the development of socially significant and widespread cardiovascular diseases such as CHD and essential hypertension. At the same time, the interests of researchers are mainly focused on the study of the relative LTL in CHD. Conclusions. Despite the scientific and clinical significance of the analyzed studies of the relative length of human LTL as a biological marker of cardiovascular diseases, their implementation in real clinical practice is difficult due to differences in the design and methodology of the analyzed studies, as well as differences in the samples by gender, age, race, and ethnicity. The authors believe that clinical studies of the role of the relative length of leukocyte telomeres in adult patients with coronary heart disease are the most promising and require large multicenter studies with a unified design and methodology.

Preventive Screening of Young People from the Perspective of Vascular Aging Phenotypes: the Role of Body Weight

Aim. To study the cardiovascular stiffness index CAVI in relation to main risk factors (RF) in young people from the point of their vascular aging phenotype and gender.

Material and methods. 264 young people (93 boys and 171 girls) at age of 18 to 25 years were examined. Vascular screening was performed with evaluating of CAVI. All subjects were divided into tertile groups for this indicator, taking into account gender. Such interval analysis of gender- and age- homogeneous sample allows to identify carriers of the phenotypes of premature (upper CAVI-tercile), normal (middle CAVI-tercile), and favorable or healthy (low CAVI-tercile) vascular aging. The first of them is also called EVA (early vascular aging) syndrome. In these groups, the incidence of carriers of insufficient, normal body mass (BM) and overweight were estimated. In three groups formed by BM indicator, the parameters of CAVI, hemodynamic and metabolic status in response to changes in BM were determined.

Results. Among of the presented RF, the correlation was significant for CAVI with a weight -0.428 (p<0.001) for R-CAVI, -0.453 (p<0.001) for L- CAVI, and even more significant with the BM index - at the level of -0.410 (p<0.001) for R-CAVI and -0.462 (p<0.001) for L-CAVI. This connection is found in boys. Among boys and girls with excessive BM, the most favorable vascular aging phenotype is observed 2.7 and 2.2 times more often than the EVA syndrome. In contrast, among girls with insufficient BM, a favorable vascular phenotype is detected almost twice rarely as compared with EVA syndrome. In similar group of boys, a healthy vascular phenotype is not observed at all. Among normal-weight boys and girls, the occurrence of the two extreme vascular phenotypes is almost identical. The arterial rigidity decrease on the background of BM increase occurs despite the сhanges of hemo- dynamic and metabolic indicators. This changes are especially pronounced in girls. The difference between the extreme weight categories in terms of R- CAVI and L-CAVI for boys was 1.4, while for girls it was only 0.3 for R-CAVI and 0.4 for L-CAVI.

Conclusion. When carrying out preventive measures among young people, one should not limit oneself to evaluating only traditional RF. Based on the concept of vascular aging, angiological screening should be more widely implemented. It will allow for more individualized preventive interventions among young people in the future.

Phenotypes of early and favorable vascular aging in young people depending on the risk factors and presence of connective tissue dysplasia

Aim. To study the main risk factors and signs of connective tissue dysplasia (CTD) in young people according  to quartile analysis of cardioankle vascular index (CAVI).

Material and methods. The study involved 243 young people (men, 81; women, 162) aged 18-25 years. All subjects were divided into quartile groups  depending  on CAVI on both sides,  or CAVI-R and CAVI-L, determined  using the VaSera-1500 system (Fucuda Denshia,Japan). According to the latest guidelines, the 4th  quartile of this distribution among persons  of the same sex and age corresponds to early vascular aging (EVA) syndrome.  The 1st  quartile corresponds to favorable vascular aging. We analyzed the main RFs and CTD signs in each  of the 4 CAVI quartiles. Data processing  was carried out using the Statistica 10.0 software package (StatSoft Inc,USA).

Results. The minimum and maximum CAVI in the sample were 3,2 and 7,9. The overwhelming majority of studied risk factors in both sexes were not associated with the stiffness. Only body mass and body mass index increasedwith a decrease in vascular stiffness and vice versa. The average number of external stigmas of dysembryogenesis in young people increased from the 1st  to the 4th  CAVI quartile, with significant differences in the extreme groups. Such CTD signs as a carpal tunnel syndrome and thumb sign also significantly differed between the 1st  and 4th quartiles.

Conclusion. The presented results can be used for prevention among young people to form more individualized programs taking into account a comprehensive assessment of vascular aging phenotype and the level of external stigmatization of each young person.