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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">arthyper</journal-id><journal-title-group><journal-title xml:lang="ru">Артериальная гипертензия</journal-title><trans-title-group xml:lang="en"><trans-title>"Arterial’naya Gipertenziya" ("Arterial Hypertension")</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1607-419X</issn><issn pub-type="epub">2411-8524</issn><publisher><publisher-name>Antihypertensive League</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.18705/1607-419X-2012-18-4-334-343</article-id><article-id custom-type="elpub" pub-id-type="custom">arthyper-1716</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ СТАТЬИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL ARTICLES</subject></subj-group></article-categories><title-group><article-title>Оценка антипролиферативной эффективности валсартана у больных ишемической болезнью сердца при реваскуляризации миокарда (исследование ПРОЛИВ)</article-title><trans-title-group xml:lang="en"><trans-title>Evaluation of antiproliferative efficacy of valsartan in patients with coronary artery disease during myocardial revascularisation (the PROLIV study)</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Алугишвили</surname><given-names>М. З.</given-names></name><name name-style="western" xml:lang="en"><surname>Alugishvili</surname><given-names>M. Z.</given-names></name></name-alternatives><email xlink:type="simple">Marianna-alugishvili@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Козулин</surname><given-names>В. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Kozulin</surname><given-names>V. Y.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Усова</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Usova</surname><given-names>E. A.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Геворкова</surname><given-names>Л. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Gevorkova</surname><given-names>L. V.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Митрофанова</surname><given-names>Л. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Mitrofanova</surname><given-names>L. B.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гордеев</surname><given-names>М. Л.</given-names></name><name name-style="western" xml:lang="en"><surname>Gordeev</surname><given-names>MX. ..</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Панов</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Panov</surname><given-names>A. V.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБУ «Федеральный Центр сердца, крови и эндокринологии им. В.А. Алмазова» Минздравсоцразвития РФ</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Almazov Federal Heart, Blood and Endocrinology Centre</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2012</year></pub-date><pub-date pub-type="epub"><day>28</day><month>08</month><year>2012</year></pub-date><volume>18</volume><issue>4</issue><fpage>334</fpage><lpage>343</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Алугишвили М.З., Козулин В.Ю., Усова Е.А., Геворкова Л.В., Митрофанова Л.Б., Гордеев М.Л., Панов А.В., 2012</copyright-statement><copyright-year>2012</copyright-year><copyright-holder xml:lang="ru">Алугишвили М.З., Козулин В.Ю., Усова Е.А., Геворкова Л.В., Митрофанова Л.Б., Гордеев М.Л., Панов А.В.</copyright-holder><copyright-holder xml:lang="en">Alugishvili M.Z., Kozulin V.Y., Usova E.A., Gevorkova L.V., Mitrofanova L.B., Gordeev M..., Panov A.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://htn.almazovcentre.ru/jour/article/view/1716">https://htn.almazovcentre.ru/jour/article/view/1716</self-uri><abstract><p>Актуальность. Операция аорто-коронарного шунтирования (АКШ) является на сегодняшний день наиболее широко распространенным методом хирургического лечения больных ишемической болезнью сердца (ИБС) с многососудистым поражением коронарного русла, вовлечением в стенозирующий процесс основного ствола левой коронарной артерии. При этом долгосрочный прогноз пациентов после выполненной операции АКШ определяется преимущественно работоспособностью сформированных венозных и артериальных аорто-коронарных шунтов. Пролиферация интимы венозных шунтов сопровождается увеличением риска тромбоза шунта. Цель исследования — проанализировать антиги-пертензивную и антипролиферативную активность валсартана (Валз) в отношении интимы венозных трансплантатов у больных ИБС после операции АКШ. Материалы и методы. Исследована когорта из 60 пациентов с ИБС, перенесших операцию АКШ. Морфологические особенности большой подкожной вены (БПВ) изучались в образцах, полученных во время операции коронарного шунтирования. Анти-гипертензивная активность Валза оценивалась с помощью мониторирования артериального давления (АД). Результаты. Среднее снижение систолического АД в основной группе пациентов составило 26,8 мм рт. ст. (р &lt; 0,01), в контрольной группе — 26,5 мм рт. ст. (р &lt; 0,01); диастолического АД в основной группе — 13,6 мм рт. ст. (р &lt; 0,01), в контрольной группе — 14,1 мм рт. ст. (р &lt; 0,01). Морфометрические показатели венозных анастамозов в группе пациентов, получающих валсартан (основная группа), не отличались показателей больных, получающих периндоприл в контрольной группе. При иммуногистохимическом анализе по показателю Ki-67 обнаружена значительно более низкая про-лиферативная активность клеток эндотелия (3,5 ± 0,02 против 4,1 ± 0,02 усл. ед.) и гладкомышечных клеток (4,38 ± 0,01 против 7,15 ± 0,05 усл. ед.) в группе пациентов, получавших валсартан. Выводы. Установлена высокая антигипертензивная эффективность и хорошая переносимость валсартана (Валз, Actavis Group, Исландия) в составе комплексной терапии больных ИБС и АГ при коронарном шунтировании. На фоне терапии валсартаном выявлено уменьшение пролиферативной активности интимы и гладкомышечных клеток венозных трансплантатов. </p></abstract><trans-abstract xml:lang="en"><p>Background. Nowadays coronary artery bypass graft (CABG) surgery is the most widely used treatment option in patients with multivessel coronary artery disease (CAD) including left main artery lesion. The long-term prognosis of these patients is determined by the properties of the grafts. Objective. To investigate antihypertensive and antiproliferative activity of the angiotesin-converting enzyme inhibitor Valsartan (Valz, Actavis Group, Iceland). Design and methods. Sixty CAD patients who underwent CABG surgery, were enrolled. Antihypertensive effects of Valsartan were assessed by 24-hour blood pressure monitoring. Venous specimens were taken during CABG surgery. Morphological changes in saphenous veins were studied by microscopy, histochemistry and immunological methods. Results. Antihypertensive effects of valsartan and perindopril were comparable. The mean systolic and diastolic blood pressure did not differ in valsartan and perindopril groups. No changes between groups were found by morphological methods. Proliferative activity of endothelial cells was significantly lower in valsartan group. Conclusion. Valsartan in CAD patients after CABG surgery is an effective therapeutic approach regarding the prevention of the intimal hyperplasia of venous grafts. </p></trans-abstract><kwd-group xml:lang="ru"><kwd>антигипертензивная терапия</kwd><kwd>валсартан</kwd><kwd>реваскуляризация миокарда</kwd><kwd>венозные шунты</kwd><kwd>аорто-коронарное шунтирование</kwd></kwd-group><kwd-group xml:lang="en"><kwd>antihypertensive therapy</kwd><kwd>valsartan</kwd><kwd>myocardial revascularization</kwd><kwd>venous grafts</kwd><kwd>coronary artery bypass graft surgery</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Бокерия Л.А., Гудкова Р.Г Итоги научных исследований по проблеме сердечно-сосудистой хирургии в 2009 г. // Грудная и сердечно-сосудистая хирургия, 2010. — № 5. — С. 4-10.</mixed-citation><mixed-citation xml:lang="en">Бокерия Л.А., Гудкова Р.Г Итоги научных исследований по проблеме сердечно-сосудистой хирургии в 2009 г. // Грудная и сердечно-сосудистая хирургия, 2010. — № 5. — С. 4-10.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Акчурин Р.С. Хирургическое лечение ишемической болезни сердца — история и современность // «Микрохирургия в России. 30 лет развития». — М.: ГЭОТАР-Медиа, 2005.</mixed-citation><mixed-citation xml:lang="en">Акчурин Р.С. Хирургическое лечение ишемической болезни сердца — история и современность // «Микрохирургия в России. 30 лет развития». — М.: ГЭОТАР-Медиа, 2005.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Wijeysundera D.N., Beattie D. N., Djanini G. et al. Off-pump coronary artery surgery for reducing mortality and morbidity. Metaanalysis of randomized and observational studies // J. Am. Coll. Cardiol. — 2005. — Vol. 46, № 5. — P. 872-882.</mixed-citation><mixed-citation xml:lang="en">Wijeysundera D.N., Beattie D. N., Djanini G. et al. Off-pump coronary artery surgery for reducing mortality and morbidity. Metaanalysis of randomized and observational studies // J. Am. Coll. Cardiol. — 2005. — Vol. 46, № 5. — P. 872-882.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Berger A., MacCarthy PA., Siebert U., Carlier S. Long-term patency of internal mammary artery bypass grafts: relationship with preoperative severity of native coronary artery stenosis // Circulation. — 2004. — Vol. 110, № 11, Suppl. 1. — P. 36-40.</mixed-citation><mixed-citation xml:lang="en">Berger A., MacCarthy PA., Siebert U., Carlier S. Long-term patency of internal mammary artery bypass grafts: relationship with preoperative severity of native coronary artery stenosis // Circulation. — 2004. — Vol. 110, № 11, Suppl. 1. — P. 36-40.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Yamamoto K., Onoda K., Sawada Y. et al. Locally applied cilostazol suppresses neointimal hyperplasia and medial thickening in a vein graft model // Ann. Thorac. Cardiovasc. Surg. — 2007. — Vol. 13, № 5. — P. 322-330.</mixed-citation><mixed-citation xml:lang="en">Yamamoto K., Onoda K., Sawada Y. et al. Locally applied cilostazol suppresses neointimal hyperplasia and medial thickening in a vein graft model // Ann. Thorac. Cardiovasc. Surg. — 2007. — Vol. 13, № 5. — P. 322-330.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Blobe G.C., Schiemann W.P., Lodish H.F. Role of transforming growth factor beta in human disease // N. Engl. J. Med. — 2000. — Vol. 342, № 18. — P. 1350-1358.</mixed-citation><mixed-citation xml:lang="en">Blobe G.C., Schiemann W.P., Lodish H.F. Role of transforming growth factor beta in human disease // N. Engl. J. Med. — 2000. — Vol. 342, № 18. — P. 1350-1358.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">HOPE Study Investigators. The HOPE (Heart Outcomes Prevention Evaluation) Study: the design of a large, simple randomized trial of an angiotensin-converting enzyme inhibitor (ramipril) and vitamin E in patients at high risk of cardiovascular events // Can. J. Cardiol. — 1996. — Vol. 12, № 2. — P. 127-137.</mixed-citation><mixed-citation xml:lang="en">HOPE Study Investigators. The HOPE (Heart Outcomes Prevention Evaluation) Study: the design of a large, simple randomized trial of an angiotensin-converting enzyme inhibitor (ramipril) and vitamin E in patients at high risk of cardiovascular events // Can. J. Cardiol. — 1996. — Vol. 12, № 2. — P. 127-137.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Fox K.M.; EURopean trial On reduction of сardiac events with Perindopril in stable coronary Artery disease Investigators. Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease: randomized, doubleblind, placebo-controlled, multicentre trial (the EUROPA study) // Lancet. — 2003. — Vol. 362, № 9386. — P. 782-788.</mixed-citation><mixed-citation xml:lang="en">Fox K.M.; EURopean trial On reduction of сardiac events with Perindopril in stable coronary Artery disease Investigators. Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease: randomized, doubleblind, placebo-controlled, multicentre trial (the EUROPA study) // Lancet. — 2003. — Vol. 362, № 9386. — P. 782-788.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Miceli A., Capoun R., Fino C. et al. Effects of angiotensin-converting enzyme inhibitor therapy on clinical outcome in patients undergoing coronary artery bypass grafting // J. Am. Coll. Cardiol. — 2009. — Vol. 54. — P. 1747-1762.</mixed-citation><mixed-citation xml:lang="en">Miceli A., Capoun R., Fino C. et al. Effects of angiotensin-converting enzyme inhibitor therapy on clinical outcome in patients undergoing coronary artery bypass grafting // J. Am. Coll. Cardiol. — 2009. — Vol. 54. — P. 1747-1762.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Julius S., Kjeldsen S.E., Weber M. et al. Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine:the VALUE randomised trial // Lancet. — 2004. — Vol. 363, № 9426. — Р. 2022-2031.</mixed-citation><mixed-citation xml:lang="en">Julius S., Kjeldsen S.E., Weber M. et al. Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine:the VALUE randomised trial // Lancet. — 2004. — Vol. 363, № 9426. — Р. 2022-2031.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Cohn J.N., Tognoni G. A randomized trial of the angio-tensin-receptor blocker valsartan in chronic heart failure // N. Engl. J. Med. — 2001. — Vol. 345, № 23. — P. 1667-1675.</mixed-citation><mixed-citation xml:lang="en">Cohn J.N., Tognoni G. A randomized trial of the angio-tensin-receptor blocker valsartan in chronic heart failure // N. Engl. J. Med. — 2001. — Vol. 345, № 23. — P. 1667-1675.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Pfeffer M.A., McMurray J.J., Velazquez E.J. et al. Valsartan, captopril, or both in myocardial infarction complicated by heart failure, left ventricular dysfunction, or both // N. Engl. J. Med. — 2003. — Vol. 349, № 20. — Р. 1893-1906.</mixed-citation><mixed-citation xml:lang="en">Pfeffer M.A., McMurray J.J., Velazquez E.J. et al. Valsartan, captopril, or both in myocardial infarction complicated by heart failure, left ventricular dysfunction, or both // N. Engl. J. Med. — 2003. — Vol. 349, № 20. — Р. 1893-1906.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Mochizuki S., Dahlof B., Shimizu M. et al. Valsartan in a Japanese population with hypertension and other cardiovascular disease (Jikei Heart Study):a randomised, open-label, blinded endpoint morbidity-mortality study // Lancet. — 2007. — Vol. 369, № 9571. — Р. 1431-1439.</mixed-citation><mixed-citation xml:lang="en">Mochizuki S., Dahlof B., Shimizu M. et al. Valsartan in a Japanese population with hypertension and other cardiovascular disease (Jikei Heart Study):a randomised, open-label, blinded endpoint morbidity-mortality study // Lancet. — 2007. — Vol. 369, № 9571. — Р. 1431-1439.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">World Sales IMS Data, 2007.</mixed-citation><mixed-citation xml:lang="en">World Sales IMS Data, 2007.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Peters S., Gotting B., Trummel M., Rust H., Brattstrom A.. Valsartan for prevention of restenosis after stenting of type B2/C lesions: the VAL-PREST trial // J. Inv. Cardiol. — 2001. — Vol. 13, № 2. — P. 93-97.</mixed-citation><mixed-citation xml:lang="en">Peters S., Gotting B., Trummel M., Rust H., Brattstrom A.. Valsartan for prevention of restenosis after stenting of type B2/C lesions: the VAL-PREST trial // J. Inv. Cardiol. — 2001. — Vol. 13, № 2. — P. 93-97.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Peters S., Trummel M., Meyners W., Koehler B., West-ermann K. Valsartan versus ACE inhibition after bare metal stent implantation — results of the VALVACE trial // Int. J. Cardiol. — 2005. — Vol. 98, № 2. — P. 331.</mixed-citation><mixed-citation xml:lang="en">Peters S., Trummel M., Meyners W., Koehler B., West-ermann K. Valsartan versus ACE inhibition after bare metal stent implantation — results of the VALVACE trial // Int. J. Cardiol. — 2005. — Vol. 98, № 2. — P. 331.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
