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Title: RELATIVE TELOMERE LENGTH OF PERIPHERAL BLOOD LYMPHOCYTES AND STRUCTURAL AND FUNCTIONAL STATE OF THE LEFT VENTRICLE MYOCARDIUM IN CLEAN-UP WORKERS OF THE CHORNOBYL ACCIDENT WHO SUFFERED FROM STENOTIC CORONARY ATHEROSCLEROSIS.
Author: Belyi DO, Ilyenko I, Nastina O, Sydorenko G, Gabulavichene Z, Kursina N, Bazyka O, Bilaya V, Kovaliov O, Bazyka D.
Journal: Probl Radiac Med Radiobiol; 2021 Dec; 26():319-338. PubMed ID: 34965558.
Abstract:
UNLABELLED: The objective was to analyze the relative telomere length (RTL) of peripheral blood lymphocytes depending onmyocardium structural and functional state in emergency workers (EW) of the Chornobyl accident who suffered fromcoronary arteries stenotic atherosclerosis. MATERIALS AND METHODS: There were examined 60 male EW who operated at the Chornobyl nuclear power plant at1986 and 25 male non-irradiated persons (control group - CG) with coronary heart disease (CHD). Everyone EW andCG patients were almost healthy before the accident. During the period 2016-2021, they underwent a comprehen-sive clinical and laboratory examination, echodopplercardiographic examination and determination of RTL by fluo-rescent hybridization in situ using laser flow cytometry. RESULTS: EW almost did not differ from CG according to its clinical characteristics, the presence of risk factors,indices of systolic and diastolic heart functions, as well as RTL. The analysis of variance showed that RTL was influ-enced by the fact of irradiation in combination with obesity (p = 0.020). At normal body weight, RTL average valuein CG was significantly higher than in EW (p = 0.023). According to the results of hierarchical cluster analysis of twovariables as RTL and end-diastolic volume normalized by body surface area (EDV/BSA), EW and CG patients togeth-er were divided into two subgroups. The first subgroup (1st cluster) differed from the second (2nd cluster) by signi-ficantly larger average values of left ventricle (LV) EDV and end-systolic volume (ESV) as well as EDV/BSA andESV/BSA, LV myocardial mass (MM) and MM/BSA, reduced ejection fraction (EF). In patients of the 1st cluster telom-eres were significantly shorter than in the 2nd one (10,3 ± 1.7 vs. 14.3 ± 2.0 at p = 0.000). The increase of myocar-dial mass and LV wall thickness caused the development of its hypertrophy. The number of people with hypertrophyLV was significantly higher among patients of the 1st cluster (91.6 vs. 67.2 %, p < 0.001) due to eccentric hypertro-phy LV. Accordingly, concentric hypertrophy LV was more common among patients in the 2nd cluster (24.6 vs. 4.2 %at p < 0.01). Patients of the 1st cluster was characterized by a more severe course of heart failure. CONCLUSIONS: In patients who suffered from CHD with stenotic atherosclerosis of the coronary arteries and wereexposed to radiation 30-35 years earlier, having normal body weight, there was a reduction in telomere. Hierarchicalcluster analysis proved to be a good tool that allows by the value of RTL and EDV/BSA to separate the group ofpatients with the most severe clinical course of CHD and LV systolic dysfunction among patients with the samepathology. Meta doslidzhennia: provesty analiz vidnosnoï dovzhyny telomer (VDT) limfotsytiv peryferychnoï krovi v uchas-nykiv likvidatsiï naslidkiv avariï (ULNA) na Chornobyl's'kiĭ AES (ChAES) zi stenozuiuchym aterosklerozom koro-narnykh arteriĭ zalezhno vid strukturno-funktsional'nogo stanu miokarda.Materialy ta metody. V doslidzhenni obstezheni 60 ULNA na ChAES 1986 roku i 25 neoprominenykh osib (kontrol'-na grupa – KG) cholovichoï stati z IKhS. Vsi ULNA ta patsiienty KG do avariï buly praktychno zdorovymy. Za period2016–2021 rr. vony proĭshly kompleksne kliniko-laboratorne obstezhennia, ekhodopplerkardiografichnedoslidzhennia i vyznachennia VDT metodom fluorestsentnoï gibrydyzatsiï in situ za dopomogoiu lazernoï protochnoïtsytometriï.Rezul'taty. Za svoieiu klinichnoiu kharakterystykoiu, naiavnistiu faktoriv ryzyku, pokaznykamy systolichnoï i dias-tolichnoï funktsiĭ sertsia, a takozh za VDT ULNA praktychno ne vidriznialysia vid KG. Provedenyĭ dyspersiĭnyĭanaliz pokazav, shcho na VDT vplyvav fakt oprominennia v poiednanni z ozhyrinniam (p = 0,020). Pry normal'niĭ masitila serednie znachennia VDT v KG bulo dostovirno vyshchym, nizh v ULNA (p = 0,023). Za rezul'tatamy iierarkhichnogoklasternogo analizu dvokh zminnykh – VDT ta indeksu kintsevo-diastolichnogo ob’iemu, ULNA i patsiienty KG buly roz-podileni na dvi pidgrupy. Persha pidgrupa (1-ĭ klaster) vidriznialasia vid drugoï (2-ĭ klaster) virogidno bil'shymyserednimy pokaznykamy kintsevo-diastolichnogo ob’iemu i kintsevo-systolichnogo ob’iemu livogo shlunochka (LSh) taïkhnikh indeksiv, masy miokarda LSh ta ĭogo indeksu, znyzhenoiu fraktsiieiu vykydu (FV). U patsiientiv 1-go klasterutelomery buly virogidno korotshi, nizh u 2-go (10,0 ± 1,7 proty 14,3 ± 2,0 pry p = 0,000). Zbil'shennia masy miokar-da i tovshchyny stinok LSh obumovliuvalo rozvytok ĭogo gipertrofiï. Chyslo osib z gipertrofiieiu LSh bulo dos-tovirno vyshche sered patsiientiv 1-go klasteru (91,6 % proty 67,2 %, p < 0,001) za rakhunok ekstsentrychnoï gipert-rofiï LSh. Vidpovidno sered patsiientiv 2-go klasteru chastishe zustrichalas' kontsentrychna gipertrofiia LSh (24,6 %proty 4,2 % pry p < 0,01). Dlia patsiientiv 1-go klasteru buv kharakternyĭ bil'sh tiazhkyĭ perebig sertsevoï nedos-tatnosti.Vysnovky. U khvorykh na ishemichnu khvorobu sertsia zi stenozuiuchym aterosklerozom koronarnykh arteriĭ, iaki zazna-ly oprominennia 30–35 rokiv tomu, z normal'noiu masoiu tila sposterigalos' skorochennia telomer. Iierarkhichnyĭklasternyĭ analiz pokazav sebe garnym instrumentom, shcho dozvoliaie sered khvorykh z odnakovoiu patologiieiu za po-kaznykamy VDT ta indeksu kintsevo-diastolichnogo ob’iemu vidokremyty grupu patsiientiv z naĭbil'sh tiazhkymklinichnym perebigom ishemichnoï khvoroby sertsia i porushenniam systolichnoï funktsiï LSh.Kliuchovi slova: uchasnyky likvidatsiï naslidkiv avariï na Chornobyl's'kiĭ AES, radiatsiĭnyĭ vplyv, ishemichna khvo-roba sertsia, stenozuiuchyĭ ateroskleroz koronarnykh arteriĭ, infarkt miokarda, vidnosna dovzhyna telomer,kintsevo-diastolichnyĭ ob’iem.

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