Pathogenetic and prognostic significance of molecular markers of myocardial remodeling in patients suffering from chronic heart failure

It is known that there are features of myocardial remodeling in various heart diseases. However, the influence of signaling regulatory factors in its development and their significance in predicting a course of chronic heart failure remains unclear. The importance of key markers of apoptosis, extracellular matrix, p-38α in myocardium of patients with chronic heart failure of different etiology in the development of cardiovascular complications after cardiac surgery is considered. It has been established that the combination of heart failure with coronary heart disease, heart failure with valvular defects are specific phenotypes with a special reorganization of myocardium. With the combination of heart failure with coronary heart disease without cardiovascular complications in the myocardium, higher activity of caspase-9 and TIMP-1 was noted, and differences in morphometric data were revealed in comparison with the group of heart failure with valvular defects. In groups with an unfavorable outcome of cardiosurgical operations of different etiology of chronic heart failure, there were no differences in the morphological indices and activity of molecular markers of the myocardium. This fact allows one to consider the activation of caspase-9, MMP-9, p38α in the myocardium as prognostic markers of the unfavorable outcome of cardiac surgery in patients suffering from heart failure regardless of etiology. A higher percentage of cardiovascular complications in the combination of chronic heart failure with coronary heart disease is probably associated with a less favorable myocardial phenotype and requires a specific pharmacological correction before cardiac surgery.