دراسة بعض المؤشرات الحيوية الفسيولوجية و الأشكال الوراثية لدى مرضى أمراض القلب الإقفارية في محافظة كربلاء

Study of some physiological Biomarkers and genetic polymorphism in Ischemic Heart disease Patients in Karbala Governorate

In all countries of the Ischemic Heart disease of morbidity and mortality. This may occur when complete myocardial ischemia, which is called reduced blood flow to the heart muscle, bypasses the healing mechanisms intended to maintain the body’s homeostasis and regular functions. This has led to improve ability to identify individuals at high risk, in order to accurately predict and diagnose. In individuals with Ischemic Heart disease , it is necessary to examine various biochemical markers. Some biochemical markers, such as fibroblast growth factor-21 (FGF-21), are associated with Ischemic Heart disease , gelatinase-associated lipocalin (NGAL), and subtilisin/kexin adapter protein. 9 (PCSK9) in heart patients.
The aim of the current study is to estimate some biochemical markers associated with ischemic heart disease to predict and consider it a prognostic marker for this disease, and the study evaluated , fibroblast growth factor-21 (FGF-21), Ischemic Heart disease , and gelatinase-associated lipocalin (NGAL). The converting protein subtilisin/kexin 9 (PCSK9) in sixty patients (60) male suffering from ischemic heart disease. Samples were collected from Karbala Cardiology Center in Imam Hussein Medical City in the holy city of Karbala from the period of November 1, 2022 to July 30, 2023 from males. With ischemia disease and the control group (apparently healthy group) were thirty (30), and this group was matched in age from (30) – (69) as a patient group.
The criteria for the current study included lipid profile and four biochemical markers. Patients were divided into four subgroups according to age, disease type, smoking, and body mass index. The results of the current study showed a significant increase in the level of cholesterol, triglycerides, and LDL level, and a significant decrease in the HDL level in patients with ischemic heart disease compared with the control group. Biochemical markers were also elevated in patients compared to controls. According to age, the oldest ages (60-69) years had a high significant increase in all compared to(30-39) , (40-49) and (50-59) years . In types of ischemic heart disease patients, the results of the current study showed a significant increase in all vital signs in myocardial infarction compared to patients with unstable angina and stable angina, there were significant differences among myocardial infarction, unstable angina, and stable angina patients. All biomarkers increased significantly in smoking patients compared with non-smoking patients.
In obese patients, all biochemical markers were significantly elevated compared with overweight and normal weight patients. The current correlation study indicated that there is a positive significant relationship between (Protein Von Factor – (PCSKA) – Lipocalin – Fibroblast Growth Factor 21) with the level of cholesterol, LDL-C and TG, while there is a negative significant relationship between all biomarkers and the HDL level. The present study concluded that all biomarkers (PCSKA9-lipocalin-fibroblast growth factor 21) are risk prognostic and predictive of atherosclerosis associated with ischemic heart disease .
Results from a study of ACE polymorphisms of patients with CVD were consistent with some groups reporting a positive association between the DD genotype and/or D allele and stroke, whereas others reported the opposite. A significant association between ACE gene polymorphisms and incidence and mortality of ischemic cardiovascular disease has been reported in patients aged 30 to 60 years or younger in unaffected patients ,reported a positive association between ACE gene polymorphisms and cerebrovascular diseases , a strong relationship between the D allele and levels of circulating intracellular and tissue activity of the enzyme ACE. Because both alleles have common dominant effects on ACE levels, the homozygous DD genotype leads to the highest levels of the enzyme, while the homozygous II genotype leads to the lowest level, and the heterozygous DI genotype leads to an intermediate level .
Increase in cardiovascular disease, and its effect on adipogenesis in the coating on a high-fat diet. The importance of the PCSK9 gene in MT1-MMP activation in cardiometabolic syndrome is further supported by data. This indicates for the first time that monocytes in CVD patients were upregulated toward the pro-migratory/pro-inflammatory state that characterizes CVD PCSK9, and its levels were not significantly changed, supporting a disturbance of LDL and inhibitor homeostasis in CVD and obese patients. This PCSK9 can be a contributor to regulation. Interestingly, regulation of hepatic LDL receptors by resistin involves the related PCSK family member PCSK9, which was recently identified as a novel target in patients with severe dyslipidemia and CVD .
The present study concluded that all biomarkers of PCSK9-lipocalin-fibroblast growth factor 21 are risk factors for diagnosing and prognosticating atherosclerosis associated with ischemic heart disease, and levels of FGF-21, NGAL, and PCSK9 can be used to identify and diagnose myocardial infarction of the heart