The condition of neuro-endocrine systems in acute experimental myocardial infarction against the background of various reactivity of the organism

Abstract

The adequacy of recovery processes in myocardial infarction (MI) significantly depends on the state of reactivity of the organism, which, in turn, is determined by the adequacy of neuro-endocrine regulation, in particular, hypothalamic-pituitary-adrenocortical (HPA) and hypothalamic-pituitary-thyroid (HPT) system system.

Purpose of the study. To investigate the condition of HPA and HPT in acute experimental MI against the background of different reactivity of the organism.

Material and methods. The study was performed on 20 outbred adult dogs weighing 8-12 kg, in which MI was simulated by ligation of the anterior interventricular artery. Animals were divided into three groups (n =5 in each group). The condition of hyperreactivity was caused by the introduction of pyrogenal (group 2), the state of hyporeactivity - the introduction of azothioprine (group 3), in group 1 drugs were not used (state of normoreactivity). In the control group used 5 falsely operated dogs with thoracopericardiotomy. In animals before surgery, on 1, 4, 7, 11 and 15 days in the blood was determined by the content of adrenocorticotropic hormone  (ACTH), thyroid-stimulating hormone (TSH) , cortisol (Cr), aldosterone (Ald), thyroxine and triiodothyronine. Statistical processing was performed using license packages Statistica 5.5 (Stat Soft Rus), Statistica Neural Networks (Statsoft Inc.).

Results. Normoreactive course of myocardial infarction was characterized by primary activation of HPA, which was most pronounced for Cortisol, followed by restoration of ACTH and Aldosterone levels and duration of activation of the central link up to 4 days, peripheral - up to 7-11 days; reciprocal in relation to HPA inhibition of the functional activity of the HPT, most pronounced on the 4th day and lasting up to 15 days. Such changes caused the healing of myocardial infarction through the formation of a full-fledged post-infarction scar. The hyperreactive course of myocardial infarction was characterized by hypersecretion of ACTH with hypercorticism and hyperaldosteronism and less pronounced suppression of HPT with the restoration of its functional activity on the 7th day. The hyporeactive course of myocardial infarction was characterized by a minimally pronounced and delayed up to 4 days activation of HPA with Aldosterone hyposecretion on the 15th day; deep hypothyroidism of both central and peripheral genesis. Impaired reactivity was accompanied by an increase in the area of necrosis and a decrease in the thickness of the heart wall with the formation of postinfarction aneurysm.

Conclusions. Desynchronization of necrotic and reparative processes with a change in reactivity leads to a disruption in the relationship between necrosis and repair with the formation of postinfarction aneurysm, which is accompanied by different activities of the HPA and HPT.