[Immunologic activity in coronary heart disease and atherosclerosis of the lower extremities].

Cytokine activation may be connected to increase of clinical symptoms both of coronary heart disease and lower limbs atherosclerosis. Our aim is to determine the influence of the atherosclerosis generalization upon immune activation in coronary heart disease, with regard to ECG stress test. 127 patients have been included in the study: 21 with stable angina and peripheral artery disease (PAD)--group A, and 106 with stable angina--group B. 20 healthy persons comprised the control group (group K). The serum concentration of TNF alpha, sTNFR 1, E-selectin and sVCAM-1 has been measured before and after the ECG stress test, using the ELISA method. Serum concentration levels of TNF alpha (A: 17.8 +/- 6.2 pg/ml, B: 17.4 +/- 3.8 pg/ml) and sTNFR 1 (A: 1678.5 +/- 600 pg/ml, B: 1376.4 +/- 558 pg/ml) have been significantly higher in both research groups than in the control group K (8.3 +/- 1.4 pg/ml, p < 0.001; 1093.9 +/- 457 pg/ml, p < 0.01). The sTNFR 1 concentration has been significantly higher in group A than in group B (p < 0.05). A significant post-exercise increase in E-selectin serum concentration has been observed, regardless to coincidence of lower limbs atherosclerosis. The atherosclerosis generalization level, e.g. the prevalence of PAD, in patients with coronary heart disease has an influence on immune activation--patients with lower limbs atherosclerosis are characterized by higher sTNFR 1 serum level. The ECG stress test induces the increase of E-selectin serum concentration in coronary patients, regardless of PAD.