The work has studied opportunities for ТЕ EPS in serial testing of antiarrhythmic drugs testing to prevent recurrent arrhythmia in patients with atrial fibrillation. Antiarrhythmic drug adjustment was performed in 85 patients with paroxysmal atrial fibrillation. Serial testing implied the usage of all 4 series of antiarrhythmic drugs. Individual effective antiarrhythmic therapy was adjusted in 83 (98 %) patients. Class I drug appeared to be most effective (in 89 % patients) with the best individual result for Cordarone which achieved effect in 61 % cases when administered as 600-800 mg daily. To obtain most reliable results of pharmacological antiarrhythmic therapy adjustment in patients with paroxysmal atrial fibrillation during diagnostic transesophageal electrical stimulation (TEES) and during serial testing of antiarrhythmic drugs it is rational to use "non-aggressive" methods of atrial fibrillation induction: accelerating, frequent and programmed atrial stimulation with one or two delayed stimuli.

Heart rhythm disturbances structure and time domain peculiarities of heart rate variability are studied at 77 patients having ventricular preexcitation syndrome and phenomenon. Among the heart arrhythmias induced during the electrophysiologic study reciprocal orthodromic tachicardia, atrial fibrillation and combination of these arrhythmias prevail.

Reliable decrease of heart rate variability values at syndrome in comparison with the ones at phenomenon determined. These data mean that vagal impact at heart rate regulation is decreased, thus leading to sympathic mechanisms predominance and, probably, to the sustained electrical instability of myocardium.

A dynamics and origin of changes in the end part of spontaneous ventricular complexes has been studied in 109 patients with permanent ventricular pacing. Pacemaker inhibition test and potassium test have been shown to increase the detection rate of true functional Chaterier syndrome characterized by ST depression and T wave inversion in spontaneous QRS complexes in leads II, III, aVF and V2-V6 , from 39. 9 % to 72. 6 % cases. This allows to rule out non-Q wave myocardial infarction overdiagnostics in this subset of patients. Furthermore, other non-coronary causes for ECG changes need to be sought (pericarditis, cardiomyopathies, myocardiodystrophies etc. ) in permanent pacing.

To examine the relation between serum fatty acids, blood pressure and heart failure in hypertensive patients we conducted a study of 58 patients with essential hypertension (mean age 45,1 ± 9,4 years) and 22 healthy subjects. It was established, that in essential hypertension the levels of saturated and monounsaturated fatty acids increased and the amount of polyunsaturated fatty acids decreased. Aforesaid changes were different within some classes of fatty acids: among saturated acids the levels of myristic and palmitic acids increased and the concentration of stearic acid decreased. Among polyunsaturated acids the amount oflinolenic and a-linolenic acids decreased and the level of arachidonic acid increased. Aforesaid changes correlated with main parameters of ambulatory blood pressure monitoring and structural and functional state of left ventricle.

112 patients were studied to evaluate the incidence of syncopal conditions caused by impaired cardiovascular regulation in young subjects. Complex evaluation has found hyperventilation syndrome to be the reason for syncopal conditions in 8.9 %, vasopressor syncopal conditions in 13.4 %, reflex in 16.1 %, postural hypertension in 13.4 %, «hypersensitive» carotid sinus syndrome in 5. 4 %; whereas the cause of syncopal conditions remained undetermined in 42.8 % patients.

The study assessed the dynamics of myocardial dimensions, mass, left ventricle (LV) systolic function and index of relative wall thickness in 64 patients in long-term follow-up after mitral and aortic valve replacement. An association between the extent of LV myocardium mass regression and specific features of LV geometry and the degree of hypertrophy. Ln 77.8 % of patients with LV myocardium mass index of > 20g/sq m, its hypertrophy was preserved after surgery, whereas impaired systolic function in 41 % >. LV myocardium mass neither returned to normal values with the index of relative wall thickness being less than 0.35. No satisfactory result was shown in patients with LV end diastolic size of 7. 0 cm or more. The results highlight the importance of timely pre-operative evaluation of LV structural and geometric parameters.

β-Adrenosensitizing activity of blood serum diluted by 50-, 100-, 500-, 1000- и 10000, from 10 almost healthy elderly people and 40 patients with acute coronary event (ACE), was studied on longitudinal strips of uterine horns of 31 rats. 10 of them underwent physical exercising during rehabilitation, thus increasing working capacity and left ventricle contractility. Serum from normal subjects showed no β-adrenosensitizing activity, i.e. contained no endogenous blockers of β-receptors. In patients with ACE including those performing physical exercise, all serum dilutions, particularly 500- and 1000-fold, increased the inhibiting effect of epinephrine (10-8 g/ml) which is explained by the presence of endogenous β-receptor sensitizers (EBRS) - like, probably, histidine, tryptophan and tyrosine. In ACE β-adrenosensitizing activity and, therefore, the EBRS level, is below the values in normal subjects, increasing in physical exercise. An opportunity of increasing the effectiveness of β-activity upon heart and vessels during rehabilitation following an ACE, and by using aromatic aminoacids and drugs (Preductal or Mildronate) is discussed.

Capacity resistive model of blood circulation and its usage in hemodynamics evaluation in patients with arterial hypertension.

Aim of the study. To evaluate clinical efficacy and safety of metoprolol (Egiloc®) in treatment of Coronary Heart Disease (CHDO complicated by chronic heart failure (CHF) in elderly and old patients with normal and elevated blood pressure (BP), selection of optimal dose.

Materials and methods. 43 patients (mean age with 78.6 ± 3.8 years) with CHD complicated by CHF NYHA II functional class were treated by Egiloc® 25-100 mg daily for 17 days. Egiloc was added to baseline treatment with mononitrates and angiotensin converting enzyme (ACE) inhibitors. Clinical data, daily BP monitoring, echocardiography and 6-minutes walking test were evaluated.

Results. Treatment with Egiloc® was accompanied by a reliable decrease in angina frequency and clinical features of CHF with no reliable changes in ejection fraction. There were no cases of hypotension in patients with normal BP levels taking 25-50 mg Egiloc® daily. Patients taking 25-50 mg Egiloc® daily demonstrated a reliable increase of physical stress tolerability, a reliable BP decrease and decreased incidence of BP elevations on BP daily monitoring. There were no cases of Egiloc® discontinuation die to poor tolerability.

Conclusion. The results indicate that treatment with Egiloc® 25-100 mg daily is safe and effective in elderly and old coronary patients with CHF NYHA II functional class with normal and elevated BP. The drug's effect is dose-dependent.

Objective. The aim of the present study was to assess effects of treatment of overweight hypertensive patients with vasodilatating and non-vasodilatating beta-blockers on glucose and lipid metabolism.

Patients and methods. 24 patients with mild to moderate hypertension were randomised into two treatment groups - nebivolol 5-10 mg per day vs nadolol 80-240 mgper day and treated for 6 months. Oral glucose tolerance test (OGTT) with the measurement of glucose and insulin levels: fasting, 30, 60, 90 and 120 minutes of test were performed initially and at the end of the study. Lipid profile and ambulatory blood pressure monitoring were also assessed for all patients.

Results. Antihypertensive effect was comparable in both groups. At the same time, nebivolol improved parameters of OGTT and reduced insulin resistance, while in nadolol group these parameters remained unchanged. Lipid profile improved during nebivolol treatment and slightly worsened in nadolol group.

Conclusion. Long-term nebivolol treatment can improve glucose tolerance and lipid spectrum in overweight patients, while administration of nadolol can slightly worsen lipid metabolism. These effects are unrelated to antihypertensive action of the drugs, which is comparable.

The work, using Enam as an example, provides a new original evaluation method for hypotensive action of drugs. The method is based upon primary analysis of daily blood pressure monitoring data with subsequent transformation into a graphic form of BP values likelihood distribution over a plane. The authors called the image obtained in this manner hypertension areal. The authors distinguish a core and a peripheral part of hypertension areal, proposing an evaluation method for many characteristic parameters. Hypotensive action is evaluated by changes in areal square over time. Patients receiving Enam were divided into 3 groups depending on the extent of hypotensive effect, by means of a neural network. Hypotensive effect is characterized based on the proposed standpoints for each group.

Medical treatment of arterial hypertension in elderly subjects: results from multicenter clinical trials and practical implementation for out-patients.

Oral intake of loading doses of antiarrhythmic drugs for sinus rhythm restoration in atrial fibrillation.

Helicobacter pylori infection, atherosclerosis and coronary heart disease.

Quality of pharmacological correction of modified cardiovascular risk factors and treatment of cardiovascular diseases in patients with non-insulin dependent diabetes mellitus in endocrinology centers.

Role of natrium-uretic peptides in the diagnostics of heart failure.

Non-glycosidic inotropic medications and new neurohumoral antagonists in heart failure treatment.