Clinical, instrumental and psychosomatic associations of ACE gene insertion/deletion (I/D) polymorphism were studied in inpatients with coronary heart disease (CHD): unstable angina (UA) - 32, myocardial infarction (MI) - 80. The control group included 66 healthy volunteers (CG). ACE gene D allele was more prevalent than I allele (p < 0.02) in CHD and MI patients. These groups also had significant difference in DD genotype prevalence, comparing to CG (p < 0.05). According to echocardiography results, severe left ventricular hypertrophy (IVH) was associated with DD genotype. According to psychometry data, patients with DD genotype had increased levels of total hostility and Type A behavior manifestation than patients with ID or II genotype (p < 0.05). Prolonged hospitalization time in MI patients with DD genotype was significantly associated with severity of Type A behavior and various hostility components (p < 0.05).

The authors analyze prolonged ECG monitoring indications for paroxysmal atrial fibrillation (AF) diagnostics. Two groups of coronary heart disease (CRT)) patients were examined. Group I included 90 patients with AF paroxysms diagnosed during three-day ECG monitoring; Group II - 90 patients without AF paroxysms in anamnesis or during ECG monitoring. In Group I, AF paroxysm incidence increased by 10 % during two-day monitoring, and by 18 % - during three-day monitoring, comparing to 24-hour monitoring. In Group I, comparing to Group II, more single, paired and grouped extrasystoles were registered (p < 0,001), as well as increased P wave duration (p < 0,001) on standard ECG. AF paroxysm incidence during prolonged ECG monitoring, including the above-mentioned signs, was 86. 7 %. Therefore, 24-hour ECG monitoring data and P wave duration on standard ECG might help to identify the patients in need for prolonged ECG monitoring and AF paroxysm diagnostics.

The article is devoted to actual problem of increasing arterial hypertension (AH) incidence in young persons. Blood pressure (BP) and spyroergometry parameter dynamics was studied in young AH males during treadmill test. In total, 78 males aged 18-30 (mean age 20,4 ± 3,9 years) were examined. According to WHO/ISH criteria (1999), essential AH was diagnosed in 42 individuals: Stage I (n=35) or Stage II (n=7). The control group consisted of 38 healthy males. All participants underwent treadmill test, by R. Bruce protocol, with gradually increasing workload until submaximal heart rate (HR) achievement. During the test, ECG, BP and exhaled air gas composition measurement were performed. There was no significant difference in systolic or diastolic BP response to dosed physical stress among AH patients or healthy persons, in spite of substantially higher baseline and test BP levels in AH group. Hypertensive individuals demonstrated significant increase in oxygen pulse, breathing coefficient, maximal CO2 exhalation pulse, and earlier anaerobic threshold achievement time.

Prognosis inpatients with pre-dialysis stages of chronic renal failure (CRF) is determined by various factors, including left ventricular hypertrophy (LVH) and coronary heart disease (CHD). At the same time, remodeling features and diastolic LV myocardial function in CRF patients are still understudied. The present study aimed to assess structural and functional LV features inpatients with early CRF stages and combined cardio-renal pathology. Among 70 patients with CHF and secondary arterial hypertension (AH), 35 also had CHD. According to clinical and echocardiography data, patients with combined cardio-renal pathology often had concentric and eccentric LVH types, as well as hypertrophic and pseudo-normal variants of LV diastolic dysfunction. Ln patients with CRF and symptomatic AH, eccentric LVH type or pseudo-normal diastolic dysfunction variant were not diagnosed. Chronic heart failure (CHF) symptoms in patients with CRF, secondary AH and CHD, were of systolo-diastolic nature; CHD-free participants had diastolic CHF.

The survey focused on municipal out-patient clinic internists' involvement into modified coronary heart disease risk factor (CHD RF) control, as well as on RF control effectiveness reported by the patients. Up to 73 % of the doctors confirmed clinical effectiveness of the intervention, and 53 % regarded it equally important as antianginal therapy. Nevertheless, there were numerous barriers for successful realization of CHD RF control measures. Delivering RF control advice was linked to doctors' working pressure in 50, 5 % of cases, to patients' cultural level in 78,8 %, to patients' interest and initiative in 33,3 %, and to personal patient-doctor relations in 21,2 %. Only brief advice was given by 44,9 % of the doctors, and no more than 18 % of the respondents were ready to forward their patient to the relevant specialist. Therefore, 26 % of the doctors reported providing lifestyle modification advice «never», «rarely», or «occasionally». Unsatisfactory follow-up on fulfillment of such advice was confirmed by 49 % of the doctors. According to patient-provided data, the majority of the patients were unable to recollect receiving any relevant advice from their doctors. Most doctors reported advising on lipid-lowering diet, body weight control and smoking cessation (94 % in each case), or physical training (77,5 %), but only 46,1 %, 32,3 %, 75,3 % and 23,8 % of their patients, respectively, confirmed receiving such recommendations. Moreover, even for smoking cessation advice, where doctor-patient reporting gap was minimal, only 13, 4 % of the patients confirmed being offered some cessation plan. Expectedly, the majority of quitters (68,85 %) were sure that cessation was their own accomplishment.

The authors propose prognostic models for separate assessment of post-hospital death risk in males and females, hospitalized with acute coronary syndrome, ACS (possible myocardial infarction or unstable angina). The models are based on parameters registered at admission and further calculation of death risk during one-year post-discharge follow-up period. This predicted risk gives a chance to divide patients into risk groups - with minimal (lethality < 1 %) to maximal (lethality > 30 %) risk, as well as to predict possible time of death. Reproducibility of prognostic results was confirmed for new ACS cases.

Different methods for determining circadian blood pressure (BP) rhythm type are used, that makes it difficult to compare various authors' data on circadian BP rhythm type prevalence or its disturbances. A modification of circadian BP type diagnostics, based on parallel 24-hour monitoring of systolic, diastolic, and mean dynamic BP, is proposed.

The authors compared antihypertensive efficacy of spirapril (Quadropril®) in two age groups: patients with arterial hypertension (AH) aged under 55 or over 55 years. Analyzing 24-hour blood pressure (BP) monitoring data, the authors demonstrated that spirapril (Quadropril®) was more effective in younger age group, that manifested in greater BP reduction and improved circadian BP rhythm.

To assess antiarrhythmic efficacy of propafenone and amiodarone in paroxysmal atrial fibrillation (AF) treatment, 204 patients (125 males, 79 females, aged 57-72 years) with various stages of heart failure (HF) were examined. Group I (HF of 0-I Functional Class, FC; n = 72) received propafenone (Propanorm, PRO. MED. CS Praha): load dose 600 mgper os, plus 300 mg 12 hours later. Group II (HFof II-III FC; n = 132) received amiodarone, 1200 mgper os, 450 mg intravenously, then - according to standard scheme. Propafenone terminated AF paroxysm in 83, 3 % of cases, amiodarone - in 78, 6 %. Inpatients without severe structural and functional myocardial changes and HF of 0-I FC, propafenone was most effective during the first 24 hours (70,8 %). In patients with severe structural myocardial changes and HF of II-III FC, maximal number of patients with rhythm restored by amiodarone was registered after 7 days of the treatment. Propafenone didn't cause any adverse hemodynamic effects inpatients with HF ofl FC. Propafenone and amiodarone combination potentiated antiarrhythmic effects in AF.

In total, 30 patients with Stage II arterial hypertension, AH (ESH/ESC 2003; Society of Cardiology of the Russian Federation 2004), mean age 51. 93 ± 7.96years. For 6 months, participants received carvedilol (Talliton, Hungary, Egis) in daily dose 25-75 mg. Microcirculation, hemorheology, and lipid profile were assessed at baseline and after treatment, by conjunctival biomicroscopy and laboratory tests. Carvedilol corrected microcirculation due to its effects on vessels and capillaries, long-term carvedilol treatment didn't affected blood lipid profile, and beneficially influenced hemorheology

In laboratory rats, a minimal arrhythmogenic dose of 1, 5 % KCl solution (15 mg/kg) was injected intravenously in 2 seconds. Hypopolarization arrhythmias were registered in 3-10 seconds, followed by regular sinus rhythm. In experimental groups, the animals received a minimal arrhythmogenic dose of KCl in 5 minutes after intravenous infusion of 1 % novocainamidum (20 mg/kg) or 0, 25 % ethacyzin (4 mg/kg). In all 20 rats, N a⁺ cannel blocker and KCl bolus administration resulted in cardioplegy; in every second animal, asystolia and death were registered (40 % and 60 %, respectively). Therefore, in coronary heart disease patients, receiving Na⁺ channel blockers, sudden death pathogenesis might be influenced by membrane hyperpolarization, due to Na⁺/K⁺-ATPase dysfunction, low cytosol concentration of K⁺ ions, and their decreased flow from the cells in final repolarization phase.

The South Federal Region (SFR) is characterized by unfavorable demographic situation, reflecting general situation in the whole country. For 2004, disease incidence in SFR has increased by 8, 7 %, and disease prevalence - by 7, 8 %. Mortality was high in all SFR subjects. In-hospital mortality (SFR, 2005) due to cardiovascular disease (CVD) was 3, 22 per 100 admitted patients, 15, 9 - for acute myocardial infarction, 7, 09 - due to cerebrovascular pathology, 4, 11 - for chronic coronary heart disease, and 0, 13 - due to high blood pressure. Prevalence of dispanser follow-up among CVD patients was 31, 77 % in 2002, 31, 29 % in 2003, 30, 96 % in 2004, and 31, 4 % in 2005. Taking into account the need for the National Health Project realization, the problems of hospital bed restructuring, health workers' professional level improvement, and preventive technology implementation are most actual.

A cardiovascular disease (CVD) screening study of 1350 Rostov-na-Donu citizens was performed. According to calculated clinical sensitivity and specificity, perspectives of «Cardiovisor - Obs « device use, as primary indicator of heart health and regulatory mechanisms status in screening studies, were determined. Among Rostov-na-Donu citizens, leading behavioral risk factors for non-communicable disease included smoking, low physical activity, and unhealthy diet, resulting in overweight and obesity. There is a need for special preventive program focused on suboptimal ecology region inhabitants.