ECG and echocardiography data of 152 coronary patients have shown posterolateral wall, as the most adaptable to hemodynamical stress and most compliant, to be the first involved in the process of post-MI dilation of the LV cavity in cases of ventricle aneurysm. Subsequently volume load on the posterior wall decreases thus alleviating regional subendocardial ischemia and improving contractility, assuring the participation of this LV area in global hemodynamics. In such cases LV posterior wall and particularly its basal areas contribute significantly to intotropic function maintaining sufficient stroke volume. 

200 coronary patients after a myocardial infarction were studied in order to examine the influence myocardial infarction (MI) localization and depth, as well as sex and age, complications, concomitant conditions and treatment may have on heart rate variability (HRV). HRV was evaluated on the 10-14th day of myocardial infarction with a 5-minutes ECG record. Women demonstrated longer RR intervals, predominant CV, dRR, NN50 and RMSSD, tended to have higher TP and SD, LF/HF, IN and IRV were greater than in men. Thus women had higher parasympathetic tone. Age showed no influence on HRV, most likely because almost all patients were within the same age group (52-62 years). In inferior-posterior MIs as compared to anterior %LF was decreased and %HF, %VLF were higher, reflecting greater vagal tone in inferior MIs. In Q-MIs decreased SD and TP were observed. Concomitant hypertension increased the impact of %VLF, implying switch of regulation to a lower humoral-metabolic level . Concomitant diabetes mellitus decreased NN50, LF/HF, VPR, IRV and IN, reflecting cardiac neuropathy. Exacerbation of heart failure demonstrated worsened HRV and markedly decreased %HF and HFnu, implying parasympathetic influences being most depressed. Early postinfarctional angina was associated with greater LFnu and %LF, also reliably decreasing %VLF which is mot likely due to significant stress of the sympathetic branch. b-Blockers increased RR, increasing RMSSD, NN50 and %HF, demonstrating vagal influence under their action. ACE inhibitors shortened RR increasing HFnu and decreasing %VLF implying activation of the parasympathetic branch of the nervous system with simultaneously decreased humoral and metabolic influences. There were no differences in HRV depending on previous MIs and treatment with aspirin or nitrates. 

Biologically relevant structural changes in cell membranes (on an RBC model) at cold test, promoting its stabilization, has a pattern of pathology in coronary patients as taking place in membranes altered by atherogenesis. Profound changes in the lipid bilayer are followed by changes in intracardiac hemodynamics such as myocardial hyperfunction on one side and diastolic dysfunction with altered perfusion on the other side. These physiologically opposite tendencies may lie behind stress cold ischemia in coronary patients. 

We have studied the dynamics of clinical - laboratory data under the influence of Low Level Laser Therapy (LLLT) in complex treatment of the ischemic heart disease (IHD). Patients were randomised to the 2 groups. In first group patients received traditional management (TM) and in second group they received TMT with LT. All patients were divided into 4 groups by received drugs treatment combinations. The received data showed that including LT in treatment of IHD potentialled TM. More effect in our investigation show up in combination LT + «Nitrates+ BKK». Less effect - in combinations LT with «Nitrates + BKK + CG», «Nitrates+ ACEI» and LT+ «Nitrates+ Aspirin». 

The aim of the study was to analyse the clinical and angiographic results of bifurcational coronary balloon angioplasty and/or stenting depending on procedural variables and treatment method. The study included 56 patients with stable angina presenting bifurcational coronary lesions. The stent was implanted in main vessel in 32 patients. 24 patients were treated without stenting. Side branch angioplasty was performed in 16 stented and in 12 nonstented segments. All stenting procedures were performed using three ways: 1) so called «standard» manner without side branch protection during stenting, 2) elsewhere well described «jailed guidewire» technique and 3) hand9mounted two9balloons system proposed by K. Aroney. In 28 cases of successful bifurcational angioplasty an immediate clinical benefit was achieved. Among patients in whom side branch dilatation attempts have failed, 4 were finally free of symptoms, 6 have still demonstrated objective ischemic signs despite of considerable improvement in terms of angina functional class and 3 patients showed no clinical benefit. Conclusion: intact side branch ostium arising from main branch stenosis becomes compromised in large number of cases. 30% of side branch angioplasty attempts fail, of which the majority fall on stented main branch cases. Among types of bifurcation treatment, Aroney’s method showed the least effectiveness. Incomplete bifurcation reconstruction substantially decrease the clinical benefit in these patients. Key words: bifurcation lesion, coronary angioplasty, coronary stenting.

128 patients of essential hypertension were examined with the help of ultrasound Doppler to measure speed of blood flow and vessels diameter on the heart, aorta, cubital arterial level. Traditional and new hemodynamic criterias have been determined. According to the test results three groups of patients were defines. The first one consisted of 98 (76,5%) patients who had normal or low cardiac output, cubital arteries over blood, low vessel resistance in cubital arteries and high general vessel resistance. The second group included 13 (10,2%) patients with normal or low cardiac output, a low amount of blood flow in cubital arteries, normal resistance in cubital arteries and high general vessel resistance. The third group included 17 (13,3%) patients on the initial stage of the disease, high cardiac output, low blood flow and high vessel resistance in cubital arteries and low general vessel resistance. According to the results blood distribution is important for the process of essential hypertension pathogenesis variants forming. Both central and peripheral blood regulation flow mechanisms take an active role in blood flow distribution. 

113 healthy subjects with normal blood pressure and 26 patients with essential hypertension (BP 140-159/90-99 mm Hg) were inspected by echocardiography. All subjects were divided into 5 groups according to the blood pressure (BP) level. Diastolic and systolic left ventricular volumes were comparable at subjects with different BP-level. Diastolic and systolic left ventricular walls thickness and left ventricular mass (LVM) were larger in subjects with BP >130/85 mm Hg. Correlation analysis showed that the LVM increase correlated with the increase of systolic and diastolic BP, and with right cardiac cavities and left atrial diameter increase. It was found indirect sighs of left ventricular diastolic function decrease (in normal limits), and smaller systolic left ventricular walls thickening in subjects with BP-level >130/85 mm Hg. 

The aim of the study was to estimate the effectiveness of transesophageal electrophysiologic assay in diagnostics of paroxysmal nodal reciprocating tachycardias compared to intracardiac electrophysiologic assays and working out treatment strategies in patients with supraventricular paroxysmal tachycardias.

We have studied 100 patients with nodal reciprocating tachycardias. Diagnostic transesophageal stimulation was performed in all, and intracardiac electrophysiologic assays to elaborate the nature and mechanism of tachycardias in 85. Effective antiarrhythmic treatment was adjusted by using transesophageal electrophysiologic assays. Series of tests supposed the usage of all 4 classes of antiarrhythmic drugs.

Comparative analysis of the data obtained showed the in most cases there was no reliable difference between anterograde functional and effective refractory periods of various parts of the conductive system, as measured by transesophageal and intracardiac electrophysiologic assays. We have worked out principal electrophysiologic criteria of diagnosing paroxysmal nodal reciprocating tachycardias based on transesophageal assays.

Individually effective antiarrhythmic treatment was managed in 96% cases. Class I drugs proved most effective (in 70% patients), and propranolol had the best individual result in the daily dose of 20-40 mg (in 50% patients). 

QT duration and variability, as well as RR dispersion are considered noninvasive tools for identifying persons prone to life-threatening ventricular arrhythmias and sudden death. Under the auspices of the WHO ”Monica” project in Novosibirsk a representative sample of unorganized male population aged 25 to 64 was evaluated by standard epidemiological methods. Fatal endpoints were established by retrieving sample cases from the overall morality register. Resting ECG was analyzed in a blinded mode (in respect to the other studied data) with the Minnesota criteria. QT and QTc duration and dispersion were measured manually in addition, as well as the temporal parameters of RR variability. Threshold prognostic indices were calculated through a combination of ROC analysis (search for “separation points” on the characteristic curve) and “survival” estimation methods (Cox model, Gehan’s Wilcoxon test, Kaplan-Meier curves) The indices developed (QTc and QTc max >=420-440 mses, DQT and DQTc>=60 msec, SDNN<=20 msec) outline persons with 2 to 3-fold increased risk of all causes death and 4 to 5-fold increased risk of cardiovascular death.

The study includes 25 patients with arterial hypertension (AH) and 25 patients with non-insulin dependent diabetes mellitus (NIDDM) combined with AH. All patients, at baseline and 2 weeks following treatment with enalapril maleate (Enam, Dr.Reddy’s Laborotories Ltd., India), general clinical examination as well as measurement of blood glucose, cholesterol, lipoproteins, triglycerides; conventional echo and evaluation of vasomotoric function of endothelium by D.S. Celermajer’s method. We have shown that even with blood pressure decreasing to the same levels, endothelium-dependent relaxation improved best in the group with NIDDM whereas LV diastolic function dynamics did not differ significantly; those changes having strong correlation to the levels of serum lipoproteins and triglycerides. The results suggest enalapril maleate not just a nephropotective measure in patients with AH and NIDDM, but also as a medication for heart protection in such patients. 

Life quality in patients with terminal chronic renal failure and nephrogenic arterial hypertension on dialysis.

A limited variety of hypotensive drugs is recommended for the treatment of I class hypertensive crises, requiring rapid action, high efficacy and having appropriate formulations available (sublingual or parenteral forms. Among β- blockers III generation drugs with additional vasodilative properties have such pharmacodynamic properties. A nationalmade αβ-blocker Proxodolol is among them. Proxodolol’s efficacy was studied in 20 in-patients with I class hypertensive crises. The drug had rapid hypotensive effect when introduced intravenously as 1-3 ml (20-30 mg), with the onset of action in 5 minutes and peak in 42,1 minutes. Maximal SBP decrease was 25,1%, DBP – 20,9%. The duration of hypotensive effect reached 3,9 hours in average. Complete hypotensive effect was noted in 17 patients. Proxodolol’s tolerability was good, with vertigo and drowsiness as the most common adverse effects. 

Antianginal and anti2ischemic effectiveness and tolerability of oxicardin in patients with stable angina of I-III functional classes: results of a Russian multicenter Russia.

Comparative study of preventive effects of two beta-blocking drugs with different mode of action was performed on SHRSP and WKY rats. Morphological and functional parameters – blood pressure, endothelium-dependent vascular relaxation, plasma level of nitric oxide stable metabolites (nitrite/nitrate), cardiac hyperthrophy and vascular remodeling were monitored during chronic nebivolol and metoprolol injection in parallel groups of rats. Nebivolol, a cardioselective beta-blocker with ancillary nitric oxide modulating and vasodilating properties exhibited more significant and stable influence on the monitored parameters than metoprolol lacking the nitric oxide modulating activity and more effectively prevented cardiovascular remodeling in experimental hypertension. 

Synergistic action of serotoninergic and cholinergic fibers resulted in augmented vagus heart deceleration when stellate ganglion stimulation was added to vagus nerve stimulation. In such cases expreimental animals developed myocarditis with increased tissue contents of acethylcholine and catecholamines. Blocking S3-serotonin receptors of vegetative ganglia and S1,2 – receptors of the myocardium decreased severity of myocarditis. 

We have studied population’s nutrition in the Republic of Dagestan (Northern Caucasus), taking regions opposite in hypertension prevalence, by method of questionnaires, food samples and measuring sodium and potassium excretion. We have studied 98 patients in high prevalence in region and 83 with low incidence of hypertension.

In the region with low incidence of hypertension protein (p< 0,001), unrefined carbohydrates (p< 0,001) and fiber (p< 0,001) intake was higher, daily sodium excretion was equal to 10,97g NaCl, drinking water was low in mineral contents (120-180 mg/l) and cations ranged as follows: Ca > Mg > Na.

In the region with high incidence of hypertension refined carbohydrates (p< 0,001) and cholesterol (p< 0,001) intake was higher, daily sodium excretion was equal to 24,81g NaCl, drinking water was high in mineral contents (543,01 mg/l) and cations ranged as follows: Na > Ca > K > Mg. 

Possibilities of using a copper vapor laser in the treatment of eye disease.

Arterial hypertension and the most prevalent cardiovascular risk factors (from the XIX Scientific Congress of the International Association of Arterial Hypertension and the XII European Congress on Arterial Hypertension).

Issues of diagnostics, treatment and evaluation of patients with myocarditis.