7-year prospective trial in 352 patients with essential hypertension (EH) was performed. The essence of the research was an original complex clinical-instrumental examination of hospitalized patients, with their annual follow-up in out- and in-patient conditions. Two clinical groups were formed: Group 1 - patients with uncomplicated EH (n = 263); Group 2 - patients with EH complicated by myocardial infarction (MI) (n = 89). Prognostic decision was based on disease manifestations at baseline investigation. The final result, reflected in the classification, was MI registered in the 7-year follow-up period. Total prognostic accuracy of the classification, verified in the control group, reached 88. 5 %. IM predictors were: smoking, absence of regular antihypertensive therapy (AHT), increased peripheral vascular resistance, enhanced angiotensin 1 level, advanced left ventricular hypertrophy, with increased end-diastolic volume, low ejection fraction, high level of very low-density lipoprotein cholesterol, and myocardial ischemia during stress tests. Integral index of individual severity, calculated on the basis of prognostic decision rule, gives a possibility to perform the targeted prevention of cardiac complications.

In patients with isolated arterial hypertension (AH) (n = 50), isolated coronary heart disease (CHD) (n = 16), and combination of AH and CHD (n = 43), myocardial perfusion at rest, and its correlation with myocardial function was investigated. The variants of myocardial perfusion (norm, diffuse unhomogeneity, local abnormalities) were nosology-independent. Local perfusion defects were assosiated with left ventricular hypertrophy (myocardial mass no less than 200 g), diastolic dysfunction, and prevailing hemodynamic load. Myocardial perfusion at rest was defined mostly by the level of myocardial stress, with left ventricular myocardial mass and dyastolic function acting as leading factors.

 

This study was conducted to investigate principal structural and functional parameters of left atrium (LA), and to evaluate the effects of combined hypotensive therapy in AH patients. Fifty-eight patients with Stage I and II AH, receving low- and moderate-dose combined therapy, as well as 30 healthy individuals, were examined. All necessary clinical diagnostic procedures, 24-hour ambulatory BP monitoring, ECG, EchoCG were perfomed at the baseline, at 3 and 6 months. Increased reserve volume (RV), LA volume and sizes, LA systolic function, and decreased LA transitory volume (TO) were observed. After 6 months of treatment, BP level, LV myocardial mass (LVMM), LA RV, LA systolic function parameters decreased significantly (p < 0.05), and LA TV increased (p < 0.05), but the latter was still lower than in the control group. Long-term antihypertensive therapy facilitated normalization of LA stucture and function, as well as left venticualr hypertrophy (LFH) regression.

The trial included 56 patients (mean age 51.8 ± 0. 8) with metabolic syndome (MS): arterial hypertension - AH (mean stage of AH 11.45 ± 1.1 yrs), non-insuline-dependent diabetes mellitus (mean stage 6. 7+0. 7 yrs), abdominal adiposity, and dyslipidemia. The control group consisted of 22 patients (mean age 49.27 ± 1.78) without metabolic abnormalities. 24-hour BP monitoring was performed in both groups. AH patients with MS demonstrated abnormalities in daily profile of heart rate (HR) and double product (DP, BPx HR/100) during all temporal intervals (whole day, day- and nighttime). This enhanced hemodynamic load on the heart and facilitated progression of left ventricular myocardial hypertrophy (LVMH). Advanced stage of high BP made MS more severe: Stage III AH patients with MS demonstrated significantly greater increase in systolic BP (SBP) (whole day, day- and nighttime) and SBP variability (whole day, day- and nighttime). Therefore, AH is an important factor in MS pathogenesis and progression.

Recently investigators' attention has been focused on searching psychological and behavioural risk factors for coronary heart disease (CHD), and on perspectives of their modification in primary and secondary CHD prevention. The study included 147 patients with stable effort angina (functional class II-III) older than 55. The main criterion for diagnosing alexithymia and dividing participants into groups was the score greater than 74, by Toronto Alexithymia Scale. All participants were divided into three groups. Group 1 included patients with alexithymia, who received basic treatment for effort angina, together with two-week course of melatonin (M). Group II consisted of alexithymia patients not receiving M. Group III included alexithymia-free patients receiving basic therapy and M. After two weeks of combined M treatment, a significant improvement of all assessed psychological and objective parameters was observed.

This population and clinical study, including so called «golden standard» - coronaroangiography, analyzed the prevalence and ethiopathogenic role of various risk factors for coronary heart disease (CHD) in women under 55. Total number of participants was 121. The main group consisted of 69 women with CHD, another 52 women formed the control group. The prevalence of arterial hypertension, dyslipidemia, thyroid pathology, anemia, gynecologic diseases and other factors was high in both groups. For the factors assessed, their prevalence and role in CHD ethiopathogenesis was analyzed among individuals with undamaged coronary arteries, coronary atherosclerosis, and unspecific changes like distal damage, spiral vessels, and muscle cross-bridges.

The efficacy of compressive-decompressive resuscitation with new device and method in cardiac patients after circulatory arrest was investigated. Comparing to traditional resuscitation methods (Jude J.R., Kouwenhoven W.B., Knickerbocker Y.Y., 1961), efficacy of our original device and methodics was significantly higher. Moreover, it prevented intra-resuscitation traumas of chest osseal components and internal organs.

One hundred one patients with coronary heart disease, aged 28-65, were examined: 23 had a myocardial infarction in anamnesis, another 78 had stable angina (functional class II). ECG, veloergometry (VEM), EchoCG, apex cardiography (ACG), ventriculo- and coronaroangiography were performed in each participant. Nitroglycerin-induced ACG dynamics in 89 patients with coronary occlusion was limited to insignificant reduction in asynergia of systolic wave, atrial complex. In 7 patients with CHD, but intact coronary arteries, nitroglycerin administration caused ACG normalization. Analyzing ACG and coronarography results, high-precision diagnostic coincidence (95 %) was demonstrated.

The aim of the study was to investigate indap hypotensive efficacy, its influence on cardiac structural and functional changes, as well as on vascular tonus autoregulation, among patients with essential arterial hypertension. The participants were 20 patients with essential hypertension, Stage I-II, aged 50,3 ± 6,7. Twenty-four-hour blood pressure monitoring, brain magnetic resonance tomography, heart ultrasonography were performed. Endothelium-dependent and independent vasodilatation of a. brachialis (AB) was measured in reactive hyperemia and nitrate administration tests. After 24-week (6 months) indap therapy, a significant decrease in blood pressure level (24-hour monitoring results) and in left ventricular myocardial mass (from 178,3 ± 49,3g to 165,7 ± 75,1 g, or by 7 %), was registered. The parameters of endothelial vasodilatatory function improved: AB diameter increase rised from 4,3 ± 2, 2 % to 7, 7 ± 4, 2 % (p = 0,002).

The aim of the study was to investigate indap hypotensive efficacy, its influence on cardiac structural and functional changes, as well as on vascular tonus autoregulation, among patients with essential arterial hypertension. The participants were 20 patients with essential hypertension, Stage I-II, aged 50,3 ± 6,7. Twenty-four-hour blood pressure monitoring, brain magnetic resonance tomography, heart ultrasonography were performed. Endothelium-dependent and independent vasodilatation of a. brachialis (AB) was measured in reactive hyperemia and nitrate administration tests. After 24-week (6 months) indap therapy, a significant decrease in blood pressure level (24-hour monitoring results) and in left ventricular myocardial mass (from 178,3 ± 49,3g to 165,7 ± 75,1 g, or by 7 %), was registered. The parameters of endothelial vasodilatatory function improved: AB diameter increase rised from 4,3 ± 2, 2 % to 7, 7 ± 4, 2 % (p = 0,002).

In experiments with isolated hearts from 31 frogs (R. ridibunda), acetylcholine (10^-7, 10^-6, 10^-5g/ml) in a dose-dependent manner reduced contraction amplitude during electrostimulation (30 s, 1 Gz, 5 ms, 5-10 W). The time to achieve maximal amplitude did not change, that meant the serum had negative inotropic effect, weakening chrono-inotropic correlations. Serum from umbilical blood in titer 1 : 100 (SUB-1: 100) did not affect contraction amplitude and chrono-inotropic correlations. But, due to endogenous blocker of M-cholinoreceptors (EMCRB), it decreased myocardial M-cholinoreactivity, demonstrating M-cholinoblocking properties. In particular, the serum shifted the dose-effect curve rightand downward, increasing acetylcholine Kd by more than 3 times. Serum acetylcholine affinity to M-CHR diminished, and M-cholinergic influence on the heart became less effective. The serum decreased acetylcholine potential (10^-7 and 10^-6 g/ml) to weaken chrono-inotropic correlations. In some cases, SUB-1: 100, due to endogenous M-cholinorecepor stabilizer (EMCRS), increased negative inotropic effect of acetylcholine. The nature of EMCRB and EMCRS, together with their possible normal and pathologic role in regulating the heart function, is discussed.