The levels of soluble CD40L (sCD40L) and other inflammatory and thrombotic markers were studied in coronary heart disease (CHD)) patients with or without Type 2 diabetes mellitus (DM-2). In total, 56 patients with various CHD forms, as well as 10 healthy volunteers, were examined. In 12 patients, CD-2 was diagnosed. In all participants, the levels of high-sensitive С-reactive protein (hsCRP), fibrinogen, tumor necrosis factor-alpha (TNO-alpha), pregnancy-associated plasma protein A (PAPP-A), soluble vascular cell adhesion molecule-1 (s VCAM-1), and sCD40I were measured. Inpatients with CHD and DM-2 (Group I, n = 12), sCD40I levels were significantly higher than in CHD patients without DM-2 (Group II, n = 44), or control group: 3,07 ± 2,03, 1,72 ± 1,54, and 1,05 ± 1,07 ng/ml, respectively (p < 0, 05). Other marker levels were similar in Groups land II There was no significant sCD40I level difference among subgroups with various CHD forms. Among other cardiovascular risk factors, sCD40L levels correlated significantly with plasma triglyceride levels (p = 0,028; r = -0,301). CHD patients with DM-2 demonstrated significantly higher sCD40L plasma levels, in comparison with diabetes-free CHD patients or healthy individuals, regardless of CHD form or main cardiovascular risk factors.

The interaction of coronary atherosclerosis severity, according to coronaroangiography data, and 24-hour electrocardiography (ECG) monitoring parameters, qualitatively and quantitatively characterizing transient myocardial ischemia, was investigated in 294 coronary heart disease (CHD) patients with various types of painless myocardial ischemia (PMI; P.F. Cohn). Among CHD and PMI patients, the majority demonstrated PMI and angina combination (59, 9 %), with lower prevalence of PMI and post-infarction cardiosclerosis (23, 8 %), or PMI only (16,3 %). Maximal coronary pathology severity, correlating with maximal QT interval dispersion (QTd) and total myocardial ischemia duration, was observed inpatients with PMI ad post-infarction atherosclerosis.

With a questionnaire «Arrhythmic Patient's Life» (APL), quality of life (QoL) dynamics was investigated in 54 patients with non-valve atrial fibrillation (AF), after radio-frequency ablation (modification) of atrio-ventricual node and pacemaker implantation. In patients with drug treatment-resistant arrhythmia, QoL improved after the surgery. Positive dynamics was observed in QoL aspects reflecting AF clinical severity, psycho-emotional status, and night sleep quality. According to APL questionnaire, QoL in AF patients was mostly affected by arrhythmia symptoms, deteriorated psycho-emotional status and night sleep, as well as the need for permanent and possibly costly treatment.

The article is devoted to complex assessment of several clinical and instrumental parameters inpatients with calcificated degenerative aortal stenosis (CDAS) of varying severity. The main group included 101CDAS patients, the control group - 32 individuals with coronary heart disease (CHD)) and / or arterial hypertension, but without aortal valve pathology, according to echocardiography data. Aortal stenosis progression was associated with increased prevalence of angina pain syndrome, paroxysmal night dyspnoe, vertigo, atypical systolic murmur, and aortal regurgitation. Hotter monitoring demonstrated myocardial ischemia in 32, 6 % of CDAS patients, and stair test - in 66, 6 % (painless ischemia in 57, 6 % of the cases). Physical stress tolerance decreased as aortal stenosis severity increased.

The aim of the study was to identify predictors of physical training (PT) hypotensive effects inpatients with Stage I-II arterial hypertension (AH). In total, 74 patients were examined. In 35 (47 %), substantial hypotensive PT effect was registered, and in other 39 (53 %), it was not observed (Group II). At baseline, in Group I, higher mean diastolic and mean hemodynamic blood pressure (BP), pressure load indices, as well as more manifested left ventricular (IV) diastolic dysfunction, and cerebral blood flow auto-regulation disturbance, taking into account metabolic and myogenic reserve ratio, were observed. In Group II, with inadequate hypotensive PT effect, middle cerebral artery (MCA) area resistance was more increased. Similar results were obtained while developing a diagnostic scale. Therefore, hypotensive PT effect predictors were AH severity, IV diastolic dysfunction, unchanged MCA peripheral resistance indices, and decreased metabolic reserve of cerebral blood flow auto-regulation.

Ninety arterial hypertension (AH) patients were divided into three groups, by AH severity. Levels ofiMg, Ca, Cu, Zn, Fe, pro- and antioxidant blood activity (POA, AOA) were measured. Various disturbances, defined as «combined biometal dysbalance syndrome» were diagnosed. POA and AOA dynamics correlated with microelement (ME) status. Hypozincemia was caused by Zn reserve deficiency and myocardial accumulation. Increased Fe levels, correlating with AH stage, confirmed Fe metabolism cumulative theory. Active ME role in АО defense and AH pathogenesis was observed.

Ninety arterial hypertension (AH) patients were divided into three groups, by AH severity. Levels ofiMg, Ca, Cu, Zn, Fe, pro- and antioxidant blood activity (POA, AOA) were measured. Various disturbances, defined as «combined biometal dysbalance syndrome» were diagnosed. POA and AOA dynamics correlated with microelement (ME) status. Hypozincemia was caused by Zn reserve deficiency and myocardial accumulation. Increased Fe levels, correlating with AH stage, confirmed Fe metabolism cumulative theory. Active ME role in АО defense and AH pathogenesis was observed.

So far, electrocardiostimulation (ECS) problems, and their regional solutions, have been inadequately described. Therefore, the aim of this study was to investigate short- and long-term ECS results in patients of Saransk City and Mordovia Republic regions; to search for methods improving end-points in these patients. The study included 51 ECS individuals who underwent pacemaker implantation at Saransk City Clinical Hospital No. 4 (1996-2004). Questionnaire survey and clinical follow-up methods were used; ECS concept was reviewed: intervention indications, short- and long-term complications, their diagnostics, treatment and prevention; recommendations for controlling the problems identified were developed. Unfortunately, Russian standards of diagnostics, treatment (including surgery), and out-patient follow-up of such patients have not been created yet. Organizing a Saransk branch of Research Institute of Transplantology and Artificial Organs, including a modern telemedicine complex, might be an optimal regional-level solution for these problems.

The aim of the study was to assess cardiovascular disease (CVD) prevalence in climacteric women with knee osteoarthrosis (OA) and joint functional deficiency. The case-control study included 117 women with clinical and X-ray signs of knee OA. The control group included 117 OA-free women. Anthropometry, lipid metabolism parameters, prevalence of arterial hypertension, coronary heart disease (CHD)), chronic heart failure, acute stroke and transient ischemic attack were assessed. Women with OA had greater body mass index, waist circumference, climacteric syndrome severity, and decreased levels of high-density lipoproteins. Knee OA was associated with increased prevalence of AH (odds ratio, OR,2,18; 95 % CI 1,24-3, 84), metabolic syndrome (OR = 3, 44; 95 % CI 1, 95-6, 07), and stable effort angina (OR = 2, 47; 95 % CI 1, 08-5, 69). In all climacteric women with OA, individual cardiovascular risk should be assessed.

The article is devoted to prolonged calcium antagonist, Cardilopin, effectiveness in patients with severe thoracic scoliosis, complicated by pulmonary hypertension and right ventricular diastolic dysfunction (RVDD). The study involved 43 patients aged 18-39, with Stage TV scoliosis diagnosed in childhood. According to Doppler echocardiography data,24 participants had pulmonary hypertension, RV hypertrophy and dilatation, Type 1 RVDD. These patients received Cardilopin (amplodipine, Egis, Hungary),5mg/d, for 12 weeks. Monthly control of pulmonary artery blood pressure (PA BP) demonstrated that the tendency towards mean PABP decrease manifested as early as by the end of the first month, lasting till the end of the study. Moreover, RV size and anterior wall thickness tended to decrease, and RV diastolic function - to improve. Therefore, Cardilopin could be used for pharmaceutical correction of pulmonary hypertension and morpho-functional RV abnormalities in patients with severe thoracic scoliosis.

The aim of the study was to assess therapeutic effects offosinopril on intravascular platelet (PL) activity inpatients with arterial hypertension (AH) and metabolic syndrome (MS). Thirty-three patients received fosinopril (10 mg/d) for 4 months. Dynamics of anthropometry and lipid profile parameters, plasma and PL lipid peroxidation, blood and PL anti-oxidant activity, intravascular PL activity were assessed. Ln AH and MS patients, fosinopril improved peroxidation syndrome and intravascular PL activity. Long-term fosinopril treatment could strengthen this beneficial effect. To reduce body mass in AH and MS patients, fosinopril should be combined with non-pharmaceutical interventions.

The authors studied N-terminal pro-brain natriuretic peptide (N-proBNP) role in 43 essential arterial hypertension (EAH) patients, as well as antihypertensive therapy effects on N-proBNP. N-proBNP levels were independent of gender or age. ACE inhibitor spirapril significantly decreased N-proBNP level, while calcium antagonist nifedipine and beta-adrenoblocker metoprolol did not affect it.

Coronary heart disease (CHD) remains an actual problem in cardiology. One of the leading causes of CHD patient death is sudden cardiac death (SCD). In CHD patients, individual SCD risk varies substantially. According to modern views, instrumental methods play an important role in adverse outcome risk assessment. T wave alternation (TWA) and heart rate turbulence (HRT) are relatively new, non-invasive tests, providing valuable information on life-threatening arrhythmia risk in CHD patients. Comparing prognostic value of already known stratification tests to that of TWA and HRT, the authors demonstrated substantial clinical importance of the new methods.

Metabolic syndrome, or insulin resistance (IR) syndrome, including abdominal obesity (АО), atherogenic dyslipidemy, arterial hypertension (AH), Type 2 diabetes mellitus, DM (or impaired glucose tolerance) etc., is a major cardiovascular threat. Cardiovascular disease remains on the first place in mortality and morbidity structure in economically developed countries. IR and resulting compensatory hyperinsulinemia, are pathogenetically linked to AH development in DM and АО. Modern data on pathogenetic interaction between AG and IR, renin-angiotensin-aldosterone system (RAAS) role in AH and IR development, RASS inhibitor (in particular, ACE inhibitor lisinopril) benefits are presented in the article.