In total, 76 patients with Functional Class (FC) II-III effort angina and disturbed intraventricular conductivity were divided into three groups, according to intraventricular block localization. Control group included 32 patients with FC II-III effort angina, but without intraventricular block. Dynamic assessment of corrected QT dispersion (dQTc. 24-hour ECG monitoring data) and disturbed local contractility index (DICI. stress echocardiography data) was performed during 2-3-week conservative in-hospital treatment period. Baseline dQTc figures associated with poor prognosis were registered inpatients with right bundle block and anterior left bundle block, with better prognosis in right bundle block. In left bundle block, dQTc was similar to that in patients without intraventricular block. In all groups, there was both baseline and dynamic correlation between dQTc and disturbed local myocardial contractility. Standard conservative treatment resulted in significant dQTc and DICI reduction only inpatients with left bundle block or without any intraventricular blocks.

The article is devoted to the association between long-term chronic heart failure (CHF) treatment and renal function in elderly patients. In total, 80 individuals aged 62-86 years were examined at Day 15-30 after myocardial infarction complicated by CHF. All participants received standard CHF treatment. At baseline, 3 and 12 months later, all patients underwent clinical examination, with CHF functional class (FC) identification, echocardiography, renal function and heart rate variability (HRV) measurement. Two groups were identified: Group 1 (n=51), with nephroprotective effect observed, according to glomerular filtration rate (GFR) and microalbuminuria (MA) data; Group 2 (n=29), with nephronegative effect of CHF therapy, manifested in deteriorated GFR and MA parameters. In patients with MI and CHF, renal dysfunction predicted poor cardiovascular prognosis. CHF therapy effectiveness in the elderly was influenced by nephrotropic action of basic treatment. Decreased or disappeared MA, normalized GFR by the end of Week 12 predicted good or satisfactory clinical effects.

The study included 15 patients with coronary heart disease (CHD), post-infarction cardiosclerosis, and chronic left ventricular (LV) aneurysm. All patients underwent interventional myocardial revascularization and Dor aneurysmectomy. Myocardial scintigraphy with ^99mTc-MYOVLEW was performed at baseline (during nitroglycerine test and at rest), and 3-4 weeks after revascularization (at rest). According to baseline scintigraphy at rest data, 35% of the segments were hypoperfused, and in 20% the agent did not accumulate. After sublingual nitroglycerine administration, hypo- and non-perfused segment percentage reduced to 24%> and 11%, respectively, after revascularization - to 24% and 11%. Single-photon emission computed tomography with ^99mTc-MYOVLEW, combined with sublingual nitroglycerin test, identifies viable myocardial zones in post-infarction LV aneurism area and might be used for predicting post-rev ascularization LF function recovery. Статья написана при поддержке Регионального общественного фонда содействия отечественной медицине

The article is devoted to associations between hyperhomocysteinemia and intravascular hemostasis disturbances in myocardial infarction (MI) patients. The role of these disturbances in post-MI angina and recurrent MI development is analyzed. Fifty-seven MI patients who underwent systemic thrombolysis were examined. Hyperhomocysteinemia was registered in 16 participants (28%); mean homocysteine level was 21,55±10,26 mkmol/l. Homocysteine concentration correlated significantly with total cholesterol level and platelet aggregation. Inpatients with hyperhomocysteinemia, natural anticoagulants activity was reduced. The data obtained are consistent with the hypothesis that hyperhomocysteinemia is a marker of poor outcome in MI patients.

Clinical course of acute myocardial infarction (AMI), associated with arterial hypertension (AH), is characterized by restricted infarction size and frequent pericarditis complications. The most important risk factors for AMI and AH combination are hypercholesterolemia, overweight status, and diabetes mellitus, as well as cerbrovascular pathology and chronic cholecystitis. Acute and chronic heart failure rates were similar in AMI with or without AH.

In 95 patients with arterial hypertension (AH), left ventricular (LV) and brachial artery (BA) remodeling, as well as parathyroid hormone (PTH) level, was studied. Increased PTH level was associated with more prevalent and manifested LV and BA remodeling, and with decreased diastolic function and endothelium-depended vasodilatation. In 21,6% of AH patients, asymptomatic PTH hyper-secretion was registered. In these individuals, pathological types ofcircadian blood pressure profile were typical.

The study investigates the correlation between structure-geometrical cardiac remodeling and bone mineral density (BMD) in essential arterial hypertension (EAH). The study included 158 Stage I-II EAH patients and 50 healthy controls. All participants underwent echocardiography and osteodensitometry. In climacteric EAH women, reduced BMD was associated with adverse, concentric remodeling variant - increased myocardial mass index and relative left ventricular wall thickness (r=-0,49; p=0,0014 and r=-0,62. p=0,0001, respectively). Including BMD measurement into EAH diagnostic algorithm provides additional benefits for individual total cardiovascular risk assessment in climacteric women.

In total, 15 patients with nоn-differentiated connective tissue dysplasia (CTD) and white coat hypertension (WCH), 10 WCH-free individuals, and 10 healthy volunteers aged 18-30 years were examined. CTD and WCH patients had greater body weight and body mass index than DCT individuals without WCH. CTD and WCH combination was associated with increased levels of adrenalin and ADP-induced platelet aggregation, endothelin-1, as well as with reduced 6-keto-prostaglandin F_1α (6-keto-PGF_1α) concentration. In CTD without WCH, collagen-induced platelet aggregation and Willebrand factor activity were decreased.

In 34 women with stable coronary heart disease (CHD), heart rate variability (ИВУ) and trans-esophageal atrial stimulation parameters were examined after the first atrial fibrillation (AF) paroxysm. Prognostic value of these parameters in recurrent AF paroxysm risk assessment was investigated. In patients with recurrent AF paroxysm developed in the next 6 months (Group 1), HRV parameters were significantly increased, and AF paroxysm >15 s was induced by trans-esophageal stimulation in 50% of the subjects. In Group 2 (sinus rhythm lasting for 6 months), this rate was 14,3% only. HRV parameters and AF paroxysm induction in trans-esophageal stimulation could be used for recurrent AF paroxysm risk assessment.

In 98 coronary heart disease (CHD) patients, who underwent complete myocardial revascularization, the effectiveness of anti-aggregant therapy with aspirin and thienopyridines, as well as cell hemostasis parameters, were evaluated in the first post-intervention year. Platelet aggregation was assessed with turbidimetric method, using ADP di-Na salt. Treatment effectiveness was assessed by end-points (death, myocardial infarction, recurrent angina, re-intervention). Statistical analysis was performed with Excel 7.0 program pack. Stable inhibition of platelet function was achieved with thienopyridine treatment. Low functional platelet activity was associated with reduced risk of adverse events in CHD patients who underwent bypass surgery, without significant difference between aspirin-sensitive and thienopyridine groups (p=0,176). Adverse event risk was increased in late post-intervention period among patients with normo- or hyper-aggregation cell hemostasis, who received aspirin monotherapy. Therefore, aspirin is effective for secondary prevention after bypass surgery, but its routine administration is not recommended when no cell hemostasis effect is observed.

The study is focused on comparative effectiveness of myocardial cytoprotectors in chronic heart failure (CHF) treatment. In total, 120 patients with Functional Class (FC) II-III CHF were divided into two groups. For 60 days, Group I received mildronate, 1.0 g/d, Group II - preductal MV (trimetazidine), 60 mg/d, in addition to standard treatment. Control group received standard treatment only (n=20). Clinical examination was performed at Days 1, 14, and 60. Therapy effectiveness was assessed by subjective, objective, laboratory and instrumental data dynamics. In mildronate group, the parameters assessed had improved significantly, comparing to control and preductal MV groups.

Detailed, age-specific information on primary cardiovascular disease-related disability dynamics in Russian Federation is presented for 12-year period (1994-2005), including data on coronary heart disease and cerebrovascular disease-related disability. Pensioners are prevalent in primary disabled population, and their percentage grew in 2004-05, due to increased number of Medico-Social Expertise Bureau (MSEB) applications since the Federal Law No. 122-FL on health benefits monetarization was launched (22.08.2004). This information is most useful for the Russian ministries and departments working with primary disability problem.

The authors analyzed NO-synthase expression in white mice exposed to chronic immobilization stress and receiving intraperitoneal 2-ethyl-6-methyl-3-hydroxypyridine succinate (EMHPS). Immune-hystochemical analysis of left ventricular myocardium was performed by standard method, with primary inducible NO-synthase isoform antibody use. Inducible isoform expression in cardiomyocytes exposed to EMHPS was significantly lower than in chronic immobilization stress without EMHPS administration.

Psycho-active substance (PAS) abuse results in morpho-functional disturbances of various organs and systems. Cardiovascular pathology (CVP) is prevalent in visceropathy structure among PAS-dependent individuals. Based on literature data, an attempt to systematize specific and non-specific factors, affecting CVP pathogenesis in PAS abuse, is made.