То investigate cardiovascular system damage, as well as changes in intracardial and central hemodynamics, a complex clinical, biochemical, and instrumental examination was performed in 563patients (189 men, 374 women aged 19-67years) suffering from Stage I-III primary arterial hypertension, AH (WHO classification, 1997) and hospitalized with hypertensive crise diagnosis. Comparison group included 619 patients (207 men, 412 women aged 25-66 years) with primary AH of similar severity. In the first 1-2 days after hospitalization, clinical, biochemical, and central hemodynamics parameters (by tetrapolar rheography) were examined. At days 3-7, echocardiography, radiocardiography, ophthalmoscopy were performed; at days 18-22, central hemodynamics parameters were re-assessed in some participants. In more than 50 % of the patients with hypertensive crises, crise development was directly linked to stressors, chronic psychological problems, and central nervous system disturbances, manifested in mioconvulsive syndrome. During the crise, central hemodynamics was characterized by hyperkinetic circulation type, increased cardiac output and heart rate, elevated systolic blood pressure (BP) and поп-significant BP gradient for both arms. These features were observed for 2-5 days and disappeared by days 18-22, with one exception - systolic BP elevation. Central hemodynamics changes were not accompanied by differences in the structure of chronic cardiovascular pathology, frequency and type of left ventricular hypertrophy, electrocardiogram changes, and retinopathy progression inpatients with or without hypertensive crises. For participants with frequent crises, thoracic aorta remodeling, retinopathy, increased total peripheral resistance, and high BP gradient for both arms were less typical than for individuals with rare crises.

Hereditary heart connective tissue dysplasia (CTD) is one of the factors aggravating left ventricular diastolic dysfunction progression in working-age patients with myocardial infarction (MI). In individuals with MI and CTD, restrictive and pseudo-normal types of transmitral flow were prevalent, while patients with MI only were characterized by impaired relaxation.

The study was aimed at determining heart pathology features in young and middle-aged patients with metabolic syndrome (MS). In total, 88people aged 35-55 years, with various MS components, were examined. Seventeen patients had three MS components (Group 1), 42-4 components (Group 2), and 29-5 components (Group 3). Left ventricular (LV) electrical myocardial instability and autonomous dysfunction were observed in 16 %, cardiac arrhythmias - in 28 %, and ischemia -in 22 %. Metabolic disturbance severity directly correlated with the number of MS components. LV structure changes manifested in myocardial hypertrophy and increased myocardial mass (65 %), diastolic dysfunction (45 %), and systolic dysfunction (10 %). Therefore, young and middle-aged patients with various MS components demonstrated LV electrical myocardial instability, heart rate variability disorders, ischemic, structural and functional LV myocardial disturbances. These changes were more manifested in patients with more MS components.

Inpatients with arterial hypertension, changes in absolute parameters of autonomous (and hormone, in women) activity were accompanied by development of age and biorhythm-related (circadian, menstrual cycles) desynchronosis between sympathetic nervous system, adrenoreceptor density, and sex hormone levels.

High prevalence and adverse prognosis of chronic heart failure (CHF) justify the need for further investigation of new complex treatment and rehabilitation approaches in these patients. The author assessed effectiveness of multi-disciplinary rehabilitation in patients with ischemic CHF. In total, the study included 255 patients with ischemic CHF I-IV (NYHA). Complex results of psychological correction, training walking courses (hospital and long-term (12 months) programs), with the use of Borg scale, were investigated. In patients with ischemic CHF, positive multi-disciplinary effects of psychological correction and physical training, in regard to psychological status and physical stress tolerability, were registered.

Bioelectrical heart function (BEHF) was assessed in 224 women with various morphological variants of euthyroid nodules (ETN). In control group (n=42), BEHF was studied by standard ECG analysis. In all ETN variants, heart rate and ECG wave amplitude were significantly reduced, and ECG wave and interval duration were significantly increased. In 92. 9 % of the cases, cardiac arrhythmias, blockades, repolarization disturbances were observed; combined disturbance rate was as high as 40, 5 %. BEHF disturbances might be explained by mild peripheral hypothyrosis, as TTG level in ETN (3. 1 mkIE/1) was close to upper norm limit.

The aim of this 20-year study performed at Chelyabinsk Medical Academy, was to develop rhythmocardiography (RCG) method for analyzing sinus rhythm variability (SRV) - the method adapted for practical cardiology settings, together with appropriate hardware/software complex (HSWC), and their approbation for non-nosological diagnostics. RCG method was developed using database including more 45 000 clinical cases and results of 15-year clinical assessment. HSWC was created (APK KAP-RK-01 «MIKOR»), together with the algorithm for SRV analysis, including assessment of inter-systolic interval wave structure in patients with various, primary cardiovascular, pathology. High potential of high-definition CRV analysis in registering multi-variant peripheral dysregulation of pace-maker sinus node activity was shown. Pathogenetical basis for mathematical SRV parameter use in non-specific diagnosis of cardiovascular pathology and somatic disease, was demonstrated.

Vasoprotective effectiveness of atorvastatin and clopidogrel was investigated in 29 patients with duplex scanning-verified carotid atherosclerosis. Clinical and instrumental examination included assessment of lipid profile, endothelial function, intima-media thickness, carotid atherosclerotic plaque volume, serum levels of tumor necrosis factor-alpha (TNF-alpha) and interleukin 6 (IL-6). The study lasted for 24 weeks. Atorvastatin and clopidogrel therapy was associated with improved endothelial vasodilatation, decreased intima-media thickness and atherosclerotic plaque volume, reduced levels of circulation pro-inflammatory cytokines (IL-6, TNF-alpha). Higher levels of the latter were linked to low echo-density atherosclerotic plaques.

Clinical effectiveness of a new Russian antiarrhythmic agent nibentan, Class III, was studied in various supraventricular arrhythmias. In total, 220 patients with atrial fibrillation (AF), atrial flutter (AFl), supraventricular tachycardia (SVT) and frequent supraventricular extrasystoles (SVE) were examined. ECG monitoring and echocardiography data, electrolyte balance and blood biochemistry were assessed. left ventricular myocardial kinetics and perfusion were studied by computed Tc-99 scintigraphy (Siemens-E. CAM camera, two detectors, 90 degree rotation, 16 gates per cardiac cycle; data analysis with 4DM sped program). Nibentan pharmacokinetics and pharmacodynamics, as well as its metabolite levels, were measured with highly effective chromatography-mass spectrometry. Nibentan was highly effective in various supraventricular arrhythmias, without affecting central hemodynamics or left ventricular perfusion. There was a positive correlation between nibentan administration time, its active metabolite detection, plasma Mg level increase, and QTinterval elongation. Conclusion: Nibentan, a new antiarrhythmic agent, is highly effective for supraventricular paroxysmal arrhythmias (AF, AFl, SVT) management. Due to long QT and ventricular tachycardia risk, nibentan should be administered at cardiac resuscitation departments or intensive care units only.

The study is focused on assessing dynamics of left atrium volume and volume index after treatment of paroxysmal or persistent atrial fibrillation (AF), during ACE therapy with lipophilic (n=34) or hydrophilic (n=38) «standard» antihypertensive medications. After sinus rhythm restoration, mechanical dysfunction of left atrium was observed in 95, 8 % of the participants. Standard antihypertensive therapy, including lipophilic or hydrophilic ACE inhibitors, resulted in improved left atrium mechanical function and heart remodeling in 82, 1 %. Hydrophilic ACE inhibitor (Dapril) was no less effective than lipophilic medication (enalapril), being even more effective in terms of duration and dynamics of left atrium mechanical function recovery. Dapril demonstrated high effectiveness, no less than for enalapril, together with minimal adverse event rate (0 % vs 14 %>, respectively). This could improve patients' compliance to persistent medication therapy of the principal pathology.

The authors propose the algorithm for predicting coronary heart disease (CHD) prognosis in healthy people. The principal CHD risk factors include: psycho-emotional stress, arterial hypertension, age over 50 years, dyslipidemia, and type A behavior. Stress factor was observed in more than 90 % of the cases observed. prognostic CHD algorithm could be used for development of effective preventive programs aimed at working-age population.