Venous blood levels of fatty acids (FA), ATP, and lipid peroxidation products, were examined in heart failure (HF) patients after myocardial infarction. These levels were measured at various stages and in various morpho-functional types ofHF. In more severe HF, FA metabolism was more disturbed, that could be assessed by FA/glycerin coefficient, marker of myocardial insufficiency. In severe HF, ATP synthesis declined, and its level in peripheral blood reduced. By FA/ATP ratio, severity of myocardial insufficiency could be assessed; its greater figures were observed in dilated cardiomyopathy. Hypertrophic morpho-functional HFtype was characterized by less disturbed FA utilization and more pronounced activation of lipid peroxidation. Concentrations of blood biochemical markers, reflecting energy metabolism, correlated with cardiac hemodynamics parameters.

Vasoregulatory endothelial function and dynamics of chronic inflammatory markers were investigated in patients with chronic heart failure (CHF), receiving standard therapy including ACE inhibitors, or ACE inhibitors plus aspirin. One hundred twenty CHF patients were examined at hospitalization (first 24 hours), and 20 and 90 days later, in out-patient settings. All participants were divided into two groups - with II and III functional classes of HF, by NYHA classification. In both groups, there were patients who received aspirin plus ACE inhibitors, or ACE inhibitors only. Vasoregulatory endothelial function and dynamics of chronic inflammatory marker levels were measured in all patients. Among individuals receiving ACE inhibitors, significant decrease in inflammatory marker concentrations was observed by 90 day of the follow-up, together with clinical status improvement. In ACE inhibitors plus aspirin group, no significant decrease of these parameters was registered. Vasoregulatory endothelial function did not change in both groups. Treatment with ACE inhibitors, but not ACE inhibitors and aspirin, was associated with reduction of inflammatory marker levels and clinical status improvement.

Two hundred seven patients with diastolic chronic heart failure (CHF) were examined. Left ventricular (LV) remodeling types were identified in general, and for various functional classes of CHF. Pathophysiology mechanisms of diastolic dysfunction were analyzed. Structural and geometric LV remodeling in CHF was assessed in general and at various CHF stages. Diastolic filling types were analyzed, according to structural and geometric remodeling of left cardiac chambers. Pathogenetic mechanisms of active relaxation disturbance and LV rigidity increase during CHF progression were established.

Hypotension prevalence and severity was investigated in two regimens of streptokinase (SK) administration in acute myocardial infarction (AMI). Group I (n = 17) received intravenous SK, 0.75 mln IE, in 10 minutes; Group II (n = 9) - 1.5 mln IE, in 45 minutes. In bolus SK administration, maximal blood pressure (BP) decrease was comparable to that in slow infusion group, but observed earlier - at minute 7.5 ± 0,4, vs minute 12.5 ± 6.8 (p = 0.003). In Group I, 3 cases of collapse were registered, with little effect from mezaton administration. Significant BPfall could be expected in patients with posterior MI, right wall damage and bradycardia. To prevent severe hypotensive reaction, bolus SK administration should be optimized.

The authors describe differential approach to physical rehabilitation after myocardial infarction, according to autonomous nervous system state. Based on cardiointervalography method, adequacy of various physical rehabilitation regimens was assessed. The authors prove the conclusion that increasing physical activity in myocardial infarction patients requires not only clinical status and ECG dynamics assessment, but also analyzing individual autonomous regulation features.

Correlation between peripheral circulation (PC) disturbances and autonomous regulation of heart function was examined in young men with hypertensive neurocirculatory dystonia (HNCD). The study involved 141 young males, aged 16-21, including 111 individuals with HNCD and 20 healthy participants. Rhythmocardiography method, including cardiointervalography and correlative rhythmography, was used. For PC assessment, upper extremity rheography was performed. Vessel tonus index (VTI), and volume blood flow rate (VBFR) were calculated. In controls, normotensive CP type was registered more often than in HNCD participants; sympathicotonic CP type was observed in HNCP individuals only. Autonomous support (AS) of heart function in HNSD patients was decreased, or provided by sympathic autonomous nervous system.

To study long-term adaptation in adolescents with scoliotic disease, inpatients with various severity of thoracic scoliosis were examined. Lung function tests, physical stress tolerance, physical working capacity were assessed; veloergometry was performed. Patients with mild vertebral abnormalities demonstrated compensatory increase of minute respiratory volume, that was more effective for energy metabolism. Ln stage LV scoliosis, lung tests were abnormal, compensatory reactions of lung function were manifested primarily in increased breath rate, without adequate pulmonary ventilation increase. Physical stress tolerance and physical working capacity were significantly declined in more severe forms of scoliosis. Arterial hypoxemia compensation was associated not with increased heart contractility, but with accelerated heart rate, that was unfavorable for energy metabolism.

The authors studied the influence of peripheral vascular reactivity dynamics on antihypertensive efficacy of beta-adrenoblockers, ACE inhibitors, and calcium antagonists, in hypertensive patients.

The authors studied antianginal and antihypertensive efficacy, safety, and quality of life influence, for a third-generation calcium antagonist, cardilopin (amlodipin; Egis, Hungary) inpatients with coronary heart disease (CHD) and arterial hypertension (AH). In total, 31 patients with stable angina pectoris, silent myocardial ischemia episodes, and associated AH, were examined. General clinic examination, 24-hour monitoring of blood pressure (BP) and ECG, veloergometry, quality of life assessment were performed. After 4 weeks of cardilopin therapy (mean daily dose 5. 5±0. 3 mg), weekly incidence of angina decreased by 52, 2 %, weekly nitroglycerine intake reduced by 54, 5 %, physical stress tolerance increased by 16, 7 %. Four-week cardilopin monotherapy (daily dose 5-10 mg) significantly reduced systolic and diastolic BP, day- and nighttime pressure load, and rate of diastolic BP morning increase in patients with mild to moderate AH, without affecting normal circadian BP rhythm and its variability. Therefore, cardilopin can be administered once per day, without adverse events in morning hours even among patients with riskfactors.

Heart rate variability analysis requires the following: registered rhythm must be sinus one, regular or arrhythmic; cardiac arrhythmias should be diagnosed automatically and interpoled without disturbing RR interval dynamic row. The study included 560 patients: 217 clinically healthy volunteers, 121 patients with acute myocardial infarction, and 222 individuals with chronic coronary heart disease (CHD). Basal rhythms were sinus rhythm (73,7 %), or sinus arrhythmia (26,3 %). Patients with atrial fibrillation, ventricular and supraventricular tachycardia, sinoatrial and AV blockade were excluded. Differential diagnostics of sinus and arrhythmic RR intervals was based on searching the cut-off point, discriminating sinus or non-sinus RR intervals. Similar approach could be applied to identifying shortened intervals between sinus impulse and «noise» artifacts. This gives a chance to cluster sinus and pathologically shortened RR intervals. In automatic assessment of heart rate variability, on cardiointervalograms with extrasystoles and artifacts, effective signal filtration could be performed. Clustering sinus and non-sinus RR intervals can be achieved by analyzing information on adjacent RR intervals. Secondary modification, like RRi/RRi+1, with cut-off point no less than 118, provides optimal balance of sensitivity (94,8 %) and specificity (94,9 %), with utility coefficient 0,89, during diagnosing pathologically shortened RR intervals in sinus rhythm or sinus arrhythmia.

The peculiarities of cardiovascular mortality of patients with type 2 diabetes mellitus and people with impaired glucose tolerance have been studied in Buturlinovka region of Voronezh district between 1993 and 2003. The high cardiovascular death rate of the patients of that category has been confirmed. It has been found that the general mortality rate is comparable with the literary findings. The detected in 2001-2003 tendency to the decrease in cardiovascular mortality of the patients with type 2 diabetes mellitus and impaired glucose tolerance and mortality from infracted myocardium requires the further dynamic observation.