Tо determine principal pathogenetic factors of therapy-resistant arterial hypertension (AH), 41 patients were examined: 1 male and 40 females aged 34-65 years, who suffered from malignant arterial hypertension (MAG). Control groups included 43patients (2 males and 341 females, aged 25-66 years) with Stage I-II AH by WHO-ISH classification (1999), as well as Stage III AH patients (N=45, 2 males and 43 females, aged 34-65 years). Intracardiac and central hemodynamics was assessed by echocardiography, renal function - by renoradiography, dynamic and static renoscintigraphy, and endogenous creatinine clearance. 24-hour extraction of cyclic nucleotides (cAMP and cGMP) was assessed by radioimmune method. Renal parenchimal disorders and vasorenal factors were the leading factors of MAH development. In MAH pathogenesis, various pathogenic factors - renal, vascular, endocrine, metabolic, and neurologic - were combined. All MAH patients demonstrated resistant hemodynamic type, with severe vasospastic reactions of eye vessels, and increased cGMP excretion, a symptom of reduced vasodilatator (NO) synthesis in vascular endothelium.

The study is devoted to high-definition ultrasound assessment of intima-media thickness (IMT), for identifying anatomic atherosclerosis manifestation in adolescents and young people. In total, 65patients (10 females and 46 males) were examined. Analyzing the influence of various cardiovascular risk factors on common carotid and femoral artery IMT, the authors demonstrated that these factors were associated with increased IMT, especially for common carotid artery, as early as in adolescence. IMT was significantly greater in adolescents and young people with stable hypertension, obesity, or metabolic disturbances typical for metabolic syndrome, than in healthy participants.

The study was devoted to circadian blood pressure profile (CBPP) inpatients with arterial hypertension (AH) and chronic obstructive pulmonary disease (COPD). Sixty-four patients with Stage I-II AH and COPD in remission phase, together with 54 COPD-free patients with Stage I-II essential AH, underwent lung function (IF) assessment and 24-hour BP monitoring (BPM). There was no significant difference in CBPP for these two groups. In patients with AH and COPD, CBPP was characterized by "non-dipper" and "night-peaker" patterns associated with high heart rate, that was probably explained by COPD negative impact on AH clinical course. Key words: Arterial hypertension, chronic obstructive pulmonary disease, circadian blood pressure profile.

The article is devoted to familial arterial hypertension (AH) - its clinical features, diagnostic criteria, outpatient treatment, and prognosis. The authors have observed families of AH patients, their relatives, and offspring, for 13 years. According to follow-up results, familial AH is an independent, genetically modified disease manifested at young age.

In 214 males with arterial hypertension (AH), divided into groups according to metabolic disorder quantity, and 45 healthy males, oxidative metabolism of polymorph nuclear leukocytes (OMPL) was assessed by chemiluminescent (CL) method. The possible association between parameters obtained and insulin-glucose parameters was investigated. Metabolic syndrome clustering was associated with non-linear OMPL progression. Stages of leukocyte functional status change were identified and described. Correlations between insulin-glucose parameters and CL indices varied according to metabolic disorders' severity in AH patients. The results support initial, pro-oxidant role of hyperinsulinemia, realized via OMPL increase at early stages of metabolic syndrome development in males.

In obese patients without cardiovascular comorbidity, structural, morphometric, geometric, and systolo-diastolic parameters, as well as variants of structural and geometric left ventricular (LV) remodeling were analyzed. The mechanisms of change for left heart chambers' geometry in obesity are universal for all known processes affecting intracardiac hemodynamics. Therefore, obesity can be regarded as a universal pathologic process, affecting cardiac geometry.

To identify the most informative cardiovascular markers of aging, the association of age and several morpho-functional parameters, assessed by instrumental and laboratory methods, was investigated. Myocardial hypertrophy and left ventricular diastolic dysfunction could be used as cardiovascular markers of aging. Enhanced progression of vascular wall aging correlated with cardiovascular complication development. Vascular aging progression should be assessed for identifying young patients with high risk of myocardial infarction.

The article is devoted to the diagnostics of lipid and lipoprotein disturbances in coronary atherosclerosis among Novosibirsk City males, comparing to general population. The study included 392 males aged 35-70 years. The main group consisted of 87 patients with coronary atherosclerosis, verified at coronaroangiography. The control group was a representative population sample of 305 males. Lipid and lipoprotein profiles, baseline levels of lipid peroxidation products in low-density lipoproteins (LDL), their oxidative resistance, alpha-tocopherol and retinol levels in blood and LDL, were measured. All comparisons were performed after age adjusting. Males with coronary atherosclerosis, compared to control group, demonstrated potentially atherogenic lipid and lipoprotein profile disturbances (p<0.01): significantly increased levels of total cholesterol (CH), LDL CH (+19%), triglycerides (TG) (+86%); decreased high-density lipoprotein (HDL) CH level (-41%); substantially reduced LDL oxidative resistance (-33%; p<0.001), especially for initial LDL oxidation stages (-37%), and decreased LDL levels of alpha-tocopherol and retinol (-40% and -20%, respectively; p<0.01). The results obtained demonstrate that in coronary atherosclerosis, dominant lipid and lipoprotein disturbances include not only increased CH and LDL CH levels, but also increased TG concentration, decreased HDL CH level, and interrelated low LDL oxidative resistance and lipid-soluble antioxidant LDL concentrations. The latter is an evidence of increased atherogenic oxidative LDL modification in vascular wall.

The study was focused on clinical equivalence of two amlodipine medications (cardilopin and norvasc) in patients with Stage I-III arterial hypertension (AH). Forty-two patients (mean age 52.1±3.9years) were divided into two groups, according to cardilopin or norvasc administration. At baseline and 6 months later, echocardiography (EchoCG), Doppler cardiac and vessel sonography were performed. Monthly blood pressure (BP) control demonstrated that BP target level was achieved by the end of Month One and sustained till the study's end, at similar doses of norvasc and cardilopin (5-10 mg/d). By the end of the study, left ventricular (LV) myocardial mass reduced, and prevalence of normal LV geometry increased, with significant improvement in LV diastolic function in both groups. Initially decreased linear blood flow parameters and pulse index, as well as increased extracranial vascular resistance, normalized by 6 months. Hemodynamic parameters were similar in both groups. According to its beneficial influence on initially disturbed hemodynamics, LV geometry and cerebral blood flow in AH patients, cardilopin is as effective as norvasc.

To assess the influence of a metabolic agent, mildronate, on endothelial function in chronic heart failure (CHF) with normal systolic function, 105 patients with I-IIA Stage, II-III Functional Class (FC) CHF, and normal left ventricular systolic function, were examined. CHF developed as a result of II-III Stage essential arterial hypertension, combined with coronary heart disease (CHD): I-III FC stable angina, and post-infarction cardiosclerosis in 13% of participants, aged 45-86 years. Group I included 50 patients receiving basic therapy: ACE inhibitors, beta-blockers, diuretics, vasodilatators; group II - 55 patients who additionally received a metabolic medication, mildronate. Follow-up period lasted up to 30 days. Endothelial function was assessed by brachial artery Doppler sonography (reactive hyperemia test; "Sonos-100" device), and by measuring blood stable pool of NO metabolite - NO2 (biochemical method by Green L.C. et al). CHF patients demonstrated the signs of endothelial dysfunction: decreased plasma concentration of NO; increased N02 level in red blood cells; reduced endothelium-dependent vasodilatation; vasospastic reactions; in 25% of participants, vasoconstrictory reactions in reactive hyperemia test. Basic CHF therapy resulted in disbalanced NO system activation, endothelial hyperstimulation and dysfunction. Adding mildronate to basic therapy resulted in NO system normalization, and endothelial vasoregulatingfunction improvement, that increased treatment effectiveness

The authors studied enalapril therapy perspectives for correction of factors related to arterial thrombosis and inflammatory disturbances development in vascular wall among patients with essential arterial hypertension (EAR). The study included 21 males with Stage II ЕАН, and 17 healthy individuals. Echocardiography, blood rheology parameters, white blood cell functional activity, plasma levels of von Willebrand factor and ICAM, were measured. Next examination was performed after 24-week enalapril therapy (10-40 mg/d). Enalapril therapy was associated with improved blood rheology, decreased white blood cell functional activity and plasma levels of von Willebrand and ICAM, as well as left ventricular hypertrophy (LVH) regression. In EAH patients, long-term enalapril therapy resulted in LVH regression, reduced thrombo- and atherogenesis.

The aim of the study was to identify and compare informative values of combined high-dose dipyridamole stress echocardiography (EchoCG) and pair bicycle stress test, or transesophageal atrial pacing (TEAP), in coronary stenosis diagnostics. In 118 patients, bicycle stress test and EchoCG with dipyridamole, followed by pair bicycle stress test or TEAP, as well as coronaroangiography, were performed. In all participants, combined stress EchoCG was performed with achieving diagnostic criteria. At coronaroangiography, 31 patients did not have coronary lesion signs; 66 had one-vessel lesions, and 21 - multi-vessel lesions. Validity, sensitivity, and specificity of combined stress EchoCG with dipyridamole and pair bicycle stress test or TEAP, were similar: 94.6% and 94.0%, 100% and 96.5%, 95.1% and 100%, respectively. No correlation of test results with gender was observed. To choose the combination of dipyridamole stress EchoCG and pair bicycle stress test, or TEAP, one should take into account individual tolerance to physical stress.

Pathogenetic mechanisms of inter- and intraventricular synchronism influence on chronic heart failure (CHF) progression, as well as cardiac resynchronization (CR) mechanisms, are discussed. CH indications, based on multicenter trials' results, are presented. CR technique and methods ofCR effectiveness assessment are described. CR beneficial effects on clinical status and prognosis in CHF patients are emphasized.