The study aim was a prospective clinical assessment of life-threatening ventricular arrhythmia (LTVA) predictors in patients with ventricular extrasystolia (VE) and no morphological heart pathology. From 1997 to 2002, 199 patients, aged 18-35 years (mean age 27,3±2,6 years), with neuro-circulatory dystonia (NCD) and Lown Class II-V VE, were followed up. All participants underwent general clinical examination and the assessment of late ventricular potentials (LVP), QT interval dispersion (QTd), VE heart rate turbulence (HRT), and potential pathogenetic VE mechanisms. In NCD patients with VE due to early post-depolarization and re-entry mechanisms, VE was a predictor of coronary heart disease (CHD) and arterial hypertension (AH), with positive predictive values (PPV), respectively, of 74% and 44%. If these patients received Class III medications for VE treatment, and/or unstable ventricular tachycardia was developed, the risk of CHD increased up to 93%. In NCD patients with VE due to delayed post-depolarisation mechanism, PPV for gastrointestinal disease (GID) was 61%. For LVP, QTd>80 ms, and pathological VE HRT values, PPV in regard to future CHD, AH, or GID was under 30%. The predictors reflecting the mechanisms of VE development and LTVA risk were highly correlated (r>0,50) with traditional cardiovascular and gastrointestinal risk factors.

The stiffness, elasticity, and endothelial vasodilatation of common carotid artery (CCA), femoral artery (FA) and renal arteries (RA) were examined in 60 patients with arterial hypertension (AH) and obesity, as well as in 20 patients with essential AH (EAH). Comparing to EAH individuals, patients with AH, obesity and insulin resistance (IR) demonstrated reduced elasticity, increased stiffness and early atherosclerotic changes in CCA and FA. Peripheral artery stiffness depended on AH stage, duration and blood lipids. Endothelial dysfunction was linked to metabolic disturbances, as demonstrated by a significant correlation between immuno-reactive insulin (IRI) and reactive hyperemia test for brachial artery (r=-0,238; p=0,04).

Juvenile rheumatoid arthritis (JRA) and juvenile spondiloarthritis (JSA) are chronic auto-immune disorders, characterised by various extraarticular pathology, including heart pathology. The most available non-invasive method for diagnosing asymptomatic myocardial pathology is echocardiography. The study included 185 children with JRA and 43 children with JSA. The systemic JRA variant was characterised by high prevalence of left ventricular (LV) hypertrophy (48,2%), LV dilatation (32,9%), and LV diastolic dysfunction (30,6%) with unaffected systolic function. The respective percentages in the arthritic JRA variant were 11%, 13%, and 15%, which pointed to the need for follow-up and possible diagnosis revision, due to systemic character of the disease. In JSA, reduced total LV contractility was the most prevalent sign (27,9%). To identify the reasons for the latter, further detailed examination was necessary.

The features of pericardial morphology in constrictive pericarditis are described, based on the surgery material, which was obtained from 27 patients aged 5-77 years during pericardectomy. Pericarditis aetiology included infectious, non-infectious, and idiopathic variants. Uniform pericardial morphology was observed in 92,6% of the cases, regardless of pericarditis aetiology. In 70,3%, recurrent or fading inflammation was observed. Productive inflammation involved not only pericardial, but also adipose and myocardial tissues. In all samples, severe degeneration of pericardial receptors and conductive nerves was observed. These morphological features of constrictive pericarditis justify the need for long-term supportive therapy in chronic pericarditis.

The paper presents echocardiography examination results in healthy young people. The prevalence of classic and nonclassic mitral valve prolapse (MVP) is assessed. The prevalence of primary myxomatous MVP is independent of gender or age, while non-classic MVP is more prevalent in younger individuals. The mitral valve morphology is compared to that observed in the Framingham Study. The potential of color Doppler M-ultrasound is assessed for late systolic mitral regurgitation diagnostics in MVP.

The paper focuses on the effectiveness and safety of bi- and monophase defibrillators in patients with paroxysmal atrial fibrillation. In bi-phase defibrillator cardioversion, sinus rhythm was restored more often, and total defibrillation energy was substantially lower than in monophase defibrillator cardioversion. No significant differences in myocardial necrosis markers were observed.

Aim: To assess enalapril and telmisartan effects on hemodynamic parameters and left ventricular (LV) diastolic dysfunction (DD) in patients with coronary heart disease (CHD) and arterial hypertension (AH). Material and methods: In total, 51 men with stable CHD (mean age 57,3+3,4 years) were examined. The methods included general clinical and laboratory examination, 24-hour blood pressure monitoring, Holter ECG monitoring, and echocardiography. Results: In patients with CHD and abnormal relaxation LVDD, telmisartan therapy improved transmitral diastolic blood flow parameters: IVRT increased to 25%, DT – to 13,4%, E/A ratio – to 23%. Diastolic function improvement was associated with decreased LV myocardial mass index (5,6%), reduced circadian duration of myocardial ischemia, increased LV ejection fraction (9,6%), and increased fraction of systolic LV antero-posterior shortening (17,2%). The beneficial effects of telmisartan could be explained by optimised LV relaxation and early and late diastolic filling.

Aim: To assess simvastatin effectiveness in lipid profile and platelet activity correction among patients with arterial hypertension (AH) and dyslipidemia. Material and methods. In total, 34 patients received simvastatin for 4 months. The dynamics of lipid profile, lipid peroxidation in plasma and platelets, blood and platelet antioxidant protection, and platelet activity was assessed. The statistical methods included Student t-test and correlation analysis. Results. Simvastatin corrected dyslipidemia and lipid peroxidation, as well as optimised intra-platelet mechanisms of platelet function regulation, in AH patients with dyslipidemia. Simvastatin also inhibited increased platelet activation in vitro. Conclusion. Long-term simvastatin therapy resulted in stable positive effects among patients with AH and dyslipidemia.

In 35 patients with hypertrophic cardiomyopathy, the effects of ivabradine (15 mg/d) and atenolol (50 mg/d) on physical stress tolerability (veloergometry test results) were investigated. Ivabradine and atenolol therapy was associated with increased test time: +1,5 minutes (p<0,01) and +2,4 minutes (p<0,01), respectively. Both medications prevented angina attacks and paradoxical blood pressure drop during the physical stress test.

In 42-70-year-old Siberian men with coronary atherosclerosis, verified by coronary angiography, the prevalence of metabolic syndrome (MS) was as high as 89%, which suggests an important role of MS in atherosclerosis development in the Siberian region. In pre-existing coronary atherosclerosis, biomarkers of inflammation and destruction (highly sensitive C-reactive protein, inflammatory cytokines, and destructive metalloproteinases) correlated with MS components, reflecting the pathophysiological role of inflammation in MS development.

The paper reviews the input of arterial hypertension (AH) and its complications in 1983-2005 cardiovascular mortality among Astrakhan City citizens. Based on the 22-year follow-up data, the authors analysed the mortality from myocardial infarction (MI) and stroke (S), in regard to anamnestic evidence of AH presence/absence. It was demonstrated that AH was a critical, often fatal, factor in fatal MI and S development. Over 1983-2005, Astrakhan City experienced a significant increase in cardiovascular mortality, similar to that in other Russian regions. Anamnestic evidence of AH was present in over 80% of the fatal cases.

Depressive disorders, accompanying acute myocardial infarction, affect clinical course in post-infarction phase, patients’ functioning and quality of life. Early diagnostics of anxiety and depressive disorders, using special scales and other instruments, helps to identify the patients in need for corrective treatment and, therefore, improves the prognosis of the main disease.