To assess the role of left ventricular (LV) diastolic dysfunction (DD), autonomous nervous system (ANS) and P wave changes on ECG, reflecting heterogeneous myocardial repolarization and LV hypertrophy (LVH) in arterial hypertension (AH), the results of echocardiography, Holter monitoring and P wave dispersion analysis were compared in 47 AH patients and 15 controls. Cardiac rhythm disturbances were assessed separately for impaired relaxation and restrictive variants of DD. Most arrhythmias were typical for restrictive DD only, which could be explained by greater atrial and ventricular myocardial changes in this group. These patients were also characterised by severe ANS dysfunction, manifested in increased sympathetic activation and reduced vagal influence, as well as in predominant central regulation of heart rate. Restrictive DD was also associated with substantial increase in P wave dispersion, reflecting heterogeneous repolarization in atrial myocardium. Consequently, arrhythmia risk in patients with AH and LVH is mostly related to electro-mechanical heart remodelling and ANS dysfunction.

The study included 80 patients with chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) at Day 25-30 after myocardial infarction. All patients underwent clinical examination with CHF functional class identification, echocardiography, 24-hour electrocardiography monitoring, pulmonary and renal function evaluation, and quality of life assessment. Among patients with CHF and COPD, comparing to patients with intact pulmonary function, angina attacks, cardiac arrhythmias and tachycardia were more prevalent, as well as reduced left ventricular systolic and diastolic function and disadaptive myocardial remodelling. In CHF patients, pulmonary dysfunction affected nitrogen-excretory and filtration renal function and aggravated intra-glomerular hypertension.

The interaction between intercellular adhesion molecules, pro-inflammatory cytokines as apoptosis agents, and lymphocyte receptors was studied in patients with arterial hypertension (AH) and metabolic disturbances. The study involved 85 AH patients: Group I (AH and obesity, O), Group II (AH, O, and insulin resistance, IR), Group III (AH only). Integral leukocyte indices, intercellular and vascular wall adhesion molecules (ICAM-2, VCAM-1, p-selectin), lymphocyte receptors (CD16, CD25, CD95), pro-inflammatory cytokines (IL-в, IF-г, TNF-б), carbohydrate and lipid metabolism parameters were studied. Increased expression of soluble adhesion molecules sVCAM-1 and sp-selectin was observed in all AH patients, especially in Group II. Decreased levels of apoptosis initiators, CD16+(NK) and CD25+ lymphocytes with high expression of Fas-receptors (CD95) which activate neutrophil apoptosis, were observed, as well as a 2-5-fold increase in TNF concentration - a key factor in inflammation and apoptosis induction. Massive cell death and lipid accumulation is one of the main morphologic characteristics of atherosclerotic plaque, highly prevalent in patients with AH, O, and IR. Intercellular adhesion molecule expression could be regarded as endothelial cell apoptosis predictor.

Prevalence and magnitude of carotid arteries (CA) and abdominal aorta (AA) atherosclerosis, together with endothelial vasculo-reactive function (EVRF), were investigated in 147 patients with overweight and obesity and 27 controls. Manifested CA and AA atherosclerosis was observed in overweight and obese participants, but not in controls. Atherosclerotic CA and AA changes were related to body mass index, gender, age, arterial hypertension and lipid profile. EVRF was disturbed in 86 % of overweight individuals and in 94 % of obese patients.

To assess high-definition ECG potential in evaluating the effectiveness of surgery in Wolff-Parkinson-White syndrome and paroxysmal atrio-ventricular nodal reentrant tachycardia (PAVNRT), as well as to study quality of life (QoL) in these patients, 149 individuals were examined. In total, 61 participants did not have any cardiovascular disease, 45 patients suffered from WPW syndrome, and 43 - from PAVNRT. ECG was recorded in three orthogonal Frank leads. Spectral analysis included fast Fourier transformation and multiple narrow filter usage. All extrema received were divided by frequency (low, middle, high) and amplitude (low, high). Extrema ≤40 microvolt were classified as low-amplitude (LA), >40 microvolt - as high-amplitude (HA). Extrema <40 Hz were classified as low-frequency (LF), 40-90 Hz - as middle-frequency (MF), and 90-150 Hz - as high frequency (HF). QoL was assessed by 36-Item Short-Form Health Survey (SF-36) questionnaire. Spectral-temporal mapping could be used for clarifying diagnosis in patients with supraventricular tachycardias.

In total, 25 patients with acute myocardial infarction (MI) and 25 patients with MI and Type 2 diabetes mellitus (DM-2) received an ACE inhibitor zofenopril (zocardis) for 6 months, as a part of their basis therapy. Lipid peroxidation and antioxidant system dynamics, endogenous cytoprotective mechanisms - NO and HSP70 stress proteins - were assessed during first 24 hours after hospitalization, as well as 1 and 6 months after MI. Long-term zofenopril therapy was associated with reduced levels of free-radical lipid peroxidation, due to protective antioxidant enzyme activation and increase in serum total antioxidant activity. The medication also improved the parameters ofprotective HSP70 system and endothelial function.

To investigate antiarrhythmic therapy effectiveness, safety and impact on quality of life (QoL) among patients with symptomatic extrasystolia, a study was performed in 152 individuals, with 140 completing the study. Mean age of the patients was 57 years; 102 patients sufferedfrom chronic coronary heart disease (CHD), 33 - from Grade IIessential arterial hypertension (AH) without CHD. Therapy included propafenone (Propanorm, PRO/ MED.CS Praha a.s.) in the dose of 300-450 mg/d, amiodarone (Cordaron, SANOFIWINTHROPINDUSTRIE), in the initial dose of 600 mg/d, gradually reduced to 200 mg/d, and metoprolol (Egilok, EGIS PHARMACEUTICAL Ltd.) in the dose of 50-100 mg/d. The treatment started in the hospital, followed by out-patient therapy. The follow-up period varied from 12 to 24 months, with mean duration of 18 months. If clinical course improved, antiarrhythmic therapy (AAT) could be stopped, starting again in case of recurrent extrasys-tolia. AAT effectiveness was assessed by Holter ECG monitoring, QoL - by special questionnaires. Assessment took place at baseline, as well as 10-21 days and 12 months after the therapy start. In general, AAT was well tolerated. AAT discontinuation due to adverse effects took place in 11,4 %, 9,5%, and 6,1 % of those receiving amiodarone, propafenone, and metoprolol, respectively. AAT with propafenone, amiodarone and metoprolol was associated with reduction in the extrasystolia number by ≥70 %, 62 %, and 38,2 %, respectively. It was also associated with QoL improvement and reduced anxiety and depression. These changes were maximal and reaching statistical significance in those receiving propafenone and amiodarone, comparing to the metoprolol group. QoL improvement correlated with reduction in extrasystolia number. Therefore, AAT with propafenone, amiodarone, and to a lesser extent, metoprolol, improved QoL in patients with subjective arrhythmia symptoms. The magnitude of this effect depended on antiarrhythmic effectiveness of the medications used. Long-term AAT, in particular, with propafenone and amiodarone, was safe, including patients with chronic CHD.

To assess the angiotensin II blocker effects on platelet (PL) aggregation in patients with arterial hypertension (AH) and metabolic syndrome (MS). In total, 35 patients received losartan for 16 weeks. Dynamics of plasma and PL lipid peroxidation, blood and PL antioxidant protection, and PL aggregation activity was investigated and analyzed using Student t-test. Losartan therapy improved peroxidation and PL aggregation parameters in patients with AH and MS.