Saratov JOURNAL of Medical and Scientific Research

2019, volume 15

Terahertz therapy at frequencies of the molecular spectrum of nitric oxide: results and prospects of clinical use

Year: 2019, volume 15 Issue: №3 Pages: 800-806
Heading: Cardiology Article type: Original article
Authors: Parshina S.S., Afanasyeva T.N., Vodolagin A.V., Petrova V.D., Ushakov V.Yu., Kaplanova T.l., Potapova M.V., Ramazanova Z.G.
Organization: Saratov State Medical University, Clinical Hospital "RZD-Medicine", Saratov
Summary:

The purpose of the study is to summarize the results of clinical use of terahertz therapy at molecular spectrum of nitric oxide frequencies (150,176... 150,664 GHz) (THZ-therapy-NO) in cardiology, to identify general regularities and peculiarities of terahertz therapy influence. Material and Methods. We examined 312 patients with angina pectoris (150 patients with unstable angina pectoris, and 162 patients with stable angina of III-IV f. to.). Results. Antianginal effect of THZ-therapy-NO does not depend on the form of angina, sex, age, mode of exposure, hypocoagulation effect of smoking. We identified 2 types of effects of THZ-therapy-NO on hemostasis and blood rheology: active antithrombotic and protective (prevents the development of hypercoagulation shifts against the standard drug treatment). Procoagulant hemostasis is most sensitive to terahertz exposure. Reducing the duration of course exposure leads to expansion of antithrombotic effect by increasing the activity of natural anticoagulants (antithrombin III). Conclusion. Antianginal effect of THZ-therapy-NO does not depend on its hypocoagulation action. Irradiation mode "3/15" is optimal for patients with angina. Mode "2/5" does not have its own antithrombotic effect, therefore it is suitable for patients with angina with a tendency to hypocoagulation. Smoking does not affect the efficiency of the THZ-therapy-NO.

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Assessment of system's adaptive reserves by indicators of heart rate variability in young men at the initial stages of university education

Year: 2019, volume 15 Issue: №3 Pages: 796-800
Heading: Cardiology Article type: Original article
Authors: Olenko E.S., Fomina Е.М., Kirichuk V.F., Kodochigova A.l., Yupatov V.D., Konovalova A.A.
Organization: Saratov State Medical University
Summary:

The purpose of the study is to assess the activity index of regulatory systems and mechanisms of neurohumoral regulation of heart activity in healthy young men at the initial stage of university education. Material and Methods. We studied the activity index of regulatory systems (PARS) and features of the mechanisms of neurohumoral regulation of cardiac activity on a sample of 150 young men [19.0 (18.0; 19.0) years old], based on the analysis of heart rate variability. Results. 40.0% (n=60) of young men had a satisfactory state of adaptive reserves of the body, 23.3% (n=35) were in a state of low functional stress, 24.7% (n=37) had poor adaptation, and 12.0% (n=18) failed to adapt. Conclusion. In male students with satisfactory, tense, and unsatisfactory adaptation, as disadaptation increases, the total effect of all levels of regulation on the heart rate increases with an increase in the effect on the cardiac activity of the parasym-pathetic division of the ANS and a decrease in the activity of cerebral subcortical structures responsible for adaptation, against the background of an increase in psychoemotional stress. In healthy male students, the disruption of systems' adaptive reserves is often accompanied by the total decrease in all levels of regulation with a predominance of sympathetic influences on the heart rhythm and is less frequently associated with a sharp increase in all levels of regulation and the predominance of parasympathetic division of the ANS for the CVS.

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Prospective study of patients with old myocardial infarction: influence of presence or absence of type 2 diabetes mellitus on adherence to treatment

Year: 2019, volume 15 Issue: №3 Pages: 791-796
Heading: Cardiology Article type: Original article
Authors: Naumova Е.А., Bulaeva Yu.V., Semenova O.N.
Organization: Saratov State Medical University
Summary:

The purpose of the study is to conduct a prospective study of patients with old myocardial infarction with the presence or absence of type 2 diabetes mellitus and to identify factors associated on adherence to therapy. Material and Methods. 80 hospitalized patients with old myocardial infarction were included into the study: group one with type 2 diabetes mellitus (50%), group two — without it (50%). Standard clinical, laboratory and instrumental examination, calculation of metabolic indices were performed. 6 months discharge by phone viewed the continuation and regularity of therapy, end points. Results. The results of a study regarding adherence to therapy were evaluated over the phone 6 months after discharge from hospital; factors associated with continuation of therapy are presented. Conclusion. Patients with old myocardial infarction and diabetes mellitus are more adherents to treatment. Increased waist circumference, patient satisfaction with therapy, low rate of re-hospitalization and positive emotional evaluation of aspects of the therapy are factors is associated with high adherence to therapy.

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Low-frequency skin microvascular oscillations: dynamics, synchronization and compliance with changes in vascular tone during the tilt test

Year: 2019, volume 15 Issue: №3 Pages: 783-790
Heading: Cardiology Article type: Original article
Authors: Mironov S.A., Kiselev A.R., Simonyan M.A., Shvartz V.A., Karavaev A.S., Borovkova E.l., Ishbulatov Yu.M., Popova Yu.V., Posnenkova O.M., Gridnev V.I.
Organization: Central Clinical Military Hospital (Moscow), Saratov State Medical University
Summary:

The purpose is to study the dynamics of low-frequency oscillations (LF; basic frequency of about 0.1 Hz) in the spectra of fingerprint photoplethysmograms (PPG), their synchronization with a similar LF-rhythm in cardiointervalo-gram (CIG) and compliance with changes in vascular tone during the tilt test in healthy volunteers. Material and Methods. Synchronous cardiointerval recording, breathing recording, left shoulder rheovasography and PPG records from the palm surfaces of distal phalanges of anonymous fingers were analyzed, as well as central hemodynamics data by impedance rheocardiography in 30 healthy volunteers during the tilt test. Dynamics of LF-oscillations in PPG signals, their interaction (including synchronization) with similar oscillations in CIG and vascular tone parameters were studied. Results. At the stages of tilt test the values of LF-oscillations power in the spectra of PPG had no statistically significant differences. During the tilt test the index of synchronization of LF-oscillations increased (p<0.01). No correlations were found between the power of LF-oscillations in PPG spectra and vascular tone parameters. Conclusion. Absence of significant changes in LF-oscillations power in PPG spectra in the group of healthy volunteers at the stages of tilt test does not correspond to the dynamics of vascular tone parameters, estimated according to rheography data. At the same time, increased interaction between the autonomic regulation subsystems (heart rhythm — distal blood flow) was observed and resulted in the increase of of LF-oscillations synchronization.

Platelet functional pools under pharmacological suppression of aggregation in ST segment elevation myocardial infarction

Year: 2019, volume 15 Issue: №3 Pages: 779-783
Heading: Cardiology Article type: Original article
Authors: Malinova L.I., Dolotovskaya P.V., Furman N.V., Puchinyan N.F., Lipatova Т.Е.
Organization: Saratov State Medical University
Summary:

The purpose of the study is to investigate clinical significance of peripheral pool platelets functional heterogeneity, assessed with combination of collagen and ADP, under pharmacological suppression of platelet aggregation in acute coronary syndrome. Material and Methods. The study involved 374 patients with acute coronary syndrome (ACS). Functional activity of platelets (FAT) was studied on the first, the 7th and 30th days after ACS manifestation in the whole blood by impedance and luminescent aggregometry. The functional heterogeneity of platelets was studied using our own method with an estimate of AAk (functional subpopulation of platelets aggregation (cluster II)), ASk (the functional subpopulation of platelets secretion (cluster II)) and ДА (a parameter of platelets functional heterogeneity). The follow-up period was 24 months after ACS manifestation. Results. In the study sample ADP- and collagen-induced platelet aggregation remained almost constant during the whole observation period. It was established that in patients treated with double antiplatelet therapy parameters of functional platelet heterogeneity statistically significantly decreased by the seventh day of observation: ЛАк 2(0; 3)vs 1 (0; 2) Ohm, p=0,049; AS 0.26 (0.15; 0.47) vs 0.19 (0; 0.26) nmol, p=0.07. The excess of ЛАР measured on the second day after ACS manifestation, a threshold of 2 Ohms, was associated with a significant increase in the 30-day risk of rethrombotic events (HR 1.8; Cl 1.2; 3.1). Conclusion. The dynamics of platelet functional heterogeneity was revealed in patients with acute coronary syndrome treated with double antiplatelet therapy. A high degree of platelet functional heterogeneity in patients with acute coronary syndrome was associated with a significant increase in the 30-day risk of rethrombotic events.

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Tentative analytic biomarker panel of maladaptive myocardial remodeling (systematic review)

Year: 2019, volume 15 Issue: №3 Pages: 773-779
Heading: Cardiology Article type: Review
Authors: Malinova L.I., Denisova Т.Р., Furman N.V., Dolotovskaya P.V., Puchinyan N.Ph., Povarova T.V.
Organization: Saratov Road Clinical Hospital, Saratov State Medical University
Summary:

The purpose is to design a tentative analytical panel of biomarkers (BM) of maladaptive myocardial remodeling/extracellular myocardial matrix dysfunction. eLibrary.ru and PubMed were used for data extraction. Reproducibility of the obtained data was calculated, as well as the intragroup correlations of BM maladaptive myocardial remodeling/extracellular myocardial matrix dysfunction with the clinical phenotype of heart failure (HF) — т. The tentative BM panel design was carried out using the ranking method (R). Analysis included data from 5085 publications. The highest reproducibility was traced in nautriuretic peptides ((3 0.91 and 0.89) and cardiac troponins ((3 0.84), while the highest correlation ratios of BM and the clinical phenotype of CH were detected in natriuretic peptides and ST2 (т 0.81; 0.77 and 0.71). PIIINP and decorin did not reveal any significant correlation with the HF clinical phenotype. A rank of >0.5 was identified in galectin-3, GDF-15, and osteopontin. A set of biomarkers with a proven participation in the pathogenesis of heart failure, which potentially has the greatest diagnostic and prognostic value was designed, i. e. a tentative analytical panel of biomarkers of maladaptive myocardial remodeling/extracellular myocardial matrix dysfunction: NT-proBNP, BNP, cardiac rf-troponins, ST2, GDF-15, galectin-3 and osteopontin.

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Clinical and diagnostic significance of arterial stiffness in the early post-stroke period

Year: 2019, volume 15 Issue: №3 Pages: 769-773
Heading: Cardiology Article type: Original article
Authors: Mayorova S.V., Lipatova Т.Е., Haibekova T.V.
Organization: Saratov State Medical University
Summary:

The purpose of the study is the analysis of neurological functions' restoration in patients with hypertension in the early post-stroke period after ischemic stroke, depending on the parameters of vascular wall rigidity. Materials and Methods. The study included 50 patients with hypertension in the acute phase of ischemic stroke. Clinical, laboratory and instrumental studies were carried out on patients. Vascular wall rigidity was defined using the ankle-brachial index and stiffness index, as well as deficit neurological functions — using the NIHSS, MRS scales. Results. It is shown that high levels vascular wall rigidity is associated with marked shortage of neurological function in hypertensive patients in the early post-stroke period. Conclusion. Accounting indicators of vascular stiffness allow more accurate assessment of prognosis and help to develop personalized treatment strategy in patients with hypertension in the early post-stroke period after ischemic stroke.

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Features of total peripheral resistance and regional vascular resistance in arterial hypertension

Year: 2019, volume 15 Issue: №3 Pages: 763-769
Heading: Cardiology Article type: Original article
Authors: Lukyanov V.F., Kaplanova T.l., Broyaka N.A., Gompassunon O.M. M., Varezhnikova O.V., Potapova M.V.
Organization: Saratov State Medical University
Summary:

The purpose of the study is to conduct comparative analysis of brachial artery's total peripheral resistance and vascular resistance in patients with arterial hypertension. Material and Methods. We applied standard measurement techniques for total peripheral resistance and blood flow parameters of the brachial artery in 128 patients suffering from the arterial hypertension. Results. The peripheral blood flow condition depends on the following indicators: kinetic energy of blood release (Wkin), brachial artery volumetric bloodstream (Vbr) and radius (Rbr), total peripheral resistance (TPR) and peripheral resistance (PRbr) of the brachial artery. Based on these indicators the patients were split into three groups according to pathogenetic variants of the hypertonic disease. Conclusion. The proposed criteria of the bloodstream status allows to verify arterial hypertension pathogenetic mechanisms. It implies personalized approaches to treatment of patients with arterial hypertension.

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Frailty and arterial hypertension (lecture)

Year: 2019, volume 15 Issue: №3 Pages: 757-763
Heading: Cardiology Article type: Lecture
Authors: Lipatova Т.Е., Tyultyaeva L.A., Denisova Т.Р., Shulpina N.Yu.
Organization: Saratov Regional Hospital for Veterans of Wars, Saratov State Medical University
Summary:

The lecture analyses reference data on the problem of combination of senile asthenia and hypertension in elderly and senile patients. It discusses modern views on the possibilities and problems of diagnosis and treatment of patients with a combination of senile asthenia and hypertension.

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Cardiovascular risk factors and arterial stiffness in patients with ulcerative colitis

Year: 2019, volume 15 Issue: №3 Pages: 753-757
Heading: Cardiology Article type: Original article
Authors: Lipatova Т.Е., Mihailova Е.А., Dudaeva N.G.
Organization: Saratov State Medical University
Summary:

Purpose: to assess cardiovascular risk factors and arterial stiffness in patients with ulcerative colitis (UC) without clinical manifestations of cardiovascular diseases. Material and Methods. 76 patients with remission of UC, 40 patients with irritable bowel syndrome and 25 healthy volunteers of comparable age and gender were examined. The 10-year risk of fatal cardiovascular events (SCORE) was calculated. Daily monitoring of arterial stiffness, endothelium function together with its vasodilative, vasoconstrictive and adhesive functions were evaluated in all examinees. Results. Traditional cardiovascular risk factors such as hypercholesterolemia, obesity or hypertension were not typical for patients with UC. Risk SCORE was low in the majority of UC patients. Patients with UC were characterized by the increase of intima-media complex thickness, C-reactive protein level, and by the decrease of HDL cholesterol. UC patients demonstrated the increase of arterial rigidity and endothelial dysfunction which reflected in statistically significant decrease of endothelium-dependent vasodilation to 11.48%, and increase of plasma levels of endothelin-1, vascular adhesion molecules VCAM-1 and ICAM-1. Conclusion. UC patients need multidisciplinary approach to study their arterial rigidity and markers of endothelial dysfunction.

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