2019, volume 15

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.

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.

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.

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.

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.

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.

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.

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.

The purpose of the study is to conduct comparative analysis of personal psychological characteristics of medical university students and doctors of a therapeutic profile to determine possible risks of developing psychosomatic diseases with subsequent recommendations for conducting personalized psychological correction of the revealed changes. Material and Methods. To achieve this goal 44 medical students (group I) and 36 doctors working in hospitals of the city (group II) were examined using the self-assessment С Spielberger — Y Khanin' anxiety scale, E. Heim's method of stress-coping behavior, and S. Dellinger's psychogeometric test. Results. It was revealed that the members of both groups had high levels of personal anxiety and were adaptive in the emotional coping sphere. Representatives of group I were distinguished by the presence of predominantly non-adaptive reactions in the cognitive sphere, however, they were constructive in designing stress-overcoming behavior proper, in contrast to representatives of group II. Medical university students were characterized by inconsistency of intrapersonal traits. Conclusion. Thus, it is advisable to recommend psychological correction of the revealed changes, i. e. to reduce high level of anxiety in both students and doctors; to increase adaptability among students in the cognitive sphere and among doctors in the behavioral sphere; to resolve intrapsychic conflicts in students to improve psychosomatic pathology prevention.

The purpose of the study is: to conduct comparative analysis of personal response characteristics in patients with stable and unstable forms of coronary heart disease, depending on the presence or absence of acute coronary disaster in their history. Materials and Methods. 94 men and women with an established diagnosis of coronary heart disease (CHD), aged 38 to 55 years were examined. All individuals under study were divided into 4 groups: two groups with stable forms of angina pectoris, and two groups with unstable angina pectoris, depending on the presence or absence of myocardial infarction history. The following tools were used to determine personal response characteristics in CHD patients: abbreviated multifactor personality questionnaire; Toronto alexithymic scale and psycho- geometric test. Re-sults. It was found that patients with coronary artery disease had a high level of neurotization, alexithymicity, conformity, pessimism, and low self-esteem, along with sociability, friendliness and desire to avoid conflict situations. Neurotic tendencies, alexithymicity and decreased activity were most pronounced in patients with history of acute coronary catastrophe (p<0.05). Conclusion. The results of the study determine advisability of including the methods of psychological correction of revealed changes in the complex of measures for secondary prevention of cardiovascular events in patients with various forms of coronary heart disease based on a personalized approach.