Saratov JOURNAL of Medical and Scientific Research

Original article

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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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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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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Health of future and present time doctors from the standpoint of psychosomatic medicine: patterns and paradoxes

Year: 2019, volume 15 Issue: №3 Pages: 749-753
Heading: Cardiology Article type: Original article
Authors: Kodochigova A.l., Olenko E.S., Parshina S.S., Yuranova Yu.V., Puzakov K.K., Zhuk A.A., Subbotina V.G., Pavlishcheva I.D.
Organization: Saratov City Clinical Hospital No. 9, Saratov State Medical University
Summary:

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.

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Distinctive features of psychological status for patients with various forms of coronary heart disease

Year: 2019, volume 15 Issue: №3 Pages: 744-749
Heading: Cardiology Article type: Original article
Authors: Kodochigova A.l., Kirichuk V.F., Sinkeev M.S., Bogdanova T.M., Olenko E.S., Filonenko E.V., Slyusarenko Yu.A., Dolgov A.A., Ilyin A.A.
Organization: Saratov State Medical University
Summary:

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.

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Department of oncology at Razumovsky Saratov Medical University and Kunitsyna Research Society of Oncologists of the Saratov Region: History and Modernity (1968-2019)

Year: 2019, volume 15 Issue: №3 Pages: 721-724
Heading: Scientific schools and memorable dates Article type: Original article
Authors: Vertyankin S.V., Konopatskova О.М., Evdokimov G.M.
Organization: Saratov State Medical University
Summary:

The article is devoted to the activity of SSMU department of oncology and to the history and development stages of research society of oncologists named after T. A. Kunitsyna.

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Dynamics of frequency of alcohol-related fatal automobile trauma in the Saratov region from 2006 till 2017

Year: 2019, volume 15 Issue: №3 Pages: 701-706
Heading: Forensic medicine Article type: Original article
Authors: Savenkova E.N., Efimov А.А., Alekseev Yu.D., Raykova K.A., Avdeeva O.S., Gavrichenko E.P.
Organization: Saratov State Medical University
Summary:

Objective; to analyze of the dynamics of frequency of alcohol-related fatal automobile trauma in the Saratov region over the years 2006-2017. Material and Methods. The study was conducted on the basis of the results of forensic medical examinations of the corpses of persons dead in a car accident in the period from 2006 to 2017 Results. During the study period in the Saratov region slightly decreased the proportion of alcohol intoxication in traffic accidents from 35-40% (2012-2015) to 23.5% (2017). Until 2015, the frequency of alcohol intoxication with trauma in the cabin and pedestrian injury almost did not differ, making up 35-40%. By 2017, the proportion of injured pedestrians with ethanol in the blood more than twice exceeded those affected in the cabin, moreover, the structure of ethanol intoxication in pedestrians is dominated by a concentration of 2.5-3.5%o and more. Along with the decrease in the frequency of ethanol in the blood among drivers (from about 40% in 2012-2015 to 23.5% in 2017), the share of heavy ethanol intoxication decreased, which until 2012 ranged from 33 to 60%, in 2017 it decreased to 25%. The age structure of alcohol-associated automobile trauma has changed: the share of intoxication among persons of 17-30 years has decreased, has increased in age groups of 31-40 years and 41-50 years. Conclusion. During the twelve-year period in the Saratov region in the structure of alcohol- associated automobile trauma there have been positive trends, expressed in a decrease in the proportion of victims in the cabin with the presence of ethanol in the blood, among drivers, and also a decrease in alcohol intoxication among young people. Negative trends should be considered an increase in the proportion of pedestrians with the presence of alcohol in the blood with a predominance of concentration corresponding to a severe degree of ethanol intoxication, increase of the share of ethanol intoxication in older age groups.

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Distinctive features of morphological changes in renal tissue with different models of light desynchronosis

Year: 2019, volume 15 Issue: №3 Pages: 697-700
Heading: Рathophysiology Article type: Original article
Authors: Zlobina O.V., Ivanov A.N., Milashevskaya T.V., Bugaeva I.O.
Organization: Saratov State Medical University
Summary:

Purpose: a comparative analysis of the morphological changes of the kidneys that occur with different models of light desynchronization. Material and Methods. The study was conducted in two stages on 60 white male rats. Model LL 0:24 was studied on the first and second experimental groups, which were in conditions of round-the-clock light exposure for 10 and 21 days. Model LD 18: 6 was studied in the third and fourth experimental groups, which were also in the experimental conditions for 10 and 21 days, respectively. The control group throughout the experiment was in vivo. Results. The recorded decrease in the size of the renal corpus in animals of the third and fourth groups is more persistent and pronounced compared with changes in the first group. The reduction in the area of the vascular glomeru-lus and the expansion of the Shumlyansky — Bowman capsule with round-the-clock illumination are observed only for 21 days, and when studying the 18:6 model, these figures are significantly different from the control values already on the 10th day of the experiment. Also, animals of the third experimental group recorded significant changes in thejuxta-medullary nephrons, which is associated with the activation of collateral blood flow on the 10th day of the experiment. Conclusion. The detected morphological changes indicate a stronger stress effect of the LD 18:6 model, compared with the LL 0:24 model. However, in both experimental groups, the observed changes are ischemic in nature, leading to the development of sclerotic changes, which can adversely affect the work of the kidneys and lead to the development of irreversible changes.

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