[Left Bundle Branch Block in Unstable Angina. Mortality and Rate of Myocardial Infarction].

AIM: to study mortality and adverse outcomes in patients with unstable angina (UA) and left bundle branch block (LBBB). MATERIAL AND METHODS: We included in this study UA patients with (n=56) and without LBBB (n=310). Period of observation was 14 days (from admission to discharge). The following events were considered as adverse outcomes: death, myocardial infarction, carcinogenic shock, and stroke. RESULTS: Combination of UA with LBBB was associated with increases of risk of death (3.4-fold) and myocardial infarction (2.6-fold), shortening of in-hospital mean duration of life and survival time by 1 day.

[THE FEATURES OF STRUCTURE-FUNCTIONAL HEART CONDITION IN OLDER PATIENTS WITH UNSTABLE ANGINA AND LEFT BUNDLE BRANCH BLOCK].

The structural and functional parameters of echocardiography in 56 older patients with UA and LBBB were analyzed in comparison with these parameters in 186 patients with UA without LBBB. The median age of patients with UA and LBBB was 75 (67-81) years, without LBBB - 74 (65-80) years. The procedure was carried out in the first day of hospitalization in cardiology department on the UA. LBBB in patients with unstable angina is associated with remodeling of the heart with an increase the diameter of the aorta, the LVID (s) and (d), thickening of the IST and PWT and increasing the RWT, as well as a decrease of LP and RV cavities. We revealed the signs of left ventricular dysfunction without evidence valvular obstruction in the patients with UA and LBBB. The hemodynamic of patients with UA and LBBB was characterized by large LV DV and SV, as well as by decrease FS, FJ, MFS and gradients MV, AV, PV, and TV than at UA without LBBB. The echocardiographic symptoms of diastolic dysfunction with delayed relaxation were found in patients with UA and LBBB. The mitral regurgitation occurred more frequently in 2,4 times more in patients with UA without LBBB.

[Adaptation to physical load and the state of the autonomic nervous system in young women with low blood pressure].

OBJECTIVE: The purpose of research--the study of the relationship between adaptation of the cardiovascular system to physical activity and the autonomic newous system in young women with low blood pressure. METHODS: Evaluated test Ruffier index Kerdo women-university students aged 18-35 years, engaged in physical culture within the educational process. Compare the 69 women with low blood pressure (SBP 61-99 mmHg) and 35 women with normal blood pressure (SBP 120-129 mmHg). Index Ruffier groups did not differ in average and adequate "good result". In the group of women with low blood pressure showed a reduction in fitness (Ruffier-index of 10 or higher) when sympathetic activation. Reduced recorded in 14.5% (10 cases), which is significantly more than the parasympathetic activation--0 cases when p = 0.003. Analysis of the dynamics of SBP, DBP and heart rate during the Ruffier test showed that low blood pressure after 1 minute rest in SBP and DBP were higher than baseline. CONCLUSIONS: According to the test Ruffier in young women with low blood pressure and sympathicotonia in 14.5% of cases there is a lack of adaptation to physical stress. When low blood pressure with vagotonia --only good and average adaptation to physical stress. Screening test of physical activity in young women with low blood pressure are not quickens the pulse, but leads to a slight increase in SBP and DBP.

[Restoration of the blood rheological patients with cap on the background of arterial hypertension in the process of hospital treatment].

The parameters of blood rheology at constant and varying shear rates in 30 patients with community-acquired pneumonia on a background of hypertension and 30 patients with community-acquired pneumonia during treatment. When recovery of rheological properties of blood disorders are in 39-81% of patients.

[Cardiorenal syndrome and prerenal azotemia in patients with acute hypertensive encephalopathy].

AIM: To estimate changes in renal function in patients with acute hypertensive encephalopathy (AHE) during standard inpatient antihypertensive therapy. SUBJECTS AND METHODS: Patients were selected for the trial in the cardiology and admission units of a Perm hospital. The group included 60 patients with AHE. The patients received inpatient antihypertensive therapy for 10-14 days. Within the first 2 hours, enalaprilate 1.25 mg was intravenously injected, by monitoring blood pressure. After 6 hours, the patients were given enalaprilate tablets 20 mg b.i.d. plus hydrochlorothiazide 12.5 mg (Subgroup 1) or nifedipine 60 mg plus hydrochlorothiazide 12.5 mg (Subgroup 2). The laboratory parameters of kidney function were measured twice: on admission to and before discharge from hospital. Plasma creatinine and urea concentrations were estimated. Glomerular filtration rate (GFR) and urea/creatinine ratio were calculated. The patients were found to have proteinurea, low GFR, high plasma creatinine concentrations, and increased urea/creatinine ratio. RESULTS: Transient proteinuria was observed in 25% of the patients with AHE within the first 24 hours of the disease. The proportion of patients with lower GFR was unchanged during a 2-week treatment period (20 and 16%, respectively; p = 0.22). There was a rise in the proportion of patients with higher urea/creatinine ratio (83 and 95%, respectively; p = 0.006). CONCLUSION: The course of AHE is complicated by cardiorenal syndrome (CRS) with transient proteinuria and low GFR, as well as by prerenal azotemia (PRA). The number of patients with PRA increased after 2-week conventional inpatient antihypertensive therapy (enalaprilate + hydrochlorothiazide 12.5 mg or nifedipine + hydrochlorothiazide 12.5 mg).

[Cognitive functions and extracranial circulation in patients with hypertonic crisis].

We studied effects of enalaprilate and infedipine therapy on the cognitive functions and extracranial circulation in 60 patients with chronic AH complicated by acute encephalopathy. 10% of them had predemential disorders on day 1 of hospitalization and 90% mild cognitive problems. Half of the patients suffered reduced circulation in the common carotid artery. The contribution of impaired extracranial circulation to cognitive dysfunction in the acute period of hypertonic crisis was higher than that of high SAD and DAD. Antihypertensive therapy improved bloodflow in extracranial vessels, decreased their systolic and diastolic indices but failed to eliminate mild cognitive disorders in 65% of the patients. Visual-spatial orientation was restored more frequently than verbal auditory memory. Enalaprilate and infedipine had similar angio- and cerebroprotective effects but the latter had more pronounced favourable effect on verbal auditory memory than the former. The degree of recovery of cognitive function 2 weeks after hypertonic crisis depended not only on the form of cognitive disorder and therapeutic modality but also on the patient's age. Hemodynamic parameters and age 2 weeks after antihypertensive therapy are predictors of residual cognitive dysfunction soon (2 weeks) after recovery.

[Cognitive impairment in elderly patients with acute hypertensive encephalopathy].

Acute hypertensive encephalopathy in elderly patients appears reversible mild cognitive impairment. The erythrocyte sedimentation rate and blood creatinine measured during a hypertensive crisis are predictors of decline of visual-spatial orientation after two weeks of treatment.

[Prehospital thrombolysis acute coronary syndrome in patients with acute left bundle branch block].

Analyzed 30-days survival in 18 patients after a system of dark prehospital thrombolysis performed for an acute coronary syndrome (ACS) with acute left bundle branch block (LBBB). Survival after thrombolytic therapy (TLT) was 4 times higher than in patients with acute coronary syndrome and acute blockade LBBB without TLT. It is concluded that thrombolytic therapy leads to a reduction of the QRS complex in 66% of patients.

[Effect of sex on rheological properties of blood in adults]. / Vliianie pola na reologicheskie svoistva krovi u vzroslykh liudei.

The purpose of this study was to evaluate blood rheology in adult subjects aged 17-95 years. A total of 1035 volunteers (515 men and 520 women) took part in the study. The criterion of participation in the study was age over 17 years and that precluding the participation was hospital treatment. Blood, plasma, and serum viscosity and erythrocyte aggregation and deformability were analyzed on a rotation viscosimeter. Blood rheological properties depended on sex. Whole blood viscosity and plasticity were notably higher in men than in women at all ages. Whole blood viscosity in women aged 20-29, 40-49, and over 60 years is lower than in men of the same age, despite changed protein/water ratio in the plasma and serum.

External photoacoustic detection of a trace vapor inside a multimode laser.

We combine highly sensitive intracavity absorption spectroscopy in a multimode laser with external photoacoustic detection, providing high detectivity. Photoacoustic measurements of the intracavity iodine concentration in a Rhodamine 6G laser are compared with simultaneous spectral recordings. They demonstrate slightly improved overall sensitivity and a greatly enhanced dynamic range of 5 orders of magnitude that may be shifted along the absolute scale of absorber density.

Intracavity absorption spectroscopy with a Nd(3+)-doped fiber laser.

A broadband Nd(3+)-doped fiber laser has been operated in an external cavity by pumping with an Ar(+)-ion laser. The emission spectrum of the fiber laser shows high sensitivity to intracavity absorption. The equivalent absorber path length is 15 km; with a loss-reduced setup that includes pumping by a diode laser this path length is 150 km. The spectrum of atmospheric absorption in the range from 1.065 to 1.145 microm has been recorded by stepwise tuning of the 0.3-nm-wide laser emission band by an intracavity prism.