[Assessment of the clinical efficacy of telemonitoring and distant counseling in patients with uncontrolled hypertension].

The aim of the study was to investigate the mathematical correlation of the clinical efficacy of blood pressure telemonitoring and distant counseling (BPTM) in patients in uncontrolled hypertension (HTN). Telehealth tools are widely used in HTN management. However clinical efficacy of such interventions assessed mainly in groups investigated without its populational and attributable impact. Materials and methods. The total of 240 patients were included, then randomized in 2:1 manner to BPTM group (n=160, median age 47 y.o.) and control group (n=80, median age 49 y.o). The user - friendly and secure telehealth software was provided with mobile application (patients) and desktop (doctors) platforms which allowed storage and analysis of self-BP monitoring data and remote consultations. A three - month surveillance was designed with mandatory baseline and final face - to - face visits with the assessment of office systolic BP (oSBP). Mathematical evaluation was based on target SBP rates achieved in comparator groups and included the absolute efficacies (AE), the attributable efficacy (AtE), the relative efficacy (RE) and the population attributable efficacy (PAtE). Results. BPTM group characterized by larger decrease in SBP level compared with controls (-16.8±2.9 mm Hg versus -7.9±3.9 mm Hg; p.

[Recellularization of tissue engineered vascular grafts in perfusion bioreactor].

Small diameter tissue engineered vascular grafts could be a potential solution to the shortage of vascular substitutes in reconstructive cardiovascular surgery. Previously, we have developed a decellularization method for human umbilical arteries, which could be used as a scaffold in vascular tissue engineering. Objective of the study was to optimize the recellelularization of decellularized scaffolds with mesenchymal stem cells. In the study, the possibility of cell growth on decellularized vessel has been shown. We also has proved that the use of perfusion-bioreactor improves the results of recellularization.

[Myocardial protection against global ischemia-reperfusion with use of Krebs-Henseleit buffer-based cardioplegic solution].

Improvement of myocardial protection against global ischemia-reperfusion injury during cardiopulmonary bypass remains to be of primary importance for cardiac surgery. In the present study, the effectiveness of new Krebs-Henseleit buffer-based cardioplegic solution was investigated in an isolated rat heart preparation in normo- and hypothermic states. Use of this crystalloid cardioplegic solution in the normothermic mode (37 degrees C) resulted in better myocardial protection in comparison to standard cardioplegic solutions as evidenced from both infarct size data and the patterns of left ventricular postischemic recovery. The data obtained indicate that Krebs-Henseleit buffer-based cardioplegic solution might be recommended for further preclinical testing.

[Cardiac autotransplantation in a patient with congestive heart failure].

Congestive heart failure with intact or moderately lowered left ventricular pump function is caused in some patients by mitral regurgitation. Consequences are dilation of the left atrium, pulmonary hypertension, tricuspid regurgitation, thromboembolic complications, rhythm disturbances, elevated risk of sudden death. Efficacy of drug treatment, electroimpulse therapy is little and surgery is the method of choice. One of alternatives is cardiac autotransplantation. A successful experience of application of this technique is presented. Cardiac autotransplantation was carried out in a female patient with moderately lowered left ventricular contractile function, extreme degree of mitral and tricuspid regurgitation, atriomegaly, atrial fibrillation and pronounced signs of congestive heart failure.

[Autotransplantation of the heart as the method of treatment of congestive heart failure].

Congestive heart failure with preserved or moderately lowered left ventricular pump function in some patients is caused by mitral regurgitation. Its consequences are left atrial dilation, pulmonary hypertension, tricuspid regurgitation, thromboembolic complications, disturbances of rhythm with elevated risk of sudden death. As efficacy of drug treatment and electroimpulse therapy is small surgery is the method of choice and one of alternatives - autotransplantation of the heart. Here we present a successful experience of application of this technique in a patient with moderately lowered left ventricular function, extreme degree of mitral and tricuspid regurgitation, atriomegaly, atrial fibrillation, and pronounced manifestations of congestive heart failure.

[Myocardial ischemic postconditioning: a brief ischemia causes conversion of resistent reperfusion-induced ventricular fibrillation into the normal rhythm]. / Fenomen ishemicheskogo postkonditsionirovaniia miokarda: kratkovremennaia ishemiia privodit k perekhodu persistiruiushchei reperfuzionnoi fibrilliatsii zheludochkov v sinusovyi ritm.

Brief episodes of myocardial ischemia-reperfusion were shown to be protective against reperfusion injury when used during early reperfusion after a prolonged ischemic episode. This phenomenon has been termed myocardial ischemic postconditioning. In this study, an effect of ischemic postconditioning on persistent reperfusion-induced ventricular fibrillation was studied in the rat isolated heart. 2 minutes of global ischemia on the 15th minute of reperfusion after 30 minutes of regional ischemia effectively abolished the persistent ventricular fibrillation. In non-postconditioned hearts, the ventricular fibrillation continued to the end of reperfusion. The ischemic postconditioning seems to exert a strong antiarrhythmic effect protecting the heart against persistent reperfusion-induced ventricular tachyarrhythmias.

Does nitric oxide generation contribute to the mechanism of remote ischemic preconditioning?

The protective effect of local or remote ischemic preconditioning (IPC) on subsequent 40-min ischemic and 120-min reperfusion myocardial damage was investigated. Preconditioned rats underwent one cycle of myocardial ischemia/reperfusion consisting of 5-min ischemia produced as a left coronary artery (LCA) occlusion and 5 min of reperfusion. Remote IPC was produced as 15 min of small intestinal ischemia with 15 min of reperfusion as well as 30 min of limb ischemia with 15 min of reperfusion. A marked protective action was afforded by both IPC protocols with a more significant effect of local (classic) ischemic preconditioning. Since the protective effect of remote IPC was not abolished by nitric oxide (NO) synthase inhibition with Nomega-nitro-L-arginine (L-NNA) it is concluded that NO generation may not be involved in the mechanism of remote IPC.