[Vegetative disbalance in pathogenesis of metabolic syndrome].

The aim of the work was to elucidate peculiarities of neurovegetative mechanisms underlying cardiovascular regulation in patients with metabolic syndrome (MS) compared with healthy subjects and patients with arterial hypertension (AH). 46 patients presented with AH without obesity and metabolic disturbances, 42 with MS. 24-hour AD and ECG monitoring was performed and cardiac rhythm variability indices (CVI) were calculated. AH patients showed lowered CVI in association with decreased high-frequency vagal effects compared with healthy subjects. MS patients had smaller CVI than healthy and AH ones due to much poorer involvement of both parasympathetic and sympathetic divisions of vegetative nervous system. Vegetative balance index remained normal. It is concluded that the use of LF/HF ratio alone is insufficient for the evaluation of sympatovagal index in MS patients due to markedly decreased CVI; a complex analysis of all CVI temporal and spectral characteristics is needed.

[Influence of nebivolol on left ventricular remodeling in patients with arterial hypertension without chronic heart failure].

In the recent years the problem of heart remodeling under drugs in patients with arterial hypertension (AH) have been extensively discussed. The beta-blocker of the third generation nebivolol is known as a good antihypertensive agent. The aim of our study was to evaluate effects of nebivolol on structural and functional parameters of cardiac remodeling in patients with AH without heart failure. We examined 28 patients with AH aged 49.99 +/- 5.26 years, with average arterial pressure 154.42 +/- 94.37 mm Hg and ejection fraction (EF) > 60%. All of them underwent routine clinical examination and echocardiography (EchoCG) with calculation of additional indexes, and than were given nebivolol 5 mg. After 3 months and 1 year of treatment with nebivolol we assessed antihypertensive effect and the state of cardiac hemodynamics using EchoCG with calculation of remodeling indexes. After 3 months of therapy myocardial stresses (systolic - MSs and diastolic - MSd) were reduced (from 154.28 +/- 11.65 to 132.77 +/- 11.37 U, p < 0.02, and from 184.17 +/- 14.1 to 159.87 +/- 13.34 U, p < 0.02, respectively), and diastolic function improved. After 1 year of antihypertensive treatment LV diastolic function remained normal, while thickness of LV wall decreased (from 0.41 +/- 0.03 to 0.37 +/- 0.02 U, p=0.01). MS continued to decrease with high degree of significance. At the end of the first year we revealed decrease of MSs/ESVI from 9.66 +/- 1.77 at the start of treatment to 6.1 +/- 0.69 (p < 0.005) and MSd/EDVI from 3.21 +/- 0.4 to 2.57 +/- 0.38 (p < 0,005). Increase of EF/MSs (from 0.47 +/- 0.05 to 0.61 +/- 0.07, p < 0.02) was also revealed after 1 year treatment with nebivolol. There were 32% individuals in the studied group, who had concentric type of LV remodeling at the beginning, after 3 months this number decreased to 16%, and at the end of first year no patients had this type of remodeling. Thus, it was shown that nebivolol is able to interfere with the processes of structural and functional rearrangement of the myocardium, preventing development of systolic and diastolic dysfunction of the heart.

[Effect of fluvastain and its combination with aspirin and trental on hemostasis and microcirculation in atherosclerosis]. / Vliianie fliuvastatina i ego sochetanii s aspirinom i trentalom na gemostaz i mikrotsirkuliatsiiu pri ateroskleroze.

AIM: To assess effects of fluvastatin monotherapy and combined therapy with aspirin and trental on hemostasis and microcirculation in atherosclerosis. MATERIAL AND METHODS: Hemostasis and microcirculation were studied in 68 patients with coronary atherosclerosis and aortic atherosclerosis on fluvastatin monotherapy and on combined therapy fluvastatin + aspirin + trental. RESULTS: Hypolipidemic treatment with fluvastatin reduced thrombogenic blood potential due to enhancement of plasmic fibrinolytic activity [the time of XII-a dependent fibrinolysis decreased by 33% (p < 0.05)], decreased thrombinemia [blood level of soluble fibrin-monomeric complexes fell by 44% (p < 0.05)] and reduced stimulated platelet aggregation: by 18.2% in response to ADP (p < 0.05) and by 11% in response to adrenalin (p < 0.05). CONCLUSION: Correction of lipid metabolism and blood hypercoagulation improved microrheology. Combination of fluvastatin with aspirin made platelet aggregation reduction in response to both inductors faster and more stable, while combination of fluvastatin with trental contributed to better results in microcirculation improvement.

[Lipid and non-lipid effects of enduracin in patients with arterial hypertension]. / Lipidnye i nelipidnye éffekty primeneniia énduratsina u bol'nykh arterial'noi gipertoniei.

AIM: To analyze lipid and non-lipid effects of 6-month administration of enduracine in patients with marked dislipoproteinemia suffering from arterial hypertension with ischemic heart disease or without it. MATERIALS AND METHODS: 40 hypertensive patients (27 males and 13 females, mean age 52.43 +/- 1.68 years) entered the study of enduracine effects. Most of them received enduracine for 6 months in a dose 1500 mg/day. Lipids levels were measured in all the patients. Blood flow along major brain arteries was determined at transcranial dopplerography in 23 patients. RESULTS: A 6-month course of enduracine in a dose 1500 mg/day promoted normalization of serum lipid spectrum, vascular tonicity and reactivity of cerebral arteries, produced a mild hypotensive effect. CONCLUSION: Endurance (a long-acting form of nicotinic acid) has favourable lipid and non-lipid effects in patients with dislipoproteinemias and arterial hypertension in the presence or absence of ischemic heart disease.

[The use of the delayed-action form of korinfar in arterial hypertension, stenocardia and hypertrophic cardiomyopathy]. / Primenenie retardirovannoi formy korinfara pri arterial'noi gipertonii, stenokardii i gipertroficheskoi kardiomiopatii.

Corinfar-retard (CR) was tried in 146 patients, the acute test was performed in 26 cases. The findings confirm antihypertensive activity of the drug, reduced frequency of sharp changes in blood pressure and of hypertensive crises, side effects, its ability to diminish platelet aggregation. As for coronary heart disease. CR is more beneficial in non-severe angina of effort, spontaneous angina, associated hypertension. In hypertrophic cardiomyopathy prolonged administration of CR resulted in moderate subjective response. A CR two-month course did not induce noticeable changes in serum lipids. Hypertensive subjects on the acute test improved some hemodynamic and diastolic parameters.

[Lipid peroxidation and hyperuricemia in patients with ischemic heart disease]. / Perekisnoe okislenie lipidov i giperurikemiia u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Lipid peroxidation, activity of the enzymatic link of the antioxidative system, and parameters of the lipid system were studied in 62 patients with coronary heart disease (27 patients with hyperuricemia and 35 subjects with normal uric acid levels) in relation to blood uric acid concentrations. The levels of uric acid, malonic dialdehyde, total lipids, total cholesterol, beta-lipoprotein cholesterol, triglycerides were measured and the activities of superoxide dismutase, catalase, glutathione peroxidase, and glutathione reductase were evaluated. In the patients there was an increase in lipid peroxidation and lipid composition changes which were more drastically marked in hyperuricemia.