[Heart Failure in Patients With Preserved Ejection Fraction - Pumping Heart Failure?]

The review analyzes literature data on the phenomenon of chronic heart failure as a clinical syndrome of hypoperfusion of organs and systems of the body due to multiple causes of pumping inadequacy of the circulatory system. Special attention is paid to diastolic heart failure of different origin. Attention is drawn to the fact that integrated quantitative characteristic of CHF of any origin is indexed cardiac output (CO) rather than ejection fraction, and that allocation of systolic and diastolic CHF is a relatively conventional division concept. It has been shown that in heart failure of any origin, cardiac output is reduced, resulting in diminished supply of oxygen and substrates to tissues of the body. The variety of causes of heart failure with preserved ejection fraction makes it impossible to correct hemodynamic disturbances by "standard set" of drugs. Normalization of the balance between delivery of oxygen / substrates and metabolic demands of tissues may be a key approach to the treatment of diastolic heart failure of different origin.

[Effect of radiofrequency ablation of accessory atrio-ventricular junctions on electromechanical coupling of the myocardium in children with manifesting Wolf-Parkinson-White syndrome].

Aim of the study was to assess immediate and remote hemodynamic and electromechanical effects of radiofrequency ablation of accessory atrio-ventricular pathways in children with manifesting Wolf-Parkinson-White (WPW) syndrome. Radiofrequency ablation of accessory atrio-ventricular pathways resulted in diminishment of intraventricular dyssynchrony, what appeared as lowering of the degree of heterogeneity of electromechanical intervals and was associated with significant augmentation of left ventricular stroke volume. Presence of pronounced intraventricular asynchrony might be an additional indication to radiofrequency ablation of accessory atrio-ventricular pathways in patients with WPW syndrome without history of documented attacks of tachycardia.

[Electromechanical cardiac asynchrony and heart failure].

Electromechanical cardiac asynchrony is one of components of pathogenesis of heart failure. This literature review presents definition of the condition and its types (intra- and interventricular asynchrony), description of methods of detection and criteria of assessment of cardiac asynchrony in various diseases and an account of principles and methods of cardiac resynchronization therapy of heart failure.

[Endothelial dysfunction and risk factors of its development in subjects with family history of atherosclerosis]. / Disfunktsiia éndoteliia u lits s otiagoshchennoi po aterosklerozu nasledstvennost'iu.

Brachial artery blood flow reactions to hyperemia and hyperventilation (endothelium dependent vasodilation and vasoconstriction) were studied by doppler sonography in 60 persons aged 19-39 years with family history of atherosclerosis and risk factors of this disease. Reactivity of peripheral artery and risk factors of atherosclerosis development were found to be interrelated. The results allowed to suggest participation of atherogenic fractions of lipoproteins, triglycerides, proinflammatory cytokines, and monocyte derived NO in formation of pathological vascular reactions in persons with family history of atherosclerosis.

[Comparison of the results of functional tests used in non-invasive examination of endothelial function]. / Sopostavlenie rezul'tatov funktsional'nykh prob, ispol'zuiushchikhsia v neinvasivnoi otsenke funktsii éndoteliia.

AIM: To analyze results of two tests used in non-invasive assessment of endothelial function: D. Celermajer test (T1) and reactive hyperemia test (T2). MATERIAL AND METHODS: Ultrasound investigation (7.5 MHz) was employed to measure brachial artery (BA) diameter, blood flow rate and its volume at rest above the site of occlusion (T1) and under it (T2). Control group consisted of 30 men with risk factors for atherosclerosis. RESULTS: Peak value of the diameter dilation was within 10% in both tests, the difference being insignificant. The same dilatation of BA can be explained by different shift effect on the endothelium: in T1 the shift disturbance was longer while in T2 it was more intensive. CONCLUSION: To reveal endothelial dysfunction, the site of occlusion and location of the artery are not very important. However, because the shift disturbance time is different it is desirable to use the same test modification in one trial protocol.