[The role of genetic and environmental factors in phenotypic variability of arterial pressure and body weight and their interconnection (a family study)]. / Rol' geneticheskikh i sredovykh faktorov i fenotipicheskoi izmenchivosti arterial'nogo davleniia i massy tela i v ikh vzaimosviazi.

Contribution of genetic and environmental factors into phenotypic variability of blood pressure and body mass as well as into phenotypic correlation between these traits was defined. It was shown that additive genetic determinant is responsible for considerable level of blood pressure and body mass variability. Those common environmental factors are of importance which operate within the limits of one generation. Maternal effect of systolic and diastolic blood pressure variability is negligible. The correlation between systolic and diastolic blood pressure is determined both by environmental and genetic factors, whereas that between blood pressure and body mass is mediated by only environmental factors. The contribution of environmental factors into correlation between blood pressure and body mass lessens with age. The results obtained may be applied in development of population and individual programmes for preventing cardiovascular diseases.

[Significance of atrioventricular block in the development of the Wolff-Parkinson-White syndrome]. / Znachenie atrioventrikuliarnoi blokady v razvitii sindroma Vol'ffa-Parkinsona-Uaita.

The vegetative homeostasis was studied in 49 children with the Wolff-Parkinson-White (WPW) syndrome and in their relatives. To control the WPW syndrome the authors used clino-orthostatic and drug (atropine and gilurytmal) tests. In 85.7% of children with WPW syndrome there was a vagotonic orientation of the vegetative tonus, not infrequently of the hereditary nature, inducing inhibition of atrioventricular conductivity. A combination of the atrioventricular block of the first stage and the WPW syndrome in 44.1% of the children and in 51.2% of their families points to an association between these phenomena. The detection of the WPW syndrome in the presence of sympathicotonia does not contradict this postulation since the atrioventricular node may be blocked by frequent impulses which helps to increase the conductivity along the additional pathways. In connection with the frequent detection of the additional conductive pathways in normal subjects, their first appearance in elderly age and their combination with block, a suggestion is made that the retention of the additional pathways in the myocardium may be advisable. Yet, being compensatory in their nature they may precipitate arrhythmias.

[Status of cerebral structure and hemodynamics in healthy children and those with autonomic-vascular dystonia]. / Sostoianie tserebral'nykh struktur i mozgovoi gemodinamiki u zdorovykh detei i detei s vegetososudistoi distoniei.

From the standpoint of traditional neurology an attempt has been made to evaluate the function of the cerebral structures in 50 children with vegetovascular dystonia and 30 normal ones. On the basis of the data obtained a working hypothesis is advanced about a special role of the defect in the right cerebral hemisphere in the pathogenetic mechanisms of hypertension in the presence of vegetovascular dystonia.

[Changes in phospholipid composition of high density lipoproteins in children as a possible precursor of the development of ischemic heart disease]. / Izmenenie fosfolipidnogo sostava lipoproteidov vysokoi plotnosti u detei kak vozmozhnyi predvestnik razvitiia ishemicheskoi bolezni serdtsa.

The proportion of apoprotein-AI (apo-AI) phospholipids (PL) and HDLP phospholipid spectrum were determined in addition to principal coronary risk factors; cholesterol (CS), triglycerides (TG) and high-density lipoprotein (HDLP) CS, in high-risk children, whose parents had survived myocardial infarction at a young age, and also in children with vegetovascular dystonia and a control group. It is demonstrated that children with relatively low percentage of lecithin in HDLP, in the absence of changes in CS, TG, apo-B and apo-AI, and HDLP CS, could be found in all the examined groups, and were particularly numerous in the high-risk group. Correlations coefficients for the HDLP PL percentage in the father-child, mother-child and father-mother pairs were estimated, revealing a positive correlation with respect to lecithin in these pairs, an evidence of the contribution of the general familial environment to the variability of the parameter in question in the examined groups. Different correlations were demonstrated between lecithin/sphingomyelin and lecithin/kephalin ratios in boys and girls from the control and high-risk groups.

[Chronic nonparoxysmal supraventricular tachycardia in children and adolescents]. / Khronicheskaia neparoksizmal'naia supraventrikuliarnaia takhikardiia u detei i podrostkov.

An examination was performed in 111 children and adolescents with recurrent and sustained chronic nonparoxysmal tachycardias (CNPT). ECG and electrophysiological studies showed that ante- and retrograde conduction along the accessory atrioventricular junction was the most common mechanisms of arrhythmia. Holter monitoring revealed a high rigidity of cardiac rhythm in patients with sustained CNPT. Criteria for the development of arrhythmogenic cardiac dilatation were developed. In recurrent CNPT, there was a correlation between the paroxysms of ECG slow-wave activity and the "salvos" of tachycardia and a predominance of vagal effects on the heart. A new approach to the treatment of children with CNPT was proposed, which involved the correction of pathogenetic mechanisms. Indications for the usage of antiarrhythmic agents such as cordarone and a cardiac surgeon's advice were formulated. The efficiency of the therapy was achieved in 82% of the children as shown by a follow-up.

[Hypertrophic cardiomyopathy in children (clinico-echocardiographic study)]. / Gipertroficheskaia kardiomiopatiia u detei (kliniko-ékhokardiograficheskoe issledovanie).

On the grounds of clinical, electro- and echo-cardiographic examination of 39 patients with hypertrophic cardiomyopathy from 3 to 15 years of age three types of this pathological condition are distinguished: asymmetrical septal hypertrophy, idiopathic hypertrophic subaortic stenosis and symmetrical hypertrophic cardiomyopathy. The value of signs of hypertrophic myopathy obtained on clinical and instrumental examination is discussed. The high diagnostic value of echocardiography in the examination of patients is emphasized.

[Aortic coarctation associated with endocardial fibroelastosis in infants (clinical aspects, diagnosis and surgical treatment)]. / Koarktatsiia aorty v sochetanii s fibroelastozom endokarda u detei rannego vozrasta (klinika, diagnostika, khirurgicheskoe lechenie).

Among 111 infants with coarctation of the aorta, fibroelastosis of the left ventricular endocardium was found in 14 cases comprising 12.6%. Such a combination usually caused an extremely poor state of the patients and served as an indication for surgery. A resection of the coarctation of the aorta in cases of fibroelastosis provides for a significant reduction of the workload on the left ventricular myocardium, for an improvement of the patient's state permitting to survive the critical first three years of life. The problems of intravital diagnosis of fibroelastosis in patients with coarctation of the aorta are presented, the importance of chronic ischaemia of the left ventricle in the development of fibroelastosis is emphasized. The details of surgical tactics and postoperative care of such patients are discussed.

[Characteristics of 24-hour ECG and the regulation of cardiac rhythm in adolescents]. / Kharakteristika sutochnoi EKG i reguliatsii serdechnogo ritma u podrostkov.

Holter 24-hour monitoring was performed in 50 healthy subjects aged 11-15 years. Daily changes and standard values of heart rate (HR), P-R and Q-T intervals, P, R, T wave amplitudes, ST segment displacement were determined. All the patients under study exhibited sinus arrhythmia, pacemaker migration periods, short cardiac rhythm pauses (up to 1.5 s). Three adolescents were recorded to have Degree I atrioventricular block at night, 3 presented with rare (up to 2 per min) supraventricular contraction beats, 1 had a nocturnal transient Wolff-Parkinson-White syndrome. Despite HR at night, there were periods of Q-T interval prolongation. Daily changes in the neurohumoral regulation of the heart and its relation to the occurrence of various electrocardiographic events were determined.

[Functional status of the cardiovascular system of adolescents with a hereditary predisposition to atherosclerosis]. / Funktsional'noe sostoianie serdechno-sosudistoi sistemy u podrostkov s otiagoshchennoi nasledstvennost'iu po aterosklerozu.

A study of 70 teenagers between 11 and 15, whose parents had suffered, before they were 45, myocardial infarction in the presence of verified coronary arterial atherosclerosis, revealed no organic cardiac changes, while some signs of neurocirculatory dystonia were combined with increased incidence of coronary risk factors and dyslipoproteinemia.

[Characteristics of hemostasis, fibrinolysis and lipid indicators in children and their fathers with a history of myocardial infarction at a young age]. / Kharakteristika gemostaza, fibrinoliza i pokazatelei lipidov u detei i ikh ottsov, perenesshikh infarkt miokarda v molodom vozraste.

Blood coagulation and fibrinolysis characteristics are described in children whose fathers survived myocardial infarction when fairly young. Hemostatic and fibrinolytic effects of heredity are analysed, as are lipid spectrum disorders. Children with aggravated heredity showed changes in plasma fibrinogen concentration, antithrombin III, total plasma fibrinolytic activity recalcification time. The monitoring of children with aggravated heredity for coronary heart disease, particularly those with attendant dyslipoproteinemia as a specific high-risk group, is proposed.

[Characteristics of circadian variability of heart rate during Holter monitoring]. / Kharakteristika tsirkadnoi variabel'nosti chastoty serdechnykh sokrashchenii v period kholterovskogo monitorirovaniia.

24-hour Holter monitoring of 60 healthy children aged 3 to 15 years provided criteria for assessing the circadian heart rate (HR) variations as a measure of alterations occurred in autonomic heart rhythm control. Specific HR dynamics during their sleep is described, which involves changes in steady-state rhythm and higher dispersion periods associated with the alternation of slow and fast sleep phases. Sex- and age-related HR features are defined during 24-hour monitoring.

[Endomycardial biopsy in the diagnosis of various forms of cardiomyopathy in children]. / Endomiokardial'naia biopsiia v diagnostike nekotorykh form kardiomiopatii u detei

An examination technique is described, including catheterizational endomyocardial biopsy of the left ventricle, used in 10 patients with cardiomyopathy, aged 9 months to 10 years. On the basis of the obtained data it was concluded that the most frequently encountered form of cardiomyopathy in children above 1year of age is infectious-allergic myocarditis. Endocardial thickening is secondary to myocardial changes.

[Role of genetic and environmental factors in the determination of body weight and skinfold thickness in children having different blood pressure (a familial study)]. / Rol' geneticheskikh i sredovykh faktorov v determinatsii massy tela i tolshchiny kozhnykh skladok u detei s raznym urovnem arterial'nogo davleniia (semeinoe issledovanie).

Based on intrafamilial correlations, a component genetic analysis was used to evaluate the contribution made by genetic and environmental factors to variance in body weight and skin fold thickness in children who had various blood pressure. In children with initially elevated and normal blood pressures, the phenotypic variation in the body weight and adipopexia is largely determined by genetic factors, whereas in those with initially lower blood pressure, the phenotypic variation in the above parameters is greatly affected by environmental factors, mainly by those of occasional nature. The findings provide evidence for a differential approach to the primary prevention of hyper- and hypotension in children and adolescents.

[Current approaches to the study of psychosomatic effects on the pathology of the cardiovascular system in children]. / Sovremennye podkhody k izucheniiu psikhosomaticheskikh vliianii na patologiiu serdechno-sosudistoi sistemy u detei.

A total of 131 children suffering from hereditary predisposition to coronary heart disease, 70 subjects with dysfunction of the and 120 subjects with dysfunction of the vegetative nervous system and low blood pressure were examined. The examination of the children included a study of the cardiovascular system and the vegetative nervous system as well as psychological studies. The cardiovascular system response to the psychoemotional teleplay test was measured in addition. It has been demonstrated that the psychoneurosomatic interrelations are implicated in the occurrence of the main most prevalent cardiovascular diseases in children. This determines approaches to the treatment and prevention of arterial high and low blood pressure and cardiac rhythm disorders.

[Blood coagulation and fibrinolysis in ischemic heart disease. The relationship to risk factors]. / Sostoianie gemokoaguliatsii i fibrinoliza pri ishemicheskoi bolezni serdtsa. Vzaimosviaz' s faktorami riska.

The data on blood coagulation and fibrinolysis in patients with coronary heart disease are reviewed. The relationship of the coagulating and fibrinolytic systems with cardiovascular risk factors is analysed.