[Changes in activity of transcription factors in the cells of vascular endothelium as a pathological mechanism of its dysfunction in essential hypertension].

AIM: To study activity of transcription factor (TF)--the nuclear factor kappa B (NF-kB)--and its role in formation of endothelial dysfunction (ED) in patients with essential hypertension (EH). MATERIAL AND METHODS: The examination covered 74 patients with EH stage I-II with the first-third degree of arterial hypertension (AH) by WHO/IHS classification (48 males, 36 females, mean age 46.39 +/- 3.47 years, free of symptomatic AH, diabetes mellitus, hyperlipidemia, IHD, congestive cardiac failure or other diseases with proved formation of ED or NF-kB activity alteration) and 26 healthy persons (control group). Venous occlusive plethysmography of the arms for assessment of blood flow in brachial arteries with measurement of blood flow velocity at rest and after the test for reactive hyperemia was made. Functional state of vascular endothelium was estimated according to mechanic sensitivity coefficient (MSC). Molecule-1 intercellular adhesion (ICAM-1) and E-selectin production were measured in blood. By ED degree, the patients were divided into 3 groups: group 1--patients with EH and mild ED (MSC > M +/- sigma), group 2--patients with EH and moderate ED (MSC = M +/- sigma), group 3--patients with EH and severe ED. RESULTS: In EH patients, MSC is lower than in healthy controls, serum ICAM-1 level and E-selectin production were higher (by 26.99 and 50.77%, respectively). E-selectin was higher in group 2 than in group 2 by 32.70%, in group 3--by 55.84 and 17.44% than in groups 1 and 2, respectively. Serum level of ICAM-1 in group 3 was by 25.31% in group 2 by 12.02% higher than in group 1. The regressive analysis revealed that there is a significant correlation between MSC and ICAM-1 in the serum. The level of ICAM-1 is an independent factor determining MSC. CONCLUSION: EH patients demonstrate activation of HF-kB transcription factor in the cells of vascular endothelium, manifesting with an E-selectin production rise and elevation of serum ICAM-1. Activation of NF-kB in the cells of vascular endothelium is an independent and pathophysiologically significant factor promoting formation of ED in EH patients.

[Geometric state of the heart left ventricle and its correlation with contraction processes in patients with chronic obstructive bronchitis].

Geometrical features of contraction of the left ventricle of the heart (LVH) in 41 patients with chronic obstructive bronchitis marked by moderate and severe respiratory disorders without clinical signs of heart insufficiency with the help of a morphobiomechanical have been examined. The patients were selected in subgroups with different ejection fraction of LVH. The patients with diminished ejection fraction were found to have signs which respond to left ventricle dysfunctions of the heart. They are the following: loss of ability of the heart to form normal elliptical configuration during systolic contraction, extension of longitudinal contraction, and decrease in relative wall thickness of the left ventricle of the heart. It may be considered as an early sign of damage of the heart followed by development of chronic heart insufficiency.

[Remodeling of elastic arteries in patients with hypertensive disease: diagnostic value of pulse pressure]. / Remodelirovanie arterii élasticheskogo tipa u bol'nykh gipertonicheskoi bolezn'iu: diagnosticheskaia znachimost' pul'sovogo davleniia.

The study was undertaken to examine a role of pulse blood pressure (PBP) as a diagnostic marker of remodeling of large elastic arteries in patients with hypertensive disease (HD). A hundred and sixty-eight patients with HD and 38 apparently healthy individuals (a control group) were examined. In all the examinees, PBP was measured and central PBP (PBPc) was calculated. According to the value of PBPc, the patients with HD were divided into 4 groups: 1) PBPc was equal or less than 45 mm Hg; 2) that was 46-50 mm Hg; 3) PBPc was 51-64 mm Hg; and 4) that was equal or more than 65 mm Hg. With Doppler study, the aortic pulse wave propagation velocity (PWPV) was determined and the aortic stiffness coefficient was (C). Seventy-seven patients with HD and 20 control individuals underwent magnetic resonance imaging with the aortic intraluminal diameter (D(ao)) and wall thickness (H(ao)) being estimated. As compared with the controls, patients with HD were found to have significantly increased PWPV, C(s), D(ao), and H(ao) which characterizes elastic arterial remodeling in HD. Comparison of these parameters in persons with different levels of PBPc demonstrated progressive dilatation, the increased stiffness and enlarged thickness of the wall of elastic arteries in those having higher PBPc. The results of a regression analysis confirmed that there is a significant relationship of PBPc with C(s), D(ao), and H(ao) and the coefficients of correlation between were 0.89, 0.71, and 0.75, respectively. The findings have indicated that the level of PBPc may serve as a marker of remodeling of large elastic arteries in patients with HD.

[Structural and functional reconfiguration of large arteries in hypertensive disease: a role of connective tissue metabolic disturbances]. / Strukturno-funktsional'naia perestroika krupnykh arterii pri gipertonicheskoi bolezni: rol' narushenii metabolizma soedinitel'noi tkani.

The study was undertaken to define a role of connective tissue metabolism (CTM) in the structural and functional changes of arterial vessels in patients with hypertensive disease (HD). Eighty-nine patients with HD and 33 apparently healthy individuals were examined. The morphometrical parameters of the aorta were studied by magnetic resonance imaging (MRI), external and internal diameters (ED and ID, respectively) and the thickness of the wall (Hao) at the level of the ascending aorta and its mass (Mao) were determined. To evaluate aortic function, the authors made Doppler studies and determined aortic pulse wave velocity (APWV) and the aortic rigidity coefficient (RC). CTM was evaluated by the serum content of free oxyproline (FOP) and peptide-bound oxyproline (PBOP), type I procollagen C propeptides (PCPP), circulating antibodies (Cab) to elastin, and by the urinary levels of total glycosaminoglycans (TGAG) and sulfated glycosaminoglycans (SGAG). The patients with HD were found to have significantly higher levels of ID, ED, Hao Mao, APWV, RC, which is indicative of dilatation of the aorta and the increased thickness and rigidity of its wall. Patients with HD showed statistically significant serum elevated levels of PBOP and type I PCPP, a decrease in CAb to elastin, and increased urinary content of TGAG and SGAG, which indicates the activated synthesis of collagen and structural proteoglycans and the degradation of elastin in HD. The results of a multiple regression analysis demonstrated a role of CTM changes as a significant and independent factor that determines structural and functional impairments of large arteries in patients with HD.

[Endothelial-protective effects of enalapril in hypertensive patients]. / Endoteliiprotektivnye effekty énalaprila u bol'nykh gipertonicheskoi bolezn'iu.

In the article data of endotheliumprotective effect of enalapril in hypertensive patients with varying degree of systemic hypertension are presented. The above effect was assessed by changes in activity of the von Willebrand factor and degree of arterial vessels dilatation in response to infusion of acetylcholinum.

[Effects of nebivolol, metoprolol and enalapril maleate on the state of endothelium-dependent arteriolar vasodilation in patients with essential hypertension]. / Vliianie nebivolola, metoprolola i énalaprila maleata na sostoianie éndoteliizavisimoi vazodilatatsii arteriol u bol'nykh gipertonicheskoi bolezniu.

Effects were studied of nebivolol, metoprolol and enalapril maleat on the state of endothelium-dependent vasodilatation of arterioles in patients with essential arterial hypertension. Nebivolol has been shown to effectively decrease blood pressure and restore endothelium-dependent vasodilatation to a grater degree, than enalapril or metoprolol.

[Effect of anticholinergic therapy on myocardial reserve dynamics in patients with chronic obstructive bronchitis]. / Vliianie antikholinergicheskoi terapii na dinamiku miokardial'nogo rezerva u bol'nykh khronicheskim obstruktivnym bronkhitom.

The aim of the work is to study the influence of a long-term ipratropium bromide on the character of the functional heart indices changes in patients with chronic obstructive bronchitis. Positive effects on the myocardial reserve are reported under a 2-week atrovent monotherapy. Atrovent favoured a positive trend in clinical symptoms, that determined the myocardial reserve. With the above drug, the frequency of the reduced myocardial reserve has come to be lowered by 34.5%. Based on the data presented recommendations are given for use of ipratropium bromide in chronic obstructive bronchitis patients with the incipient form of heart failure.

[Assessment of quality of life in patients with chronic obstructive bronchitis]. / Otsenka kachestva zhizni u bol'nykh khronicheskim obstruktivnym bronkhitom.

The investigation performed in 117 patients with chronic obstructive bronchitis (COB) revealed a significant decline in quality of life (QL) with progressive disease. Decrement of QL level in patients with stage I and II COB has been found to be primarily associated with activation of the sympathetic nervous system and progressing of metabolic myocardial dystrophy. With stage III COB decline in QL is also caused by reduction of volume of the functional pulmonary parenchyma.

[The prognostic significance of the blood flow volume of the abdominal cavity in peptic ulcer patients]. / Prognosticheskoe znachenie velichiny krovotoka briushnoi polosti u bol'nykh iazvennoi bolezn'iu.

A total of 25 patients with duodenal ulcer were examined. Central bloodflow, that of the abdominal cavity, and characteristics of the vegetative tone were studied by the variation pulsometry method. Disturbances were revealed in the hemodynamics, manifested by a drop in cardiac output (CO) and increase in the blood volume which were particularly pronounced in unfavourable course of the disease. It has been established that the abdominal cavity CO above 1.55 l/min suggests a favourable course of the disease, while its lower values are thought to be associated with unfavourable one. The influence of the vegetative nervous system on the abdominal cavity hemodynamics is not unidirectional.

[The fractional calcium composition and the content of calcium-regulating hormones in the blood plasma of hypertension patients]. / Fraktsionnyi sostav kal'tsiia i soderzhanie kal'tsiireguliruiushchikh gormonov v plazme krovi bol'nykh gipertonicheskoi bolezn'iu.

It has been established that the degree of ionization of serum calcium increases with the progression of hypertensive disease (HD) concurrently with the elevation of the level of calcitoninemia. Concentrations of parathyroid hormone remain unchanged at early stages of HD and it is not until hypertrophy of the left ventricle becomes clinically apparent that they begin to increase. The data obtained will, we believe, help in accounting for the features of the clinical course of variant forms of hypertrophy of left ventricle in patients with hypertensive disease.

[The activity of the antioxidant system and membrane lipid peroxidation in hypertension patients]. / Aktivnost' antioksidantnykh sistem i sostoianie perekisnogo okisleniia lipidov membran u bol'nykh gipertonicheskoi bolezn'iu.

With the view to study state of antioxidant protection and membrane lipid peroxidation (LPO) in hypertonic disease (HD) 200 patients with HD of I and II stage (WHO classification) were examined. Structural and functional state of myocardium was assessed echocardiographically. Enzymatic and non-enzymatic LPO, catalase and superoxide-dismutase activity were analyzed in erythrocytes. Destabilization of cell membranes due to LPO activation and alteration of antioxidant potential established in patients with HD was paralleled by the degree of left ventricle hypertrophy.

[Calcium metabolism in various forms of hypertrophy of the "hypertensive" heart]. / Metabolism kal'tsiia pri variantnykh formakh gipertrofii "gipertenzivnogo" serdtsa.

To study the changes occurred in integral calcium metabolic parameters in evolving "hypertensive" heart, a total of 100 patients with Stage I-II (WHO Classification) were examined. Myocardial structure and function were echocardiographically examined. Plasma concentrations of ionized calcium were measured by direct potentiometry. Plasma levels of calcitonin and parathyroid hormone were measured by radioimmunoassay. As the "hypertensive" heart progressed, the ionization of serum calcium was found to enhance along with an increase in calcitoninemia. In early formation of the "hypertensive" heart, parathyroid hormone remained unchanged, but became elevated only in severe left ventricular hypertrophy. The findings may explain the features of the clinical aspects of variant left ventricular hypertrophies in the "hypertensive" heart.

[Structural-functional state of the hypertensive heart and atrial natriuretic factor during treatment with nifedipine]. / Strukturno-funktsional'noe sostoianie gipertenzivnogo serdtsa i predserdnyi natriiureticheskii faktor pri lechenii nifedipinom.

The time course of structural and functional parameters using echocardiography and the level of atrial natriuretic factor (ANF) employing immunoradiometric assay were examined in 37 patients with essential hypertension taking a 3-week therapy with nifedipine (corinfar) in doses individually chosen. The changes in the structural and functional parameters of the hypertensive heart were found to be associated with its endocrine function. A course therapy of patients with essential hypertension with nifedipine in individually based doses caused a significant rise in plasma ANF levels, a normalization of cardiac compensatory mechanism function. The findings may be a basis for studying the new mechanisms of calcium antagonist action.

[Atrial natriuretic factor and the structural and functional condition of the "hypertensive" heart]. / Predserdnyi natriiureticheskii faktor i strukturno-funktsional'noe sostoianie "gipertonicheskogo" serdtsa.

A radioimmunoassay was used to study the structural and functional status of the myocardium and blood natriuretic factor levels in 45 patients with hypertensive disease and 17 healthy subjects. Left atrial dysfunction was revealed to affect natriuretic factor levels in the blood of hypertensive patients with moderate left ventricular hypertrophy. As myocardial contractility became lower, natriuretic factor levels were reduced. The changes found in the levels in left ventricular hypertrophic variants may be accounted for by various values of intramyocardial stress. The findings suggest that cardiohemodynamic abnormalities may affect the secretion of natriuretic factor.

[Myocardial status, hemodynamics and pressor humoral substances in patients with bronchial asthma and arterial hypertension]. / Sostoianie miokarda, gemodinamika i pressornye gumora'lnye substantsii u bo'lnykh bronkhia'lnoi astmoi s arteria'lnoi gipertenziei.

The analysis of data obtained for 101 bronchial asthma (BA) sufferers with hypertension and 30 normotensive patients demonstrated the dependence of arterial hypertension in BA patients on a significant increase in the systemic peripheral resistance, pulmonary circulation pressure, diastolic dysfunction, reduced cardiac output, pulse brain filling as well as on elevated serotonin level and monoamine oxidase hyperactivity. The findings provided additional information on the causes and triggering mechanisms of arterial hypertension in BA patients, are helpful in design of antihypertensive treatment and the disease prevention.

[Diastolic heart function during bicycle ergometry in patients with hypertension and different mass of the left ventricle]. / Funktsiia serdtsa v period diastoly u bol'nykh gipertonicheskoi bolezn'iu s razlichnoi massoi levogo zheludochka pri veloérgometrii.

Changes in parameters for cardiac filling and pump functions during graded exercise were studied in 29 hypertensive patients with various left ventricular myocardial mass and 30 healthy subjects by unidirectional echocardiography. The volume of early diastolic filling decreased and that of diastasis and atrial systole increased with increasing left ventricular mass. These changes were found during graded exercises rather than at rest.