[The clinical picture and treatment of depression spectrum disorders in patients with cardiovascular disease].

AIM: To study the impact of depressive and anxious disorders on the course of cardiovascular disease (CVD) and the specific features of clinical changes during combined pharmacotherapy (with cardiovascular agents and antidepressants). SUBJECTS AND METHODS: Seventy-eight patients with arterial hypertension (AH), acute myocardial infarction (AMI), chronic heart failures (CHF), or concomitant affective spectrum disorders were examined. Clinicopsychopathological and clinicofunctional studies were conducted. RESULTS: Statistically significantly higher degrees of anxiety and depression were revealed in patients with AH and in those with CHF than in patients with prior AMI. After AMI, the degree of psychopathological symptomatology reduced during treatment more rapidly than that in patients with AH and in those with CHF. In all three groups, combined therapy using the antidepressant tianeptine (coaxil) improved intracardiac hemodynamics and left ventricular structural and geometric parameters. CONCLUSION: Anxious and depressive disorders substantially affect the formation of a clinical picture in CVD. Inclusion of tianeptine (coaxil), that has antidepressive and anxiolytic activities, into the combined therapy of patients with CVD and depression spectrum disorders leads to a reduction in affective symptomatology, contributing to the positive impact on intracardiac hemodynamic and left ventricular structural and geometric parameters.

[Physiological properties and possible correction of adenosine triphosphate-sensitive potassium channel function].

Unique function of ATP-sensitive K channels (K(ATP)) is maintenance of interrelation between a metabolism and excitability of cells of various bodies and fabrics. In smooth muscle cells activation KP channels lead to vasodilatation, in beta-cells of a pancreas these channels play a role in interface of excitability of a membrane and secretion of insulin. Sulfonylurea drugs lowering a level of glucose in blood which use for treatment of a 2 type diabetes,--influence, contacting SUR 1 subunit and oppressing thus a K(ATP) current. It leads to membranes depolarisation, to Ca2+ entrance in cells and secretions of insulin. As opposed to this, diazoxide and pinacidil which reduce allocation of insulin, reduce arterial pressure, are specific K(ATP) activators. These preparations render therapeutic effects, stimulating K(ATP) and as consequence, limit increase of a level intracellular Ca2+ at depolarisation. At an ischemia of heart activation of K(ATP) channels reduces duration of potential of action, and it leads to reduction of Ca2+ entrance and renders cardio protective action. For last years significant successes in understanding of molecular mechanisms, determines K(ATP) channels activity, and in finding-out of their role in physiological and pathological processes are achieved. In this review of the literature the basic achievements in this area, and also problems which should be solved are considered.

[Combined effect of agonists and antagonists of the membranes channels on hemodynamic indices in rats with normal blood pressure and spontaneous hypertension]. / Kompleksnyi vplyv aktyvatoriv i blokatoriv membrannykh kanaliv na pokaznyky hemodynamiky shchuriv z normal'nym arterial'nym tyskom ta zi spontannoiu hipertenziieiu.

It has been investigated the influence of synthesized in Institute of Organic Chemistry NA of Science fluorinated Compound "C" on haemodynamic indexes of normotensive (Wistar) and hypertensive (SHR) rats. Molecules of Compound 'C' contain the blocker of calcium channels foridon and the potassium channels activator flocalin. It was shown that separately used foridon (0.5 mg/kg) and flocalin (which has dose-depended effect) evoke hypertensive reaction, decreasing the total peripheral resistance. They differently affect the systolic blood volume (foridon decreases and flocalin increases) but do not change the heart rate. Compound "C" (0.5 mg/kg) decreases arterial pressure and total peripheral vessels resistance, decreases heart rate and increases systolic blood volume. In hypertensive animals these effects were more pronounced in comparison with normotensive animals.

[Modern antidepressants in complex management of patients with hypertension and concomitant affective disorders]. / Sovremennye antidepressanty v kompleksnom lechenii bol'nykh s arterial'noi gipertenziei s soputstvuiushchimi affektivnymi rasstroistvami.

According to results of multiple studies depression and anxiety are found in more than 50% of patients with hypertension. Presence of affective disorders elevates risk of progression of hypertension. That is why complex therapy comprising antihypertensive drugs from various groups and antidepressants takes on higher and higher significance. Modern antidepressants produce no substantial cardiotoxic effects. Combination of an antihypertensive drug (angiotensin converting enzyme inhibitor captopril or beta-adrenoblocker metoprolol) with an antidepressant affects favorably clinical course of hypertension, 24-hour blood pressure profile, characteristics of intracardiac hemodynamics, structural and geometric left ventricular parameters, allows to achieve sufficient antihypertensive effect with acceptable tolerability.