[Diagnostic value of small concentrations of troponin in patients with myocardial infarction].

We have reviewed here studies of measurement of small concentrations of troponin in patients with myocardial infarction conducted in 2010-2011 which were most significant for the clinic. Troponin is a most specific and sensitive cardiomarker appearance of which in blood serum evidence for a necrotic process in cardiac muscle. We discuss the problem of interpretation of small troponin concentrations by clinicians as well as the states in which appearance of the cardiomarker in blood serum has noncardiac origin. We also discuss novel possibilities of application of troponin as a prognostic marker in patients with stable or unstable angina after revascularization procedures.

[Interpretation of the concentrations of procalcitonin during infectious and inflammatory processes].

The paper analyzes the most important clinical studies dealing with the measurement of procalcitonin concentrations in patients with lower respiratory tract infections or sepsis. Procalcitonin is a marker of bacterial infection, which is successfully used for diagnosis and antimicrobial therapy monitoring in patients with pneumonia or in septic states. The review presents the latest algorithms for interpreting the concentrations of procalcitonin in clinical practice.

[Specific cardiomyopathy in patients with hemochromatosis].

The paper contains data on specific features of cardiac involvement in primary and secondary hemochromatosis (symptomatology, echocardiographic signs, etc.) as well as on pathogenesis of hereditary hemochromatosis. Algorithm of diagnosis of hereditary hemochromatosis is also presented.

[Exercise tolerance in patients with exertion angina pectoris after therapeutic plasmapheresis]. / Tolerantnost' k fizicheskoi nagruzke u bol'nykh so stenokardiei napriazheniia posle lechebnogo plazmafereza.

The bicycle ergometric test was used to examine exercise tolerance in 73 patients with coronary heart disease following a single remedial plasmapheresis session, which removed an average of 1562.2 ml plasma. A rapid increase in exercise tolerance was significantly revealed in patients with Functional Class IV exertional angina.

[Target organs involvement in arterial hypertension. The role of heredity and environment (study of twins)]. / Porazhenie organov-mishenei pri arterial'noi gipertonii. Rol' nasledstvennosti i sredy (bliznetsovoe issledovanie).

AIM: To elucidate relationship between hereditary and environmental factors in development of target organ damage in hypertension. MATERIAL AND METHODS: The state of myocardium, central nervous system, blood vessels (including funduscopic examination) was assessed in 64 pairs of mono- and dizygous hypertensive twins (mean age 57.2+/-3.2 years) and clinical and genetic analysis of qualitative and quantitative signs was carried out. RESULTS: Hypertensive twins had similar qualitative features of target organs involvement irrespective of duration of hypertension. Concordance of signs of target organ damage in homozygous twins was more than twice higher than that of same signs in dizygous twin pairs. Left ventricular myocardial mass and intima-media thickness were mainly determined by hereditary factors. Their contribution into overall phenotypic variability of a sign exceeded 70%.

[The role of heredity and environment in formation of 24-hour blood pressure profile in patients with hypertension (a study of twins)]. / Rol' nasledstvennosti i sredy v formirovanii sutochnogo profilia arterial'nogo davleniia u bol'nykh arterial'noi gipertoniei (bliznetsovoe issledovanie).

Twenty four hour blood pressure monitoring was carried out in 64 sex concordant pairs of monozygotic and dizygotic hypertensive twins (mean age 52.7-/+3.2 years). Clinico-genetic analysis of quantitative parameters showed that during day awake time systolic, diastolic, and mean blood pressures were mainly determined by environmental factors while pulse pressure and heart rate were predominantly affected by genetic factors. Formation of parameters of variability of blood pressure and its biphasic rhythm were under the influence of random (intrafamily) environmental factors.

[Myocardial function in patients with hereditary hemochromatosis based on echocardiographic data]. / O sostoianii miokarda u bol'nykh nasledstvennym gemokhromatozom po dannym ékhokardiografii.

In order to reveal changes in the myocardium at the preclinical stage of heart failure, 34 patients with hereditary hemochromatosis (HHC) underwent echocardiography in the M-mode. There were 26 men and 8 women aged 24 to 59 years. The control group was made up of 20 healthy persons. The HHC patients over 35 years of age (49.5 years on the average) manifested enlargement of the left ventricular cavity, an increase of the thickness of the interventricular septum and of the posterior heart wall, and reduction of pump function of the left ventricle.

[Physical work capacity studied by measured physical loading in patients with hereditary hemochromatosis]. / Issledovanie fizicheskoi rabotosposobnosti v usloviiakh dozirovannoi fizicheskoi nagruzki u bol'nykh naseldstvennym gemokhromatozom.

A significant decrease of work fitness was revealed in 23 patients with verified diagnosis of hereditary hemochromatosis exposed to graded physical exercise. It is assumed that the decrease of exercise tolerance in these patients may be most possibly accounted for by the lowering of myocardial contractility as a result of its injury due to iron overload. It is not excluded, however, that nonspecific dystrophic processes determined by diabetes mellitus, liver damage and coronary atherosclerosis in some cases may develop.

[Plasmapheresis in the treatment of critical stages of ischemia in diabetic angiopathy of the lower extremities]. / Plazmaferez v lechenii kriticheskikh stepenei ishemii pri diabeticheskoi angiopatii nizhnikh konechnostei.

The authors have used gravitation plasmapheresis in the treatment of 26 patients with diabetic angiopathies of lower extremities. It was established that continuous gravitation plasmapheresis facilitated the immediate correction of most of the altered biochemical and coagulation parameters of blood, in patients with diabetes mellitus. The use of rheopolyglucinum is followed by stable central hemodynamics and stabilization of the general state of the patients during continuous plasmapheresis which allows to recommend rheopolyglucinum as the main plasma-substituting solution for fractionation of blood in patients with diabetic angiopathies. The gravitation plasmapheresis used in the treatment of critical degrees of ischemia in patients with diabetic angiopathies of lower extremities is thought by the authors to allow to preserve the extremity or to make the level of its amputation lower in most patients.