[Vasoprotective effects hypotensive therapy in patients with coronary heart disease combined with chronic kidney disease stage 2-3 after coronary stenting].

Aim      To study the condition of coronary vasculature by data of coronarography (CG) in patients with chronic ischemic heart disease (IHD) and arterial hypertension (AH) associated with stage 2-4 chronic kidney disease (CKD) and to evaluate the effect of a 12-week complex treatment with perindopril or with a combination of perindopril/amlodipine on changes in vascular wall stiffness, endothelial function, and structure and function parameters in this patient category after coronary stenting.Material and methodsr This study included 87 patients with chronic IHD and AH associated with stage 2-3 CKD for whom CG was performed due to ineffectiveness of the antianginal therapy. The patients were divided into three subgroups: subgroup 1 included 28 patients who received a conservative treatment with perindopril 10 mg/day; subgroup 2 consisted of 25 patients who underwent coronary stenting and were prescribed perindopril; subgroup 3 consisted of 34 patients who underwent stenting and were prescribed the perindopril/amlodipine combination. The reference group included 47 patients with IHD and AH with preserved kidney function. Anatomic and functional parameters of the heart, arterial stiffness, pulse wave velocity, cardio-ankle vascular index, augmentation index, central aortic systolic and pulse pressure, endothelium-dependent vasodilation, plasma concentration of endothelin-1 (ET-1), and plasma concentration of nitric oxide metabolites were evaluated at baseline and after 12 weeks of treatment.Results In patients with IHD, AH, and stage 2-3 CKD, arterial stiffness was more pronounced than in patients with preserved kidney function. Concentrations of ET-1 were significantly higher and levels of nitric oxide were lower in CKD. Supplementing the complex therapy with perindopril resulted in a considerable hypotensive effect in all subgroups, improvement of the kidney function, and positive dynamics of arterial stiffness and endothelial function. Changes in these parameters were more pronounced in patients after coronary stenting than in patients receiving only a conservative treatment. The use of perindopril/amlodipine following stenting exerted the most significant angioprotective and cardioprotective effect.Conclusion      Patients with IHD and AH in combination with early CKD have pronounced impairment of the condition of arterial blood vessels and the heart. Addition of perindopril to the treatment not only exerted a hypotensive effect but also beneficially influenced mechanisms of progression of this combined pathology.

[Tailed. New options in therapy of bronchial asthma]. / Tailed. Novye vozmozhnosti terapii bronchial'noi astmy.

Patients with mild and moderate bacterial bronchial asthma received tailed in a dose 8 mg/day for 15 days. Positive changes were registered in bronchial permeability, hemodynamics in the lesser circulation. Hydrocortisone and immune unbalance was corrected.

[Evaluation of the effect of obsidan in essential hypertension patients with different types of circulation]. / Otsenka deistviia obzidana u bol'nykh gipertonicheskoi bolezn'iu s razlichnymi tipami krovoobrashcheniia.

A study of the effect of propranolol on the central hemodynamics using the polycardiographic method in 90 patients with essential hypertension showed that in 83% of them, disregarding the type of hemodynamics, beta-blocker made a negative chronotropic effect, and in 17% of the patients it increased the heart rate. In the patients with the hyperkinetic circulation the negative inotropic effect of propranolol was noted in 42% of the cases, and in the patients with the eu- and hypokinetic circulation 37.5%. However, the improvement of myocardial contractility expressed in an increase in the cardiac and stroke blood volume, the stroke and cardiac indices, and a decrease in peripheral vascular resistance were found in 24.4% of the total number of patients.

[Significance of progesterone in the pathogenesis and treatment of pulmonary hypertension and cardiopulmonary failure]. / Znachenie progesterona v patogeneze i lechenii legochnoi gipertonii i legochno-serdechnoi nedostatochnosti.

Study of blood progesterone and diurnal urine pregnanediol revealed that progesterone level substantially increased in the initial stage of cor pulmonale formation (in respiratory failure without heart decompensation). Meanwhile as heart insufficiency and pulmonary hypertension in patients with chronic nonspecific lung diseases augmented, blood progesterone and excretion of pregnanediol dramatically fell. Application of progesterone (2.5% solution, 2 ml i.m. once a day over a week) favoured an increase in pulmonary ventilation, improvement of myocardial contractility, and pressure drop in the pulmonary artery.

[Steroidal hormones, biogenic amines in arteriosclerosis and pulmonary hypertension in patients with chronic nonspecific pulmonary disease]. / Steroidnye gormony, biogennye aminy pri ateroskleroze i legochnoi gipertenzii u bol'nykh s khronicheskimi nespetsificheskimi zabolevaniiami legkikh.

A comparative study of the heart phasic pattern was carried out using phlebo-, sphygmo- and kinetocardiography in male patients with chronic nonspecific pulmonary disease and the chronic pulmonary heart syndrome with or without atherosclerosis. Systolic pressure in the pulmonary artery was calculated using Burstin's method. Atherosclerosis in patients with chronic nonspecific pulmonary disease was shown to be accompanied by high pulmonary hypertension and feature corticosteronemia, hyperestrogenemia, androgen (testosterone) deficiency and increased production of serotonin and noradrenalin.