THE SIGNIFICANCE OF CIRCULATING SURFACTANT PROTEIN D AND DYSLIPIDEMIA IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE, CORONARY HEART DISEASE AND THEIR COMBINATION.

As it is widely known, cardiovascular diseases represent one of the leading causes of mortality. In the coexistence of chronic obstructive pulmonary disease (COPD), the mortality rate is increasing as well. The research conducted reviews the effect of surfactant protein D on the coronary heart disease and chronic obstructive pulmonary disease.The cohort of 90 patients was included in the study. The patients were divided into five groups: group I (the patients with coronary heart disease - CHD); group II (the patients with dyslipidemia); group III (the patients with COPD); group IV (the patients suffering from the combination of CHD and COPD); group V (control group). The laboratory (dyslipidemia - through enzymatic method) as well as the instrumental methods (echocardiography, spirometric examination) were applied in the study.In consequence of the statistical processing of materials within the study, the relatively high level of surfactant protein D (SP-D) values determined in groups was revealed in group II (the patients with dyslipidemia), SP-D-25.9±19.6 ng/ml. Similar data were identified in practically healthy individuals - control group (group V). Performing the comparative analysis of data, the statistically high value of anti-atherogenic HDLC (52.5±10.5 mg/dl) was observed in group II (the patients with dyslipidemia) compared to group IV (p=0.002). It is worth noting that in the patients of group IV (COPD+CHD) the quantitative HDLC was statistically lower (43.6±6.5mg/dL) in comparison with the data of all other groups: (group I - HDLC-51,6±6,8; group II -52.5±10.5; group III-50.7±9.5; group V - 50.3±8.4) p1-4<0.001; p2-4=0.002; p3-4=0.005; p4-5=0.02. Considering the above-mentioned data, we can draw the conclusion that along with the elevated level of circulated SP-D, the low HDLC value can be utilized as a marker of the severe course of disease in relation to COPD as well as CHD.The high level of SP-D, which does not have the significant atherogenic effect (due to the presence of high HDLC), was detected in individuals with isolated dyslipidemia. The study has established that in the presence of CHD, in line with the increase in atherogenic lipoproteins and relatively low HDLC value, there is detected the high level of SP-D, which is correlated with lung function indices (FEV 1 and FVC). And in case of the coexistence of COPD and CHD where dyslipidemia, the elevated level of SP-D and corresponding changes in pulmonary function tests are manifested, there were identified the high risks of severe course of disease, the development of heart failure and mortality.

[Beneficial effects of Hartil on cardiovascular remodeling process in elderly and old patients with isolated systolic arterial hypertension].

The aim of present study was to assess antihypertensive efficacy of ramipril 5-10 mg (Hartil "EGIS", Hungary) and its influence on hemodynamical changes and vessel endothelial function in old and elderly patients with isolated systolic hypertension. 32 patients were studied. The duration of the therapy was 6 months. 24-hour blood pressure monitoring was performed and left ventricular parameters, systolic, diastolic function and endothelial function of brachial artery (endothelium - dependent vasodilatation), blood tests, lipid profile were investigated before and after 3 and 6-months of treatment. The study detected high antihypertensive efficacy of Hartil: mean daily and pulse pressure were significantly (p<0,001) decreased after 3 and 6-months of treatment (TA(syst) 9,1 and 16%, TA(diast) 2,2 and 8,4%, pulse pressure 2,2 and 7,5%, respectively), beneficial effect revealed on 24-hour blood pressure profile: number of patients with normal dipper profile increase from 33 to 46% with decrease of number of non-dippers and night-peakers. During study tendency of left ventricular mass/index reduction was detected. That become statistically significant (p<0,001) after 6-months of treatment (11,7/11,4%), consequently increased number of patients with concentric remodelling (from 18,7 to 25%) and normal geometry (from 12,5 to 18,7%), and decreased number of patients with concentric hypertrophy (from 31,3 to 25%) and eccentric hypertrophy (from 37,5 to 31,3%). Also there was significant (p<0,05) improvement of diastolic and endothelial functions (up to 28,7 and 45,5%, respectively) and increase of number of patients with normal endothelial function (from 25 to 53%). Data of laboratory tests revealed metabolic neutrality of Hartil. Thus, Hartil (5-10 mg daily) revealed high antihypertensive efficacy, metabolic neutrality and beneficial effects on cardiovascular remodeling process in old and elderly patients with isolated systolic hypertension, which contributes to reduce the risk of cardiovascular complications.

[Isolated systolic arterial hypertension in elderly and senile patients].

Systolic arterial pressure rises uninterruptedly with age and it appears as a strong independent risk-factor of cardiovascular, cerebral and renal complications. A combined using Norvasc and Egilok gives stable hypotensive effect, provides regression of left ventricular hyper-trophy with improvement parameters of systolic and diastolic function, which is vitally important for researched contingent of patients. A combined using small therapy doses of drugs protects geriatric patients against side effects.

[Prevention of paroxysms of atrial fibrillation in old and senile patients].

It is known that the atrial fibrillation is a sorrow "privilege" of the senile groups of people. The aim of the given paper was to study the reasons of atrial fibrillation arising in old (60-74 years) and senile (75-89 years) patients and possibility of prevention paroxysms of atrial fibrillation and its complications with help of prolonged selective beta-blocker egilok retard pro daily doses 50-100 mg. The results which were received after the examination and treatment of 147 patients who were under stationary and dispensary treatment at the Research Institute of Experimental and Clinical therapy for 12 months. We have achieved full absence of paroxysmal atrial fibrillation in 89.8% patients (132 patients). The use of egilok retard gives stable hypotensive effect in old and senile patients, provides the regression of the left ventricular hypertrophy with improvement of its parameters and diastolic function, which is especially important for the studied contingent of the patients.

["Hypertensive heart" symptoms in the elderly]. / Simptomatika "gipertonocheskogo" serdtsa v pozhilom i starcheskom vozraste.

Arterial hypertension is a leading pathology in the elderly. This pathology become extremely important in a spread atherosclerotic process commonly observed in the geriatric patients. While the aspects of left ventricle in arterial hypertensive patients are rather well known, this pathology needs further investigations connected with the studies on age-related changes in cardiovascular system. Particular attention should be paid to a symptomatic of "hypertensive heart" in the elderly patients.

[A comparative evaluation of the antianginal efficacy of aldizem and korinfar in patients with stable stenocardia]. / Sravnitel'naia otsenka antianginal'noi éffektivnosti aldizema i korinfara u bol'nykh stabil'noi stenokardiei.

As many as 46 men suffering from coronary heart disease combined with angina pectoris of effort, functional classes II-IV, were examined. The two-week treatment with nifedipine (30-60 mg/day) and aldizem (180-270 mg/day) exerted an antianginal action in 47.8 and 39.1% of the cases, respectively, which was supported by the data of clinical examinations, loading tests, and by the data of ECG monitoring. Nifedipine turned out most effective in patients of functional class II with arterial hypertension.