[Cognitive impairment and compliance in chronic heart failure]. / Kognitivnye narusheniia i priverzhennost' lecheniiu u patsientov s khronicheskoi serdechnoi nedostatochnost'iu.

AIM: To determine the factors of cognitive impairment and non-compliance in patients with chronic heart failure (CHF). MATERIAL AND METHODS: One hundred and fifty-seven patients with CHF and 32 patients without chronic heart failure (controls) were examined. Neuropsychological assessment using a 30-minutes protocol recommended by NINDS-Canadian Stroke Standards (NINDS CSS), magnetic resonance imaging, cognitive ERP and a test of compliance were used. RESULTS AND CONCLUSION: Approximately 62% of patients did not perform medical prescriptions. Non-compliance was associated with an increase in the severity of subcortical and perivenricular leukoaraiosis, a slowdown in decision-making processes (an increase in the P300 latency), worse performance on speech activity tests, optical/spatial and frontal dysfunctions and memory. Patients with non-compliance had frontal cognitive impairment (58%), memory impairment (40%) and mixed forms (21%). Cognitive impairment in patients with chronic heart failure was associated with the lower left ventricular ejection fraction and deterioration in indices of diastolic function.

[Desadaptive Reaction and Development of Arterial Hypertension in Conditions of Professional Stress].

PURPOSE: to compare prevalence of maladaptive responses and risk of hypertension and cardiovascular remodeling. MATERIAL AND METHODS: We examined using clinical and instrumental methods 1321 workers of locomotive crews; 472 of those examined were followed-up for 12 years. RESULTS: Machinists with maladaptive responses compared with the group of individuals with normal tension of adaptation processes had greater left ventricular myocardial mass and carotid artery intima-media thickness regardless of blood pressure (BP) level. During follow up 380/472 persons maintained normal BP while 87 developed hypertension (5 patients with symptomatic hypertension were excluded from analysis). According to modified MMPI test persons with hypertension had higher scores on scales 2, 8, and 6. Personality profile was characterized by presence of mixed type of response with combination of high need for self-realization and tendency to curb behavioral reactions.

[Cognitive functions in patients with chronic heart failure].

OBJECTIVE: To evaluate cognitive functions in patients with different stages of chronic heart failure (CHF) and different degrees of stenosis of precerebral arteries. MATERIAL AND METHODS: Authors examined 148 patients with CHF and 21 patients without CHF (controls). Neuropsychological assessment (NINDS-Canadian Stroke Standards - 30 minutes protocol), ultrasound scanning of the main cranial arteries and transcranial dopplerography and echocardiogram were made. RESULTS AND CONCLUSION: Patients with CHF more frequently had combined (multifocal) cognitive impairment. Patients with systolic heart failure performed significantly worse on neuropsychological tests, in particular, functional domains within the frontal lobes and "executive" dysfunction, than those with diastolic heart failure. Cognitive impairment in patients with CHF was associated with the lower left ventricular ejection fraction and deterioration in indices of diastolic function but not with carotid artery stenosis.

[Left ventricular hypertrophy and thickening of common carotid artery wall in men aged 40 - 54 years with I degree arterial hypertension].

We carried out clinical-instrumental examination of 456 men aged 40-54 years. First degree arterial hypertension was revealed in 165 men. Left ventricular hypertrophy was found in 48 (30%), increased intima-media thickness (IMT) - in 67 (41%) patients. There was significant medium power relationship between IMT and left ventricular myocardial mass (correlation coefficient 0.41). Formation of left ventricular hypertrophy was related to parameters of 24 hour blood pressure monitoring, arterial hypertension in brothers and sisters, body weight, and duration of obesity. Significant medium power relation was obtained between tension of endothelial system of hemostasis (protein C) and severity of left ventricular hypertrophy (correlation coefficient - 0,3). Age, heredity, low density lipoprotein, cholesterol, uric acid level mattered for IMT increase.