Interstitial Edema of the Interatrial Septum in Patients with Atrial Fibrillation and Chronic Heart Failure.

We studied the presence of interstitial edema of the interatrial septum in patients with chronic heart failure (CHF) with atrial fibrillation (n=23) or without rhythm disturbances (n=9). The intensity of the MRI signal of the interatrial septum, interventricular septum, and skeletal muscle by T2-weighted MRI and the enhancement index of interatrial septum (the ratio of the signal intensity of the interatrial septum to the signal intensity of the skeletal muscle) were evaluated. The enhancement index of interatrial septum ⩾2 was regarded as an MRI sign of myocardial edema. The enhancement index of interatrial septum in patients with persistent atrial fibrillation was 2.4 (2.21; 2.69) and was higher than in CHF patients with paroxysmal atrial fibrillation and in CHF patients without arrhythmias and surpassed the control values (p<0.05), which indicates the presence of MRI signs of edema of the myocardium of the interatrial septum. The obtained data confirm the presence of myocardial edema of the interatrial septum in CHF patients and persistent form of atrial fibrillation, which expands the understanding of the pathogenesis of this condition.

The level of NT-proBNP in ambulatory patients with chronic heart failure with preserved ejection fraction of the left ventricle.

AIM: The prevalence of chronic heart failure (CHF) remains high. Echocardiography is a reliable method of diagnosing heart failure. Determination of brain natriuretic peptide allows to identify patients with the most probable diagnosis of heart failure, which requires further instrumental examination of patients. To study the level of the brain natriuretic peptide in patients with diastolic chronic heart failure with preserved left ventricular ejection fraction. MATERIALS AND METHODS: The study included 96 outpatients with diastolic chronic heart failure I-III functional class with a preserved left ventricular ejection fraction at the age of 65.06 ± 1.15 years and 50 practically healthy people aged 39.90 ± 1.64 years as a control group who underwent a preventive examination. The level of the N-terminal fragment of the medullary natriuretic peptide (NT-proBNP) in serum was determined using a test system (Vector-Best, Russia). RESULTS: The concentration of NT-proBNP in patients with diastolic heart failure with a preserved left ventricular ejection fraction was 108.18 ± 21.64 in the range from 0.0 to 1212.3 pg/ml compared to the control of 7.6 ± 1.38 pg/ml, p<0.05. A positive correlation was found between the concentration of NT-proBNP and the area of the left atrium (r=0.35), left ventricular E/e '(r=0.6), and left ventricular end-systolic volume (r=0.48). The level of NT-proBNP had no correlation with the functional class of CHF (r=0,23), as well as with the stage of CHF (r=0,23). CONCLUSION: Thus, patients with diastolic CHF with a preserved ejection fraction in 67% of cases had a level of NT-proBNP in the blood less than the diagnostic threshold. The concentration of NT-proBNP in the serum positively correlates with increased pressure in the cavity of the left ventricle, the end-systolic volume in it and the area of the left atrium.

Increased concentrations of serotonin and 5-hydroxyindoleacetic acid in blood plasma from patients with pulmonary hypertension due to mitral valve disease.

Serotonin content in the plasma and platelets and 5-hydroxyindoleacetic acid concentration in the plasma were shown to increase in patients with pulmonary arterial hypertension due to mitral valve disease. A positive correlation was found between the severity of pulmonary arterial hypertension and concentrations of serotonin (r=0.48) and 5-hydroxyindoleacetic acid in the plasma (r=0.9).

[The state of sympathetic-adrenal system in patients with chronic cardiac insufficiency].

Activation of sympato-adrenal system plays an important role in the development of chronic cardiac failure (CCF). However, its relation to morpho-functional state of myocardium in CCF patients is virtually unknown. HPLC with electrochemical detection was used to determine plasma noradrenalin, adrenalin, and their precursors, 3,4-dioxyphenylalanine (DOPA) and dopamine, in patients with different morpho-functional changes in myocardium. The study demonstrated enhanced activity of sympato-adrenal system in patients with CCF. It showed for the first time that activity of sympato-adrenal system in CCF patients depends on the morpho-functional status of myocardium.

[Pharmacological sympatectomy changes heart's inotropic reaction on serotonin in postnatal ontogenesis of rats].

In the present study, the influence of 0.1 microM, 1.0 microM, 10.0 microM serotonin (5-HT) on inotropic function (contraction force, time to peak force, time to relaxation) of desympathetized rats by guanethidine in postnatal ontogenesis was investigated. 5-HT has a positive inotropic effect on atria (178 %) and ventricles (122%) in 21-day old rats. In 21-day old desympathetized rats, serotonin influence on the atrium was depressed by 49 %, while ventricle contraction did not change. Atria contraction force in 100-day old rats increased by 38 %, while ventricle contraction force was decreased by 5-HT. In the 100-day old desympathetized rats, a significant elevation ofinotropic effect of 5-HT in atria by 91% and ventricles by 51% was revealed. It was shown that injection of guanethidine during three weeks since birth changes reaction on 5-HT in postnatal ontogenesis ofrats. In 21-day old desympathetized rats, 5-HT had a negative inotropic effect in the early period after pharmacological sympatectomy, while in the period of compensation the elevation of the positive inotropic effect of 5-HT occurred. Positive inotropic effect of atria in 100-day old desympathetized rats was twice as high as in control group. Our data suggest that there exists an interaction between adrenergic and 5-HT regulation in postnatal ontogenesis of rats.

Adrenergic and serotoninergic regulation of myocardial contractility in patients with various morphofunctional changes in the heart resulting from chronic heart failure.

A relationship between morphofunctional changes in the heart and predominance of adrenergic or serotoninergic influences on the strength of myocardial contraction in the right atrium was revealed in patients with chronic heart failure. During left ventricular hypertrophy, the strength of myocardial contraction in response to serotonin exceeded that induced by epinephrine and was realized via 5-HT2 receptors.