[Hemodynamic Derangements in Patients With Functional Univentricular Heart: Mechanisms of Development, Possibilities of Treatment].

Heart failure (HF) is a predictable outcome of nearly all cardiovascular diseases including congenital heart diseases (CHD). A special category comprises patients with functional single ventricle (FSV) of the heart because of extreme diversity of anatomical changes of the heart and great vessels, complex mechanisms of development of HF, multistage surgical correction of the defect, presence of arrhythmias, progressive rise of pulmonary vascular resistance, etc. Prevention and treatment of HF in patients with FSV includes surgical optimization of pulmonary blood flow during neonatal period, timely staged surgical correction of the defect, pharmacotherapy, cardiac resynchronization therapy, and in severe cases mechanical cardiac support and heart transplantation. This article contains review of the mechanisms of HF development in patients with FSV as well as analysis of current approaches to recognition and treatment of this condition.

[Correlation of Endothelial Dysfunction With Course of Essential Arterial Hypertension in Adolescence].

AIM: to study laboratory parameters of endothelial dysfunction (ED) and their correlation with risk factors (RF) of cardiovascular diseases at early stages of essential arterial hypertension (AH) in adolescents. MATERIAL AND METHODS: We examined 299 adolescents aged 12-18 years with EAH. According to results of 24-hour blood pressure (BP) monitoring all patients were divided into three groups: (1) 98 adolescents with "white coat hypertension", (2) 108 adolescents with liable AH (LAH), (3) 93 patients with stable AH (stAH). Control group consisted of 27 healthy adolescents. Examination included 24-hour BP monitoring, measurement of some laboratory parameters of ED (Von Willebrand factor [vWF], nitric oxide metabolites, urine catecholamines), and assessment of cardiovascular RF. RESULTS: Mean vWF values in groups (2) and (3) were clinically significantly different from control. Increase of vWF activity by 1 unit was associated with increase of mean nocturnal pulse pressure by 0.36 mm Hg (p = 0.048). Markers of ED were related to family history of AH, overweight and low birth weight.

[METHOD OF INCREASING MICROBIOLOGICAL PURITY OF POWDER FROM COCOA-VELLA].

In the article there is described in detail the characteristic of the product of processing cocoa beans--cocoa-vella, there is presented a comparative analysis of the chemical composition, quality indices, the dispersive pattern, microbiological indices of the powder from the cocoa-vella in comparison to cocoa powder, obtained by traditional technology from the core of the cocoa beans. To improve the microbiological purity of the powder from the cocoa-vella there was suggested to be the modern and environmentally safe manner for the preparation of the powder The use of cocoa-vella disinfecting power by means of the electromagnetic field of ultrahigh frequency (RF EMF) was established to allow to obtain a product that meets the requirements of Technical Regulations of the Customs Union (TRCU 021/2011) on Food Safety. This work is of practical interest, since it helps to improve the safety of the powder from the cocoa-vella, and thus the quality of confectionery and food products based on it, which is relevant in terms of the management of a healthy diet.

[Correlation of Endothelial Dysfunction With Course of Essential Arterial hypertension in Adolescence].

AIM: to study laboratory parameters of endothelial dysfunction (ED) and their correlation with risk factors (RF) of cardiovascular diseases at early stages of essential arterial hypertension (AH) in adolescents. MATERIAL AND METHODS: We examined 299 adolescents aged 12 - 18 years with EAH. According to results of 24-hour blood pressure (BP) monitoring all patients were divided into three groups: (1) 98 adolescents with "white coat hypertension", (2) 108 adolescents with liable AH (LAH), (3) 93 patients with stable AH (stAH). Control group consisted of 27 healthy adolescents. Examination included 24-hour BP monitoring, measurement of some laboratory parameters of ED (Von Willebrand factor [vWF], nitric oxide metabolites, urine catecholamines), and assessment of cardiovascular RF. RESULTS: Mean vWF values in groups (2) and (3) were clinically significantly different from control. Increase of vWF activity by 1 unit was associated with increase of mean nocturnal pulse pressure by 0.36 mm Hg (=0,048). Markers of ED were related to family history of AH, overweight and low birth weight.

[Remodeling of left ventricular myocardium at early stages of essential arterial hypertension in adolescents].

We studied geometric changes of the left heart in 299 teenagers aged 12-18 years with essential arterial hypertension (EAH). According to 24-hour blood pressure monitoring all patients were divided into three groups: patients with phenomenon of "white coat hypertension" (WCH, n=98); patients with labile arterial hypertension (LAH, n=108); patients with stable atrial hypertension (SAH, n=93). Control group comprised 27 healthy adolescents. Parameters of central hemodynamics were assessed by echocardiography. Geometric left ventricular (LV) changes were found in 69 (23.1%) teenagers with EAH. Risk of formation of eccentric LV hypertrophy in teenagers with SAH was significantly higher than in subjects with WCH and LAH. Pulse pressure made significant contribution to formation of LV hypertrophy. Excess weight contributed significantly to formation of structural and geometric changes of LV and left atrium.

[The state of cerebral blood flow in hypertensive crises and possibilities of its correction].

We examined 60 patients with arterial hypertension admitted to hospital during hypertensive crisis. Control group consisted of 30 patients with normal arterial pressure. We investigated parameters of cerebral blood flow with the method of transcranial dopplerography, content of NO and a row of cytokines (interleukin-6, interleukin-0, tumor necrosis factor) in blood serum during hypotensive therapy with inclusion of calcium antagonist amlodipine and cerebroprotector vinpocetine. After 12 weeks of hypotensive therapy we noted significant antihypertensive effect, improvement of parameters of cerebral blood flow, and elevation of NO content in all groups of studied persons most pronounced in patients receiving amlodipine as monotherapy or in combination with vinpocetine. Administration of vinpocetine in addition to hypotensive therapy is justified in patients with hypertensive disease, as this significantly improves blood flow in cerebral vessels. This appears as elevation of linear blood flow velocity, lowering of peripheral resistance and increase of content of NO in blood serum.

[Complex assessment of vasomotor function of vascular endothelium in patients with hypertension]. / Kompleksnaia otsenka vazomotornoi funktsii sosudistogo éndoteliia.

Vasomotor function of vascular endothelium was studied in 62 patients with grade 1-2 hypertension with moderate and high added risk. Methods included study of brachial and middle cerebral artery endothelium dependent and independent vasodilation/vasoconstriction, measurement of plasma levels of nitric oxide metabolites (NO(n)-), endothelin-1, and antithrombin, as well as registration of their changes during vasomotor tests with calculation of integral indexes. Most patients with hypertension differed from controls by preponderance of vasoconstrictor over vasodilator reactions both in peripheral and cerebral vascular bed. At the same time patients with hypertension had pronounced dissociation between vasomotor responses of cerebral and peripheral vessels compared with subjects with normal blood pressure (p<0.05). Besides lowered basal level of NO(n)- and high concentration of endothelin-1 patients with hypertension were characterized by hyperreactivity of nitricoxidergic system, augmented lability of endothelin producing system, and impaired athrombogenecity of vascular endothelium. Complex assessment of vasomotor function of vascular endothelium by sequential vasoactive tests characterizes functional and metabolic activity of cerebral and peripheral vessels and can be used for improvement of risk stratification and monitoring of efficacy of treatment of patients with hypertension.

[Diagnosis and therapy of resistant temporal epilepsy]. / Diagnostika i lechenie rezistentnykh visochnykh épilepsii.

A complex research of epileptogenic focus (electroencephalography, invasive electroencephalography, MRI, PET) has allowed to localize a primary epileptogenic zone in medial temporal epilepsy in amygdale in 52% of the patients, in the anterior hippocampus--in 30% cases, a simultaneous and equivalent involvement of both amygdale and anterior hippocampus was diagnosed in 18% of the patients examined. Stereotaxic selective amygdalehippocampotomy was found to be effective in patients with resistant medial and lateral temporal epilepsy. The attacks stopped in 36% of the cases. In other patients frequency and duration of epileptic paroxysms considerably reduced, the structure of the paroxysms changed.

[Clinico-experimental evaluation of therapeutic effectiveness of 1-dihydroxyphenylalanine in circulatory insufficiency]. / Kliniko-eksperimental'naia otsenka terapevticheskoi effektivnosti 1-dioksifenilalanina pri nedostatochnosti krovoobrashcheniia.

The indices of central hemodynamics and myocardial contractility were studied by poly- and mechanocardiography in 25 patients with stage I-IIA circulatory insufficiency prior to and after treatment with 1-dioxyphenlalanine. The content of lactic and pyruvic acids in the blood and erythrocyte permeability to 32P were determined at the same time. The activity of the redox enzymes was studied in rats with experimentally induced circulatory insufficiency on the background of 1-DOPA medication. It was established that contractility of the heart and indices of central hemodynamics improved due to the effect of 1-DOPA. A decrease in the lactate concentration and an elevation of the pyruvate level in the blood of patients were noted. In animal experiments increased activity of cytochrome oxidase, succinic dehydrogenase, and alkaline and acid phosphatase in the myocardium was demonstrated.