[Level of nitrous oxide in peripheral blood serum in patients with various severity of arterial hypertension].

AIM: To elucidate the role of nitrous oxide (NO) in development of severe primary arterial hypertension (AH) including malignant hypertension and concomitant ischemic heart disease (IHD). MATERIAL AND METHOD: Patients with diagnosis of primary 1-3 degree AH (n=62, 21 men, 41 women aged 39-87 years, mean age 63.7+/-2.7 years) and 28 subjects with normal arterial pressure (AP) (n=28, 13 men, 15 women aged 30-85 years, mean age 57.5+/-7.8 years). Blood serum levels of NO stable metabolites (nitrates and nitrites) were measured by reaction of their reduction in the presence of vanadium chloride and by reaction of diazotization of sulfanilamide by generated nitrite (modification by R.M.Miranda et al., 2001). RESULTS: NO level (level of its stable metabolites) was substantially elevated in patients with various severity of AH compared with subjects with normal AP. Severe and malignant course of AH was not associated with substantial lowering of NO level in blood serum. Relation between NO level and age found in subjects with normal AP, was not observed in patients with labile and stable course of AH. In patients with AH, normal serum NO level and signs of chronic involvement of cardiovascular system the disease was several times more often associated with atrial fibrillation and class II-III angina than in patients with high NO levels. Patients with AH combined with IHD more often had signs of heart failure and history of myocardial infarction.

[Derangements of contractility of left ventricular myocardium in patients subjected to coronary bypass surgery. Methods of their correction].

Coronary bypass grafting with the use of cardiopulmonary bypass was performed in 119 patients (age 41-75 years) with stable angina. In addition to standard therapy in pre and post operative periods patients of group 1 (n=40) received mildronate (750 mg/day for 3 days then 750 mg twice weekly), patients of group 2 (n=41) received trimetazidine (70 mg/day). Patients of group 3 (n=38) received no "metabolic" drugs. The use of cardioprotectors mildronate and trimetazidine facilitated improvement of total and local myocardial contractility both before and after surgery, and caused limitation of development of myocardial stunning, associated with derangement of local contractility in post operative period.

[Levels of sex hormones in obese women with hypertension during various periods of reproductive activity]. / Kharakter izmenenii urovnia polovykh gormonov u zhenshchin, bol'nykh arterial'noi gipertenziei, s ozhireniem v raznye periody generativnoi aktivnosti.

AIM: To assess effects of hypertension and obesity on blood plasma levels of sex hormones and gonadotropins in fertile and postmenopausal women. MATERIAL: We assessed endocrinological status and measured levels of sex hormones and gonadotropins in 228 women with grade I-III hypertension (WHO, 1999) and 114 normotensive women of fertile and postmenopausal ages (17 to 74 years). There was a definite relationship between obesity and levels of sex hormones which did not depend on blood pressure level. The authors regarded this relationship as an endocrinological consequence of obesity. Severity of hypertension was associated with elevation of luteinizing and follicle-stimulating hormones and lowering of progesterone level in fertile women and with elevated levels of sex hormones in blood plasma in menopausal women. The authors interpreted the latter phenomenon as a sign of adrenal gland hyperfunction.

[Free radical oxidation in patients with hypertrophic cardiomyopathy]. / Sostoianie svobodnoradikal'nogo okisleniia u bol'nykh gipertroficheskoi kardiomiopatiei.

As shown by the study of 27 patients with non-obstructive form of hypertrophic cardiomyopathy (HC), this disease is associated with a significant rise in the production of active oxygen forms by leukocytes, significant changes in the activity of enzyme antioxidant defense, unchanged lipid peroxidation, high total antioxidant activity of blood plasma. The patients received a complex of natural antioxidants varying by mechanism of action and glutaminic acid. Antioxidants produced a subjective clinical response, reduced incidence of cardiac arrhythmia, improved exercise tolerance. The response becomes still better in combination of antioxidants with conventional therapeutic tools.

[The joint use of plasmosorption and enterosorption in the combined treatment of patients in the acute period of a myocardial infarct]. / Sochetannoe ispol'zovanie plazmosorbtsii i énterosorbtsii v kompleksnom lechenii bol'nykh v ostrom periode infarkta miokarda.

Plasmosorption and enterosorption were assigned to 35 acute myocardial infarction (AMI) patients. Plasmosorption was performed within an hour since AMI onset followed by a 5-day course of enterosorption (enterosorbent YO-A in a dose 30 g/day). The above combination produced a positive effect on hemodynamics and blood rheology resultant from a reduction in hematocrit value, plasma levels of fibrinogen and its derivatives, plasma viscosity and platelet aggregation. Ibustrin (200 mg) combined with heparin (100000 U) introduced into extracorporeal circulation effectively prevents thrombogenesis. AMI patients treatment with enterosorption plus plasmosorption enhances the response to nitroglycerin, reduces the rate of complications and lethal outcomes.

[Effects of laser therapy in patients with functional class II-IV effort angina (using instrumental techniques of the study)]. / Effektivnost' lazernoi terapii u bol'nykh so stenokardiei napriazheniia II-IV funktsional'nogo klassa (s ispol'zovaniem instrumental'nykh metodov issledovaniia).

Infrared laser therapy using an arsenide-gallium laser was used in 54 patients aged 30-75 years who suffered from coronary heart disease. A positive clinical effect was achieved in 47 (87%) of 54 patients, as evidenced by the reduced number of nitroglycerin tablets used and improved bicycle ergometric, echo- and electrocardiographic parameters in the patients.

[Role of imbalance of sex hormones and gonadotropins in the development and course of essential hypertension in women]. / Rol' narushenii balansa polovykh gormonov i gonadotropinov v razvitii i techenii éssentsial'noi gipertenzii u zhenshchin.

Overall 146 females suffering from essential hypertension (borderline, stage I and II according to WHO, 1980) were examined for basal concentrations of estradiol, estriol, progesterone, testosterone, cortisol, ACTH, prolactin in plasma, LH and FSH in blood and urine. The patients and 69 control normotensive females were reproductive, premenopausal, menopausal, postmenopausal, postcastration. Latent hypertension was elicited at bicycle exercise. It was found that relationships between sex hormones and gonadotropins both in hypertensive and normotensive women did not differ noticeably in reproductive period and in menopause. Hormone defects due to primary and secondary infertility, castration, menopause did not raise the risk of arterial hypertension onset. An-Unfavorable course of hypertension was observed in premenopause, following operative castration, in climacteric syndrome. The severity of AH at reproductive age was associated with hyposecretion of progesterone, estrogens and gonadotropins LH, FSH. This relationship was absent in menopausal women. A conclusion is proposed on miner significance of sex hormones imbalance and gonadotropins in the onset of arterial hypertension in females varying by generative activity.

[Differences in metabolic rate of Na+/H+ in the erythrocyte membrane in hypertension and symptomatic hypertension of renal origin]. / Razlichiia v skorosti Na+/H+ obmena v membrane éritrotsitov pri gipertonicheskoi bolezni i simptomaticheskoi gipertenzii pochechnogo geneza.

Na+/H+ turnover rate in the erythrocyte membranes were measured in 20 patients with Stages II and III essential hypertension, 11 patients with renal hypertension and 10 healthy subjects. The patients with essential hypertension showed a two-fold increase in Na+/H+ turnover rate as compared to the controls. Those with renal hypertension displayed no changes in the rate. The rate of Na+/H+ turnover was not associated with the patients' sex and was the same in Stages II and III essential hypertension. Measuring the Na+/H+ exchange rate was proposed to be an additional diagnostic tool for the differential diagnosis of arterial hypertension.

[Effects of nirmin on central hemodynamics in patients with heart failure in the acute period of myocardial infarct]. / Vliianie nirmina na tsentral'nuiu gemodinamiku u bol'nykh s serdechnoi nedostatochnost'iu v ostrom periode infarkta miokarda.

Nirmin, a novel dosage form of nitroglycerin, was used to treat heart failure in 47 patients on days 1-3 after acute myocardial infarction. The drug was intravenously injected at 12-400 micrograms/min for 3-24 hours. Central hemodynamic changes were evaluated from equilibrium radionuclide ventriculographic data and pulmonary diastolic and central venous pressures. Nirmin improved the clinical status in 89.3% of the patients. Hemodynamic effects of the agent were manifested by reduced myocardial preload and its improved contractility, followed by elevated left ventricular ejection fraction and decreased hypokinesia of the myocardial affected areas.