LONG-TERM BLOOD PRESSURE VARIABILITY IN STRENGTH AND ENDURANCE PROFESSIONAL ATHLETES WITH OFFICE PREHYPERTENSION OVER ANNUAL TRAINING MACROCYCLE.

Considering the high spreading of arterial hypertension (AH) in professional athletes involved in different types of physical activities, as well as the high probability of its development in individuals with high normal blood pressure (BP), we aimed at investigating the daily profile of BP during three periods of annual training summer macrocycle: the preparation, competitive and transition ones. The investigation included 30 athletes having levels of systolic BP ≥130 and <140; as well as diastolic BP ≥ 85 and <90 mmHg during a thorough office examination in the preparation phase, who were divided into two groups without changes on age, sex, the duration of the sporting career depending on the type of a performed physical activity - strength (Str) and endurance (End). The athletes underwent office BP measurements and home BP monitoring (over the course of 3-7 days (M=5.2 (0.9) days), medical consultations, anthropometric and clinical examinations on each phase of the macrocycle. Although symptoms of chronic stress and autonomic dysfunction were quite common in athletes with prehypertension, still the emergence of the detected symptoms didn't differ significantly between two groups under investigation. When comparing the average values of office and home BP, the differences between Str-group and End-group regarding all indicators during the competitive phase have been identified. In particular, the levels of home diastolic BP differ the most - in Str-group they amounted to 91.1 (5.5) mm Hg, whereas in Endgroup to 83.7 (5.9) mm Hg (р=0.002). Nevertheless, the average maximum home systolic BP in Str-group has exceeded the high normal limit and accounted for 142.5 (10.2) mm Hg, in End-group the same parameter was 133.1 (7.6) mm Hg (р=0.019). The spreading of hypertension during preparation, competitive and transition periods in the Str-group has consecutively accounted for 20%, 53.3% and 13.3%.; in End-group the BP has accounted for 6.7%, 13.3% and 6.7% respectively, herewith during the competitive phase that indicator in Str-group was much higher (р=0.02), and the relative risk of developing hypertension during the competitive phase equaled 4 (р=0.048). Therefore, the increase of AH frequency and the level of BP in athletes involved in strength exercises isn't supported by an increase of autonomic symptoms development in comparison to the athletes performing endurance exercises, i.e. the frequency of asymptomatic, masked cases has a tendency to rise. To detect hypertension in time, we suggest performing home BP monitoring for athletes with high normal blood pressure during the competitive period.

VENTRICULAR REPOLARIZATION MEASURES IN PROFESSIONAL AND AMATEUR ATHLETES WITH HIGH NORMAL ARTERIAL PRESSURE.

There is merely little data regarding changes in repolarization among professional athletes with prehypertension, especially in comparison with amateur athletes. It was previously shown that disturbances of repolarization may have an important role in the development of cardiac changes in athletes and be observed in a number of conditions, such as ventricular hypertrophy, channelopathies, and aortic aneurysm. Therefore, in this study, it has been aimed to compare the ventricular repolarization measures in professional and amateur athletes with high normal arterial pressure.Thirty professional and thirty amateur all-around track and field athletes were enrolled in this project. According to the level of sport activities and the presence of HNBP, all athletes were divided into 4 groups. The first group consisted of professional athletes with normal and optimal blood pressure (NOBP) values (<130/80 mmHg, total of 21 persons), the second group was formed by 9 professional athletes with HNBP (≥130/85 mmHg), the following 3rd (17 persons) and 4th (13 persons) groups were composed by amateur athletes with the level of arterial blood pressure up to 130/85 mmHg and higher respectively. We have indicated that professional athletes with upper normal values of blood pressure have an extension of the TpTe interval compared to other groups of athletes, the average value of this indicator comprised 86 ± 10.94 ms, which, however, was below the dangerous level of >100 ms. This group of people also showed an increase in the ratio of TpTe/QT values (p=0.001) in the absence of a significant difference in S-Tpc intervals (p=0.605). These changes indicate an increase in transmural dispersion of repolarization with the development of left ventricular remodeling of professional athletes with upper normal values of blood pressure. In order to establish a connection between the revealed features of repolarization and non-functional overreaching/overtraining and altered autonomic cardiovascular activity with sympathetic activation syndrome, other pathogenesis features, their clinical and prognostic value, further examinations are required.

[FUNCTIONAL STATUS OF THE VISUAL ORGAN DURING PREECLAMPSIA].

The purpose of this research is to study the effect of preeclampsia of pregnant women on the functional status of the visual organ. The research study was made on 77 pregnant women (154 eyes) from 17 to 43 years old. Based on the analysis of the research results, during uncomplicated pregnancy and mild preeclampsia we found no significant changes in the foveolar retinal thickness and macular retinal volume both during various trimesters of pregnancy and postpartum. In moderate preeclampsia along with spasm of retinal arterioles and congestion in the venous bed in the third trimester, there was a statistically significant increase in the average thickness of the foveolar retina (183.8±4.2 micron versus 158.6±4.4 and 157.8±4.1 micron respectively in the control and in the comparison group, p<0.05); 57% of the eyes have a significant increase of the average FRT data (7.38±0.05 mm³ versus 7.01±0.02 mm³ in the comparison and control groups, p<0.05); in one case, the macula oedema was determined by ophthalmoscopy. In this group, the highest increase of the foveal retina thickness and the increase of the macular retina volume (198.3±4.5 micron, and 7.90±0.07 mm³, p<0.05) were observed. After 2-4 months postpartum in the subgroups of moderate and severe preeclampsia, there was a reduction in the average values of foveal retinal thickness and macular retinal volume, although the mean MRV values still significantly exceeded the baseline, and in 10 eyes FRT elevated remained indices. Changes in the retina morphometric parameters directly correlated with the severity of preeclampsia. Identified changes in the macular retina must be considered when predicting the risk of the macular pathology formation many years postpartum.

[FEATURES OF EARLY REPOLARIZATION SYNDROME DEPENDING ON EVIDENCES OF HEART HYPERTROPHY IN PROFESSIONAL ATHLETES].

A syndrome of early repolarization, common in professional athletes, has recently been considered as a possible predictor of acute arrhythmias. It is known that for this category of young people the development of compensatory hypertrophy of the heart is also common. The aim of the study was to investigate the features of early ventricular repolarization in professional athletes, depending on the presence of signs of cardiac hypertrophy. The study included 28 high-level competition athletes who had regular intensive physical activity for at least six months. Syndrome of early repolarization was diagnosed on the basis of ECG registration, in case of elevation of the J-point on 1 mm and more above the isoelectric line in the lower or lateral leads was detected. Diagnosis of cardiac hypertrophy was established by electrocardiography and echocardiography. On the background of high prevalence of early repolarization syndrome in professional athletes, we did not reveal the statistically significant relationship between its presence and cardiac hypertrophy. However, the combination of these two syndromes in the examined athletes was accompanied by a statistically significant shortening of the corrected QT interval, the last, in a case of the presence of certain anamnestic data, may be one of the risk factors for acute arrhythmias. This necessitates a deeper examination of such patients and monitoring of them. Further studies are needed to determine the prognostic value of early repolarization in athletes with cardiac hypertrophy.

[ANALYSIS OF THE ASSOCIATION BETWEEN THR83ALA POLYMORPHISM OF MATRIX GLA-PROTEIN GENE AND LOWER EXTREMITY ARTERIAL CALCIFICATION].

Lower extremity arterial calcification (AC) is a common pathological process that has independent significance in the pathogenesis of many cardiovascular diseases. There is evidence that development of AC associated with Thr83Ala polymorphism of matrix GLA-protein gene. The objective of this study was to examine the association between Thr83Ala polymorphism of matrix Cla protein (MGP) gene and AC in male and female subjects of the Ukrainian population. 40 AC and 40 healthy controls were recruited to the study. MGP exon 4 Thr83Ala polymorphism (rs 4236) was examined using the polymerase chain reaction with subsequent restriction fragment length polymorphism analysis. The obtained data show that the substitution of threonin by alanine at position 83 in a molecule of MGP can affect its functional characteristics and anticalcinogenic properties. The distribution of homozygous carriers of a major allelic variant, and heterozygous and homozygous minor allele variants of Thr83Ala polymorphism in patients with AC was 40,0%, 47,5%, and 12,5% respectively. The corresponding distribution of variants in the control group was 32,5%, 42,5% and 25,0% (p=0,352 by χ2 -test). In women who are carriers of Ala/Ala-variant, CA occurs more rarely than in men with the same genotype (p=0,036 by χ2 -test). The substitution of threonine by alanine due to MGP exon 4 Thr83Ala polymorphism is related to a decrease in the likelihood of CA in female persons in the Ukrainian population.

[The medical activities of the first head of Sumy Children's Hospital St. Zinaida - A. F. Belousov].

The article examines the work of the first head of the Children's Hospital St. Zinaida at Sumy--Alexander Fedorovich Belousov. We considered his contribution to the organization of the first children's hospital in Sumy region and the creation of specialized pediatric services for children population in the Sloboda Ukraine. The article describes the personal role of A. F. Belousov in improving medical and sanitary care in a difficult socio-economic situation of the majority of citizens of the Russian Empire in the late 19th-early 20th century.