Saratov Institute of Cardiology, Russia

Nowadays paroxysmal AV nodal reentrant tachycardia (AVNRT) is one of the most widespread arrhythmias. In most cases AVRNT is a recurrent process, and it worsens the life quality of such patients, reduces their workability and increases the incidence of applying for medical help. Thus AVNRT today is of special attention among investigators. The interest of clinicians to the problem of cardiac arrhythmias is associated with permanent dissatisfaction with the results of antiarrhythmic therapy and also with the rapid development of the surgical methods of treatment, i.e. the use of radio frequency catheter ablation.

Goal: to investigate angiographic and clinical efficacy of percutaneous coronary interventions (PCI) on chronic total coronary occlusions (СТО) in patients with angina of low functional classes (FC) in direct and long-term period, comparatively to conservative medical treatment. Materials: 56 patients with СТО were included. Standard medical treatment was provided to all of them, everybody suffered angina FC 1-2. Left ventricle ejection fraction (LV EF) was 54±3%. 36 patients of group I underwent PCI of СТО 20 patients of group II were given conservative medical treatment. The follow-up period was 12 months. Results. In 30 patients of group I 36 attempts of PCI were angiographically and clinically successful -the absence of anginal symptoms and objective signs of myocardial ischemia. In the long-term period 21 patients of 30 had clinical success. LV EF increased to 57±4%. Long-term clinical success had 17 patients of group II, 5 patients had the decrement of angina FC by 1, 12 had initial clinical results. LV EFaccountes53,9±2,4%. There was no difference in the frequency of major adverse cardiac events between the groups. Conclusions: PCI of СТО in patients with angina of low FC improves clinical status in direct and long-term period. When isolated, angiographically unfavorable form of СТО is diagnosed, conservative treatment with effective medication in case of angina of low FC is used

Aim: to estimate the dynamic regulation of cerebral blood flow (CBF) and significance of clinical, and laboratory parameters as a possible markers of CBF violations. Material. 179 elderly patients with arterial hypertension were involved in the study. Transcranial Doppler ultrasonography (Philips Envisor HD, USA) was used for CBF parameters dynamics during orthostatic hypotension. Results. Main directions of CBF parameters changings (Friedman ANOVA p 0,0091 ... 0,012, coeff. of concordance 0,308 ... 0,691) were detected. Gender differences of CBF parameters, as well as blood pressure level influence upon CBF regulation during orthostatic hypertension were studied. Conclusion. Received data allow us to consider gender, controlled or uncontrolled hypertension, cytomorphological parameters of peripheral blood, diuretics usage as clinical, and laboratory markers of dynamic regulation of CBF in elderly patients with arterial hypertension

The aim of the investigation is to carry out comparative evaluation of metabolic and hemodynamic indices in patients with arterial hypertension (AH) and renal dysfunction; to study the interrelation between arterial blood pressure level normalization and the presence or lack of microalbuminuria (MAU) in the morning urine portion of patients with AH after therapy with antihypertensive preparations (APs) of various groups. Methods. 121 persons have been investigated, 91 out — patients of both sexes, aged 33-55, with the diagnosis of arterial hypertension of stage II risk III, who have been taking Perindopril, Telmisartan and Bisoprolol for3 months. The control of arterial pressure level, biochemical analysis of metabolic indices and morning urine portion test for microalbuminuria has been carried out. Results. MAU has been revealed in 17,6% patients, occurring more frequently in men than in women. Microalbuminuria is accompanied by reliable decrease of total and ionized calcium and magnesium concentrations, an increase of potassium level in blood plasma, increase of cholesterol, triglycerides, glucose and levels. Patients with AH and renal dysfunction reliably demonstrate higher levels of systolic and diastolic arterial pressure in the morning and evening hours, their normalization effect after APs intake is significantly interconnected with MAU presence. Conclusion. In patients with AH and MAU the main risk factors of cardio-vascular diseases development are more expressed. Microalbuminuria is a risk factor in patients with arterial hypertension and may influence on the basic blood electrolyte balance. While carrying out antihypertensive therapy the presence of MAU should be taken into consideration

The most important forms of digestive pathology have been analyzed in a large industrial center for 16 years. Development of fragment of the phase portraits in a multidimensional space on the planes of «time dependence of the parameter — rate of its change» allowed forming prognosis for further course of specific nosology form of gastrointestinal tract lesion and optimizing treatment tactics

Aim: In spite of recent achievements in public health, average lifetime in the Volga region as in whole Russia is rather short. Issues of longevity in the region produce scientific interest by clinical, epidemiological and social characteristics of long-lived persons. Material and methods: In total 167 long-lived persons were examined. Medical, social, psychic, emotional and epidemiological characteristics were assessed. Results: The typical long-lived person of the Volga region was brought out. The high quality of life was revealed. The negative influence of smoking and alcoholism on the longevity was shown. Most of the patients needed communication. Lack of complaints was revealed, patients mentioned only the general weakness. Conclusion: The study has explained new social and demographic features of the Volga region long-livers

Cardiovascular pathology spectrum and dynamics in veterans of Great Patriotic War and aged patients of Volga agricultural and industrial region were studied. Clinical signs and course of cardiovascular pathology in aged patients were determined. A «dissolution» phenomenon of chronic cardiovascular pathology was revealed in patients aged over 100 years

Aim: To estimate the dynamics of intima-media complex in elderly patients with arterial hypertension. Materials: 179 elderly patients with arterial hypertension were involved in the study. Mean intima-media wall thickness (IMT) of common carotid arteries in plaque-free sites and prevalence of plaques were evaluated by B-mode ultrasound investigation (Philips Envisor HD, USA). Results: IMT changing was of nonlinear character, remained stable up to 74 years. Mean rate of the following IMT augmentation was 0.157 mm per year. Frequency of atherosclerotic plaque revealing was significantly increased since the 7th decade. Significant correlation between IMT and systolic, diastolic, mean blood pressure levels or medication spectrum was not revealed. Conclusion: Received data proved significant influence of aging upon IMT enlargement

The research goal is to study the correlation between indices of variational pulsometry, entropy of heart rate, temporal and spectral analyses and heart rate variability in healthy patients and patients with coronary heart disease. Materials. Of the study are indicators of variational pulsometry and temporal and spectral analyses from 111 patients with coronary heart disease and in 61 healthy individuals. Results. Most parameters of HRV correlated with each other. In healthy patients the greatest independence was characterized by Mo and LF/HF, in patients with coronary artery disease — only by LF/HF Significant correlation with SDNN RMSSD, TP, LF, HF was determined. Conclusion. The variational pulsometry, temporal and spectral analyses of HRV and entropy of heart rate provide HRV assessment. The indices are interdependent and indicate interchangeability of methods

The research work provides current understanding of the functional organization of vegetative regulation of cardiovascular system. The basic oscillatory processes in vegetative regulation system have been determined, and the information about their functional properties has been generalized. The most significant oscillatory processes are main heart rhythm, respiration and low-frequency oscillations in vegetative regulation of cardiovascular system. The article considers intersystem interactions involving the vegetative regulation of cardiovascular system