A population of fourth-, fifth-, and sixth-generation hybrids obtained by crossing SI IR and WKY rats was studied. These hybrids were a basis for obtaining a genetic model of myocardial hypertrophy (МH) without elevated blood pressure (BP). To reveal the given phenotype (MH without elevated BP), the degree of MH was noninvasively estimated by vectorocardiography in combination with noninvasive BP measurement on the caudal artery. Systolic BP in male hybrids of die fourth and fifth generation was 127 ± 3 and 123 ± 3 mm Hg, respectively, which was much lower than that in male rats of the progenitor line SHR (183 ±5 mm Hg) and practically equal to that in rats of the progenitor line WKY (128 ± 3 mm Hg). The similar BP values were also observed in female rats of the study populations. The weight of the heart of male hybrids F4. F5, and F6 was more than that in the WKY group (1,17 ± 0,03, 1,01 ± 0,04, and 1,19 ± 0,03 g, respectively, and 0,89 ± 0303 g, at p < 0,05 in WKY rats), but less than the values for the SHR group (1,38 ± 0,11 g, p < 0,05). The experimental model may be interesting and useful in solving a variety of physiological, genetic, and pharmacological problems.

The paper considers the clinical pharmacology, mechanism of action, efficacy, and safety of AT₁-angiotensivе receptor blockers. Some studies have indicated that A AT₁-angiotensivе receptor blockers may prevent the development of cerebral stroke, diabetes mellitus in the treatment of arterial hypertension in patients at high risk for these diseases. By taking into account the unique spectrum of their pharmacological effects and excellent tolerability AT₁-angiotensivе receptor blockers may be used in therapy of arterial hypertension of a great variety, irrespective of sex, age, race, comorbidity.

Sixty five patients (mean age 55.7 ± 8,7 years), including 51 patients with arterial hypertension (AH) (mean age 54,9 ± 8,6 years) and 14 patients with a combination of AG and coronary heart disease (CHD) with postinfarction cardiosclerosis (mean age 54,9 ± 8,6 years) were examined. According to the values of average daily blood pressure variability (HPV), the patients were divided into subgroups with normal (11 patients with AH and 3 patients with AH and CHD) and increased (39 patients with AH and 12 patients with AH and CUD) BPV. Patients with isolated AH were found to have developed concentric hypertrophy of the left ventricle (LV), and moderate LV diastolic dysfunction mainly with impaired relaxation and the patients with a combination of AH and CHD with postinfarction cardiosclerosis had more significant LV structural and geometric derangements with a tendency for the development of eccentric hypertrophy of the LV, as well as more marked diastolic dysfunction with a larger proportion of the pseudo-normal and restrictive types of LV diastolic function. Patients with increased average daily BPV were found to have more significant LV structural, geometrical, and diastolic impairments.

In some regions of Russia, the prescription of different antihypertensive drugs by physicians was analyzed. This made it possible to assess their experience and knowledge and to direct ways to further improvements of the quality of care to patients with arterial hypertension. Despite the recommendation that diuretics and ß-blockers should be used as the first-line drugs, these agents are less frequently used due to the fact that pharmaceutical companies make effective marketing for ACE inhibitors and Ca²⁺-channel blockers. Physicians more commonly prefer a combination of drugs, but this slightly deteriorates the adherence of patients to treatment. Combined drugs are sometimes used. The present-day medical treatment of arterial hypertension in the Russian Federation is mainly determined by the recommendations made by the All-Russian Scientific Society of Cardiology in 2001; however, the choice of a drug should be primarily based on a comprehensive assessment of risk factors available in a patient.

Introduction. The indices of ventricular repolarization variability arc higher in patients with hypertensive left ventricular hypertrophy (LVH) and correlate with the Left ventricular myocardial mass index (LVMMI). Aim. To develop diagnostic criteria for I.VI I, based on the analysis of the parameters of ventricular repolarization heterogeneity - the variability indices QT-, JT- и Т_apex-T-_end-intervals. Subjects and methods. The study enrolled 69 patients with arterial hypertension and 20 patients without cardiovascular diseases who were divided on the basis of echocardiographic determination of LVMMI into those with and without LVH. The following repolarization variability indices: dispersion (Disp), normalized dispersion (Dispnorm), and standard deviation (SD) QT_end-, JT_end-, QT_apex-, JТ_apex- и T_apex-T_end-intervals of EGG lead 12, were analyzed. Results. As compared with male patients with normal LVMMI, the male patients with LVH had higher parameters of variability of QТ_end-intervals, JТ_end-intervals и T_apex-T_end-intervals, which correlated with l.VMMI. During a regression analysis, LVMMI was an independent predictor of the indices of variability of QТ_end-intervals и JТ_end-intervals. Disp of JТ_end-intervals ≥ 71 msec and Dispnorm JТ_end-intervals ≥ 22 msec (52 % sensitivity, 91 % specificity, 89 % positive prognostic value, 57 % negative prognostic value). As compared with female patients with normal LVMMI, the female patients with LVH had higher parameters of variability T_apex-T_end-intervals, which correlated with LVMMI. During a regression analysis, LVMMI was an independent predictor of the indices of variability of T_apex-T_cnd-intervals. Disp of T_apex-T_end-intervals of ≥ 61 msec demonstrated the best diagnostic characteristics (45 % sensitivity, 94 % specificity, 91 % positive prognostic value, 52 % negative prognostic value). Conclusions. The parameters of ventricular repolarization heterogeneity may be used as independent criteria for LVH in patients with arterial hypertension.

QТ dispersion was studied in 60 patients (12 males and 38 patients; their mean age, 48,4 ± 9,1) with Grades I — III arterial hypertension. Patients with prior myocardial infarction, with angina pectoris, and with severe heart failure were excluded. The hypertrophy of the myocardium, its systolic and diastolic function were evaluated with echocardiography. QT dispersion was determined by ECG. In arterial hypertension, the myocardium was found to be characterized by the development of not only hypertrophy of the left ventricle (LV), but also by its remodelling. Multifactorial regression analysis indicated that systolic blood pressure had an independent direct impact on the relative thickness of the LV wall and on LV mass index. There was a direct correlation of trans-myocardial QT dispersion with the parameters of pulmonary venous blood flow, reflecting the early symptoms of heart failure: Smax, the peak velocity of systolic flow; S/D, the ratio of the peak velocities of systolic and diastolic flows; VTIAR/Va, the ratio of the integral parameter of reversion flow to the time-velocity integral of peak A of transmitral blood flow. It is concluded that in patients with arterial hypertension, transmyocardial QT dispersion increases with the occurrence of the early symptoms of heart failure, as evidenced by transmittal and pulmonary venous flows.

The paper shows how the spatial indices of a cardiac signal obtained from recording high-performance signal-average EGG may be useful in diagnosing left ventricular hypertrophy.