Arterial hypertension in pregnancy is now believed to be a risk factor for future maternal cardiovascular diseases. Despite the low immediate cardiovascular risk in a population of young women, a pregnancy complicated with hypertension carries a significant additional risk of future disease.

Although preeclampsia (PE) is a major cause of maternal and fetal mortality, its pathogenesis is not fully understood. Endogenous digitalis-like cardiotonic steroids (CTS) are implicated in the pathophysiology of PE, as illustrated by clinical observations that Digibind, a digoxin antibody which binds CTS, lowers blood pressure in patients with PE. Recently we reported that plasma levels of marinobufagenin (MBG), a bufadienolide vasoconstrictor CTS, are increased four-fold in patients with severe PE. In the present study, we compared levels of MBG in normal and preeclamptic placentae, and tested whether antibodies against MBG, and against ouabain for their interaction with the material purified from preeclamptic placentae via high-performance liquid chromatography (HPLC). Levels of MBG, but not that of endogenous ouabain, exhibited a four-fold elevation in preeclamptic placentae. The elution time of endogenous placental MBG-like immunoreactive material from reverse-phase HPLC column was identical to that of authentic MBG. Immunoassay based on Digibind did not detect cross-reactivity with HPLC containing ouabain-like immunoreactive material, but cross-reacted with HPLC fractions having retention time similar to that of MBG and other bufadienolides. Our results demonstrate that levels of MBG are significantly elevated in preeclamptic placentae, and suggest that MBG is a potential target for immunoneutralization in patients with preeclampsia.

Clinical aspects, risk factors, results of selective coronary angiography, features of DNA-polymorphism (I/D polymorphism of gene ACE, isoalleles polymorphism gene APOE, SsTI polymorphism gene АРОСЗ, С677Т polymorphism of gene MTHFR, 4a/4b, G894T and T786C polymorphisms eNOs) in 89 women with a various degree of a coronary obstruction.
In patients with sings of coronary artery atherosclerosis, familial history i heart disease was observed in most
cases (greater degree on a line of mother). The obtained data show the reliable role of allele T, genotype CT gene MTHFRand gene-gene interaction of ACE and MTHFR genes (DD и СС, DD и СТ) in development of i heart disease.

Study objective. To investigate efficacy and safety of amlodipine (Cardilopine) in the elderly hypertensive patients.
Patients and methods. 34 pateints on 65-79 years old with uncomplicated stage 1-3 hypertension were studied. Systolodiastoloc hypertension (SDH) was in 61,76% of cases, isilated systolic hypertension (ISH) in 38,24%. Hypertension duration was 11,18±1,26 yrs. Crdilopine EGIS) was administrated once daily in dose 5 mg. After one month of treatment the dose was increased or hydrochlorothiazide added. 24 blood pressure monitoring was performed at baseline and after 3 and 12 months of treatment. Treatment efficacy was evaluated according to criteria of Kobalava G (2002). Drug safety was analyzed according to side effects registration.
Results. The blood pressure was reduced by 39,07/16,27 mm Hg and 21,69/3,60 mm Gh respectively (p<0,001), pulse pressure was also reduced. Blood pressure variability was normalized during 24-hors and mean daytime. The morning surge of blood pressure also decreased. The was a tendency for normalization of diurnal pressure rhythm - the number of "night-peakers" reduced and proportion of "dippers" increased. Effect of therapy was observed in 93,33% of patients.
Conclusions. Cardilopin is effective and well-tolerated in elderly hypertensive patients.

Severity of atherosclerosis of common carotid arteries in patients with abdominal obesity (aged from 30 to 55 years old) was evaluated by ultrasound duplex scan. Atherosclerotic plaques of common and/or internal carotid arteries were revealed in 35% of patients. Correlations were observed between intima-media thickness of the common carotid artery, blood pressure levels, waist circumference and metabolic parameters.

Purpose: The aim of the study was: 1) to determine the 24-hour ambulatory blood pressure monitoring (ABPM) profiles in 437 hypertensive patients (36-60 yrs): 309 patients with diabetes mellitus (Gr.HD) and 128 patients without carbohydrate metabolism disturbance (Gr.H); 2) to examine the changes of ABPM pattern depending on diabetes duration; 3) to assess the potential role of ABPM parameters together with non-haemodynamic factors as determinants of the intrarenal vascular resistance.
Methods: The analysis of ABPM profiles in dependence of diabetes duration was performed in 128 specially formed. pairs of patients of Gr.H and Gr.HD who have the same duration of arterial hypertension . The comparison of ABPM parameters without examination of duration of disease was performed in 309 patients of Gr.HD, in 90 patients of Gr.H and in 34 healthy subjects. Renal blood flow velocities profiles was detected by duplex scanning and resistance index in the arcuate intrarenal arteries were calculated. 24-hour ambulatory BP recordings were performed using a SpaceLabs 90207 recorder. Plasma levels of the lipids, glucose and HbA₍ were estimated. Serum concentration of insulin, aldosterone, Cortisol and blood renin activity were measured by RIA method. All the investigated clinical, instrumental and laboratory parameters were included into the multiple linear regression analysis.
Results and conclusions: Compared with pts of Gr.H, pts of Gr.HD demonstrated marked indirect signs of neurogumoral activation and the insufficient decrease of nocturnal BP whereas patients of Gr.H showed higher level and prolonged
АРТЕРИАЛЬНАЯ ГИПЕРТЕНЗИЯ ТОМ 14 № 1 2008 77
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diastolic hypertension at daytime. There was earlier increase in systolic BP variability, rate of morning systolic BP rise and formation of systolic BP circadian rhythm disturbance (in average 5-7yrs) in diabetic pts. Opposite to pts of Gr.H, disproportional increase of systolic BP was characteristic of diabetics already in 3-5yrs after clinical manifestation of the disease that resulted in higher level of nighttime pulse BP in average in 7yrs and of 24-h pulse BP - in 16yrs. In the final regression model that explained 40% variation of resistive index in the arcuate intrarenal arteries (adjusted multiple R2=0,3978), the most important determinants were nocturnal pulse BP (standardized coefficient beta=0,556, P<0,0001) and postprandial insulinemia (0,409, P=0,0001).

The types of surgical correction of the mitral valve pathology, hospital and long-term results were studied. The mitral valve repair being compared to the mitral valve replacement is procedure of choice as it provides stable results. In the study we demonstrate that the long-term results of reconstructive procedures on the mitral valve have advantages over mitral valve replacement in terms of survival, freedom from reoperation and tromboembolc complications.

The aim of the present study was to investigate evolution of autonomic function during normal pregnancy without history of hypertension. 23 women of mean age 27,4±4,4 yrs on 12-14 weeks of gestation were examined. Spontaneous baroreflex function (BRS) was analyzed by Finometer device with beat-to-beat blood pressure registration. All measurements were performed at supine rest and 5 minute passive tilt (70). Baroreflex was calculated by sequence technique. 12 women were studies second time on 26-30 week of pregnancy. A normal or increases values of spontaneous baroreflex were observed in early pregnancy with e significant reduction of baroreflex sensitivity during tilt. In late pregnancy restoration of the orthostatic tolerance was accompanied by decrease of BRS.