Vol 14, No 4 (2008)
КОЛОНКА РЕДАКТОРА
REVIEW
306-314 2533
Abstract
Asymmetric dimethylarginine (ADMA) is a methylated derivative of the amino acid L-arginine that is receiving increasing attention as a cardiovascular risk factor. As a structural analog of L-arginine, ADMA can inhibit the activity of nitric oxide (NO) synthase, resulting in decreased NO production in blood vessels and other tissues. While substantial epidemiological and experimental evidence links elevated levels of ADMA with endothelial dysfunction and adverse
vascular events, the causative role of ADMA in cardiovascular diseases remains still largely unproven. To definitively determine whether ADMA is a biomarker or a causative risk factor, a better understanding of the biochemistry, genetics, and pharmacology of the ADMA metabolic pathways is needed.
vascular events, the causative role of ADMA in cardiovascular diseases remains still largely unproven. To definitively determine whether ADMA is a biomarker or a causative risk factor, a better understanding of the biochemistry, genetics, and pharmacology of the ADMA metabolic pathways is needed.
315-319 1013
Abstract
The aim of our study was to evaluate whether abnormal endothelial function is present in patients with arterial hypertension. Endothelial function was assessed by measuring flow-mediated dilatation (FMD) and nitroglycerin-mediated dilatation of the brachial artery using high-resolution ultrasound. In the group of subjects with arterial hypertension endothelial function was significantly impaired (FMD 9,26%), whereas nitroglycerin-mediated dilatation was normal.
320-323 766
Abstract
This article summarizes data on homocysteinemia and its influence on vascular pathologic changes in patients with different diseases including diabetes type 1 and type 2. The role of homocystein as an independent risk factor for diabetic nephropathy in children and adolescents is discussed. The problem of homocysteinemia treatment is reviewed.
324-331 2272
Abstract
The results of clinical trials have proved that elevated heart rate (> 80-85 beats/min) at rest is directly related to the risk of arterial hypertension and atherosclerosis development, and it is a powerful predictor of cardiovascular morbidity and mortality. Epidemiological studies have shown that these relationships are independent of other risk factors of atherosclerosis and are present in asymptomatic individuals as well as in patients with cardiovascular diseases. The results of experimental and clinical studies suggest that hemodynamic changes due to elevated heart rate have a direct influence on the arterial wall, favouring the development of atherosclerotic lesions. Moreover, heart rate is directly related to the development of cardiovascular events associated with atherosclerotic plaque disruption. Based on these data we believe that heart rate should be listed among major risk factors for ischemic heart disease
347-355 839
Abstract
This article summarizes data of the studies with the use of positron emission tomography (PET) and devotes technical aspects and clinical application of PET for assessment of the autonomic nervous system of the heart in patients with cardiac diseases. According to the results of experimental and clinical studies PET with radiolabeled сatecholamines and adrenoreceptor ligands provides us with information about alteration of cardiac sympathetic innervation at different steps of neurotransmission. It plays a key role in the progression of various heart diseases such as ischemia, diabetes mellitus, heart failure and noncoronary arrhythmia. Cardiac sympathetic neuronal PET imaging seems to be a good tool for the stratification of the risk of the severe cardiovascular complications.
ORIGINAL ARTICLES
332-335 1107
Abstract
The aim of this work was to examine the contents of annexin A5, sApo-1/Fas and sBcl-2 and the number of circulating mononuclear cells in apoptosis in order to clarify their role in the pathogenesis of acute coronary syndrome (ACS) combined with arterial hypertension (AH). We examined 83 patients with ACS (47 patients with unstable angina and 36 with myocardial infarction) and 14 healthy individuals. AH has been identified in 15 patients with unstable angina and in 17 with myocardial infarction. The number of viable mononuclear cells was significantly decreased and the number of mononuclear cells at the early stages of apoptosis (annexin A5-positive) was significantly increased as compared to control group in patients with the ACS, especially if combined with AH. At the same time there was a significant increase of sBcl-2 and sApo-1/Fas and annexin A5 in blood of the patients with myocardial infarction compared to patients with unstable angina, especially if combined with AH. The association between the level of sAro-1/Fas, annexin A5 and the number of circulating mononuclear cells at the early stages of apoptosis was shown in the study. Thus, in ACS, especially if combined with AH, enhanced cell apoptosis resulting from hemodynamic abnormal changes leads to activation of antiapoptotic mechanisms aimed at the decrease of the thrombophilia severity by reducing thrombogenic features of endotheliocytes subjected to apoptosis.
336-340 922
Abstract
The main topic of the article is the assessment of the endothelial dysfunction and the rigidity of arterial wall in the small, medium and large vessels in young patients with short anamnesis of hypertension and with different variability of blood pressure (BP). In young patients even at the beginning of arterial hypertension (AH) the disturbance in rigidity of arterial walls in great and peripheral vessels occurs. The increased variability of BP in young patients with AH is an aggravating factor of the arterial rigidity disturbances. The assessment of arterial rigidity in young patients at the early stages of the disease can elicit the early signs of endothelial dysfunction
341-346 1415
Abstract
87 participants of the study aged 30−60 years suffered from arterial hypertension of grade I-II, with low, moderate and high overall cardiovascular risk. Average age of patients was 47,7 ± 7,4 years old and average disease duration was 11,1 ± 9,4 years. Level of serotonin and adrenoreactivity by a method based on erythrocyte osmoresistance change under beta blockers influence were evaluated in all patients. Psychoemotional features were assessed by psychological testing. The performed study showed elevated adrenoreactivity and plasma serotonin level in more than 50% of cases. According to our study all patients suffering from arterial hypertension can be divided in 3 groups depending on psychoemotional status: 1st group - patients with high aggressiveness; 2nd group - patients with high situative and personal anxiety and high hostility; 3d group - patients without changes in psychoemotional status. Results of the study confirm the fact that psychoemotional status dysfunction is encountered in 67,8% while 32,2% of patients do not demonstrate significant changes of emotional profile
I. Yu. Panina,
A. Sh. Rumyantsev,
M. A. Menschutina,
V. V. Achkasova,
E. V. Schevyakova,
O. A. Degtereva,
F. A. Tuguscheva,
I. M. Zubina
356-359 1095
Abstract
Arterial hypertension (AH) is a leading cause of morbidity and mortality of the patients with chronic kidney disease (CKD). The aim of this study was to estimate the function of endothelium in patients with CKD and AH during the period of 12 months. The target blood pressure was achieved in 57 patients initially. Complex examination including biochemical, immune-enzyme analyses and instrumental methods was performed. All patients achieved target blood pressure in 12 months. The glomerular filtration rate (GFR) increased in 55 patients (1st group) from 52,1 ± 2,9 to 70,7 ± 3,5 ml/min (p < 0,01). GFR decreased in 27 patients (2nd group) from 48,9 ± 4,8 to 38,7 ± 4,3 ml/min (p < 0,01). The level of annexin-A5 in patients of 2nd group was more than 3,5 ng/ml. Endothelium-dependent vasodilation improved in patients of 1st group. Endothelium-dependent vasodilation did not change in patients of 2nd group.
360-368 2644
Abstract
Background: asymmetric left ventricular hypertrophy (ALVH) is the rarest type of hypertensive left ventricular (LV) remodeling, which is prevalent in approximately 1% of people with essential hypertension (EH). Aim: to estimate 24-h blood pressure (BP) parameters, ultrasound left ventricle features, sympathetic and rennin-angiotensin-aldosterone system (RAAS) activity, insulin secretion level, and to assess the efficacy of RAAS pharmacologic blockade in EH patients with ALVH. Material and methods: we examined 101 EH subjects with 1-3 degree of BP increase (ESC/ESH, 2007) and I-II stages of hypertension. 37 of them had ALVH, 32 ones had symmetric LVH (SLVH), 32 people had normal LV geometry. Results: Patients with ALVH in comparison with SLVH people demonstrated a significantly higher LV mass index (LVMI, p < 0,001), LVH concentricity degree (p < 0,001), 24-h epinephrine excretion levels (p < 0,05), aldosterone and insulin secretion levels (p < 0,001). 24-week therapy based on angiotensin-converting enzyme inhibitor (ACEi) Quinapril resulted in significant reduction of 24-h systolic and diastolic BP (p < 0,05), LVMI (p < 0,001), 24-h epinephrine (p < 0,01) and norepinephrine (p < 0,001) excretion levels, aldosterone secretion level (p < 0,001). Conclusions: asymmetric (i.e. non classic) type of LVH is a result of interaction of traditional proliferateive haemodynamic and neurohumoral patterns and also it can be a target for RAAS-blockade.
369-372 963
Abstract
Norepinephrine, blockers of beta-adrenoreceptors, angiotensin-converting enzyme inhibitors and angiotensin I receptor blocker were investigated in organotypic tissue culture of cardiomyocytes of 10-12-day-old chicken embryos and newborn rat heart in a wide range of concentrations. The data obtained show that low concentration of norepinephrine led to the cardiomyocyte growth control. The application of beta-adrenoblockers metoprolol and atenolol prevented stimulating effect of norepinephrine. Zofenopril inhibited the growth of cardiomyocytes but enalapril had no effect on this process. The effect of angiotensin I receptor blocker depended on concentration - low concentrations resulted in activation of cardiomyocyte growth; and high concentrations led to the decrease of their growth.
381-384 1734
Abstract
The aim of the study was to investigate blood pressure levels and the prevalence of arterial hypertension in population of working people in rural and the farthest areas of Irkutsk region. Screening blood pressure measurements were taken in 1002 individuals (229 men, 773 women) 18-72 years old (mean age was 46,5 ± 12,6 years). Mean systolic blood pressure was 140,6 mm Hg (95%CI = 139,1-142,2 mm Hg), mean diastolic blood pressure was 85,9 mm Hg (95%CI = 85,1-86,7 mm Hg). Age and sex adjusted prevalence of arterial hypertension was 48,1%.
Discussion
НОВЫЕ КЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯ
391-396 947
Abstract
Unfavorable metabolic effects and possible diabetes type 2 development in patients with arterial hypertension and metabolic syndrome taking diuretics over a long period of time are under discussion. According to the results of the STAR study fixed-dose combination drug «TARKA» trandolapril + verapamil CP (T/V) had a definite advantage over combination therapy with angiotensin II receptor antagonists (ARA) lozartan and hydrochlorthyazide (L/H) considering glycemia control and the risk of diabetes development. A sample of patients included in STAR study took part in a 6-month-long project STAR-LET. Those who were prescribed for the T/V therapy initially continued this treatment, and the ones taking L/H began T/V therapy. The results of oral glucose tolerance test (the 2 hour glucose level) are the following: the glucose level did not change significantly in the group of patients taking T/V from the beginning of the STAR study as compared to the initial level (7,7 ± 2,4 vs 8,1 ± 3,3, p > 0,05), and it improved in subjects taking T/V after L/H therapy (8,5 ± 3,0 vs 7,2 ± 2,3, p < 0,001). Thus, STAR-LET study showed benefits of «TARKA» in subjects with metabolic syndrome and arterial hypertension - its metabolic neutrality as well as its ability to improve impaired glucose tolerance resulting from thiazide diuretic therapy.
402-407 647
Abstract
The increase of quantity of coronary artery bypass graft surgery is interfaced to necessity of active introduction of the methods which improve the nearest and remote results of these interventions. The mediated role of chemokine system is supposed in mechanisms of development and progressing of atherosclerosis in a shunting material. The researches which were performed during the last years allow to consider that ω-3 polyunsaturated fat acids as additional means for improvement of outcomes of surgery treatment of coronary artery disease. In our research it was shown that the administration of OMACOR in a dose 2,0 g daily within 14 days before coronary artery bypass graft surgery leads to maintenance increase of мRNA CCR1, CCR3 and CCR5 in the aorta and the great saphenous vein. The expression of chemokine receptors ССR1 in blood against OMACOR comes nearer to the level in healthy individuals
КУНСТКАМЕРА
ISSN 1607-419X (Print)
ISSN 2411-8524 (Online)
ISSN 2411-8524 (Online)