ЭНДОТЕЛИЙ – ОРГАН-МИШЕНЬ ТЕРАПЕВТИЧЕСКОГО ВОЗДЕЙСТВИЯ У ЖЕНЩИН С АРТЕРИАЛЬНОЙ ГИПЕРТОНИЕЙ НА ФОНЕ ЭСТРОГЕНОВОГО ДЕФИЦИТА

Purpose. To study the endothelial function in the onset of arterial hypertension (AH) in perimenopausal women and to evaluate the possibility of the influence of antihypertensive therapy on endothelial dysfunction.Materials and methods. The study included 81 patients with essential hypertension (EH) I–II stage of 1–2 degrees and 23 healthy perimenopausal women. The level of estradiol and follicle stimulating hormone (FSH) were analyzed. Endothelial function was assessed by endothelium-dependent (EDVD), endothelium-independent (ENVD) vasodilation of the brachial artery and laboratory markers.Results. Regardless of the AH stage and degree 50 % of patients had endothelial dysfunction by EDVD / ENVD and vasoconstriction endothelial markers (endothelin-1 (ET-1), asymmetric dimethylarginine (ADMA)) were increased. 12 weeks of treatment showed a statically significant reduction (p<0,05) in the concentration of ET-1 and ADMA, and increasing NO production (p<0,05) in all patients with hypertension.Conclusion. Perimenopausal women with EH regardless of the stage and degree blood pressure had a violation of EDVD/ ENVD and a change of endothelial markers. Monotherapy blockers of the renin-angiotensin-aldosterone system (RAAS) showed blood pressure normalisation and endothelial function improvement in most women with AH stage I-II and 1 degree, with 2 degree required a combination therapy with the addition of bisoprolol and low doses of hydrochlorothiazide to RAAS

МАГНИТНО-РЕЗОНАНСНАЯ ТОМОГРАФИЯ КАК СОВРЕМЕННЫЙ МЕТОД ПРОГНОЗИРОВАНИЯ РЕЗУЛЬТАТОВ РЕВАСКУЛЯРИЗИРУЮЩИХ ВМЕШАТЕЛЬСТВ НА ЛЕВОМ ЖЕЛУДОЧКЕ СЕРДЦА В РАННИЙ ПОСЛЕОПЕРАЦИОННЫЙ ПЕРИОД

The purpose. Demonstrate the capabilities of magnetic resonance imaging (MRI) of heart as a modern imaging technique in the diagnosis of surgical treatments on the heart left ventricle (LV) in the early postoperative period.Materials and methods. With the help of MRI in the dynamic («Cine») scan was an assessment of the functional parameters of the left ventricle of the heart: end-systolic, end-diastolic volume (ESV, EDV) and ejection fraction (EF) to revascularization and after 2–3 weeks after intervention interference. Then there were two groups of patients with increasing and decreasing LV EF in the early postoperative period, where by subsequently conducted a comparison of volume indices in patients before and after surgery.Results. In the period up to 2–3 weeks after revascularization improvement of myocardial contractility was observed in 57 % of patients. The group with an increase in ejection fraction compared with the preoperative value LV EDV value decreased by 19 % and ESV LV – 22 %. The group of patients with a decrease in LV EF after surgery LV EDV decreased by 15 %, and the value of ESR by 8 %. In the postoperative period in patients with an increase in ejection fraction traced LV EDV values decrease by 1,3, and CSR LV by 2,8 in alignment with those parameters in a group of patients with reduced ejection fraction after revascularization surgery.Conclusion. Due to data obtained by MRI heart doctor may have valuable information about the patient’s condition, which allows to predetermine in the early postoperative period, the severity of left ventricular improve the functional status, which gives an opportunity not only to assess the quality of the operation, but also allows us to predict a positive or negative result of revascularization in the late postoperative period

РОЛЬ ШОВНОГО МАТЕРИАЛА В КАЛЬЦИФИКАЦИИ КАРДИОВАСКУЛЯРНЫХ БИОПРОТЕЗОВ

Purpose. Assess the impact of the sutures and unfractionated heparin on biomaterial calcification in an experiment.Materials and methods. Porcine aortic valve cusps, preserved in glutardialdehyde and ethylene glycol diglycidyl ether, were used. The test models were sutured with polypropylene, polydioxanone and nitinol (TiNi) threads. The sutured cusps were modified with unfractionated heparin. The model of accelerated calcification was used to study the impact of suture material and heparin on biological tissue mineralization by implanting the test models into male rats for 2 months.Results. Two months after the implantation all the test models had calcium deposits in the peri-suture region; the amount of calcium in the biomaterial with polypropylene threads was 31-fold higher (р=0,0009), with TiNi threads it was 14-fold higher (р=0,001) and with polydioxanone threads it was 9-fold higher (р=0,0049) as compared to the controls. The modification with unfractionated heparin significantly decreased the amount of calcium in the biomaterial. The maximum effect was observed in the test models containing TiNi: the amount of calcium was 14,5-fold lower (р=0,0013), which was comparable with non-implanted models.Conclusion. Cardiovascular bioprosthetic heart valves calcification can be initiated by the suture material due to inflammation in the peri-suture region. The amount of calcium in the biomaterial depends on the quality of the latter. Polypropylene threads precipitated the calcification of epoxy-treated xenocusps in the experiment. The modification with unfractionated heparin can effectively inhibit biological tissue calcification