FEATURES OF HEART RATE REGULATION IN ADOLESCENTS WITH ESSENTIAL HYPERTENSION

Cardiointervalography is an important method of analyzing the regulation of heart rate variability, which allows evaluating the balance of the entire spectrum of humoral-metabolic and vegetative effects, both in condition of physiological rest and in various functional tests. It is noted that in hypertensive patients, in most cases, there is a chronic predominance of ergotrophic metabolic reactions that reflect the system tension in the regulatory mechanisms. The aim of our study was to conduct a comparative analysis of the features of the mechanisms of heart rate regulation in adolescents with confirmed essential hypertension and their healthy age mates. Material and methods. The study involved 50 adolescents (12–16 years of age) – 26 boys and 24 girls with labile essential hypertension (EHT) and stage 1 HT on the background of the standard medical correction of blood pressure (enalapril 0,58 mg/kg per day). Each participant of the study and control group underwent recording of at least 512 cardio cycles in the state of physiological rest in a sitting position, as well as registration of blood pressure. Results and discussion. We have found that for adolescents with EHT a significantly lower (by 15 %) average duration of the heart cycle is typical in combination with a decrease in the variation range, which indicates some rigidity of the heart rate regulatory mechanisms. The relative decrease in the proportion of high-frequency spectrum components in comparison with the low-frequency and very low-frequency ranges in adolescents with hypertension also indicated a tendency to predominance of sympathicotonic effects with the predominant involvement of the structures of the diencephalic region and the brain stem. At the same time blood pressure inversely correlated with the index of the variation range of cardiointervals, reflecting the lower adaptive potential of the heart rate regulation mechanisms. Conclusion. We have found regular changes in the regulation of heart rate in adolescents with hypertension, that can be taken as markers of its progressive development and used by clinicians to develop more personalized approaches to medication treatment

EXPERIENCE WITH ROBOTIC LUMЕNIS CO LASER IN ENDOSCOPIC LARYNGEAL SURGERY

2 The paper describes the first experience in using robotic CO laser at the Department of Head and Neck Tumors, Moscow City Cancer Hospital Sixty-Two. With advances in endoscopic techniques and anesthesiology, there have been new possibilities of usingdirect (rigid) larygoscopy in conjunction with laser systems.The Lumеnis laser assembly consists of three interconnected components: a videocamera, an operating microscope, and directly CO laser. It includes a computer system that sets a program to perform an operation.The heart of the laser system is a scanning Digital Acu Blade micromanipulator. This unique assembly makes itpossible to control the area and depth of incision, to cut intricate shapes in relation to the surface anatomy, and to precisely control ablation and hemostasis. The effect of tissue carbonization during surgery is minimal at the expense of the physical characteristics and different modes of radiation. It is noted that this system allows organ-sparing treatment in cancer patients and their prompt rehabilitation after surgical interventions

Efficiency of conducting cardiobiofeedback in healthy adolescents and adolescents with essential hypertension

Introduction. The article discusses the problem of using cognitive visceral cardiobiofeedback as a preventive and non-drug method for correcting disturbed regulation mechanisms associated with an increase in blood pressure in adolescents with essential hypertension (EH) against the background of standard antihypertensive therapy with enalapril. Aim of the study was to investigate the indices of the cardiointervalogram (CIG) during a biofeedback session and to evaluate the effectiveness of cardiobiofeedback in healthy adolescents and adolescents with EH living in Novosibirsk. Material and methods. Each participant underwent a 5-minute CIG recording using the hardware and software complex VedaPulse under physiological rest and during biofeedback session. In the course of biofeedback, the subject was asked to lengthen the expiration phase of the respiratory cycle with parallel relaxation of muscle tone and visual feedback on the dynamics of a multimedia plot reflecting changes in the duration of the cardiac cycle. Results and discussion. We found that the effectiveness of cardiorespiratory synchronization (CRS) is characterized by an increase in SDNN indicators by 8.3% and the total power of spectral influences (TP) by 23.6% due to a significant increase in the parasympathetic spectral index of HF by 29.4%. An increase in the power index of the spectrum of low-frequency oscillations (LF) by 51.3% can be considered as an element of CRS within 0,1 Hz. In healthy adolescents, the reactivity of the suprasegmental levels of regulation (IC) is preserved and their growth is noted by 7.6%. In adolescents with EH, an increase in the duration of the cardiac cycle by 5.2% and TP by 31.2% was recorded in the course of cardiobiofeedback, which is associated with an increase in the power of the spectrum of high-frequency oscillations (HF) by 2.4%. This phenomenon should be considered as a positive pathophysiological response of the autonomic link of the nervous system, which is recorded by a decrease in blood pressure. Conclusion. We assume that the test with cognitive visceral cardiobiofeedback can serve as an effective marker for the analysis of the rigidity of autonomic mechanisms of regulation in adolescents with essential hypertension. Conscious regulation of the heart rate through the mechanism of controlled respiration (biofeedback) can be an effective non-drug method for correcting autonomic regulation disorders in adolescents with arterial hypertension, which is manifested by a significant decrease in blood pressure