Biomedical subjects
Publications and source records attributed to L F Konopleva.
Blood microcirculation and immunity were studied in 52 patients with rheumatic valve disease associated with pulmonary hypertension. The most pronounced changes were observed in patients with "active" pulmonary hypertension. Microcirculatory and immune disorders are likely to be pathogenetical factors aggravating prognosis of pulmonary hypertension.
Considering the common aspects of tissue structure of the aorta and pulmonary artery the authors suggest that in unspecific aortoarteritis in the form of generalized arteriopathy, involvement of pulmonary artery is real. Analysed were 45 autopsy cases. In 31 cases vessel changes of two kinds were seen: destructive-proliferative and sclerotic. Not all cases of sclerotic changes may be explained by lesser circulation hypertension and, thus, the reported data evidence frequent involvement of the pulmonary arteries with development of generalized pathology of the vascular system.
Basing on the response obtained in 46 patients with stage II essential hypertension, the conclusion is made on a positive action of hemosorption plus plasmapheresis on blood rheology, hemodynamics, clinical course of hypertension. The response persisted for up to 6 months.
It was established that use of plasmapheresis in association with hemosorption in 36 patients suffering of hypertensive disease improved the clinical course of the disease, reduced the resistance to drug treatment, increased the treatment efficacy, decreased the risk of complications. Simultaneously there was an improvement of the hemodynamics and hemorheological properties of the blood.
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The state of the greater and lesser hemodynamics in patients with rheumatic mitral heart disease complicated by pulmonary hypertension was analyzed after treatment with peripheral vasodilators and hemosorption. It is suggested that inclusion of hemosorption in the treatment complex favoured reduction of the degree of pulmonary hypertension, improvement of the central hemodynamics which may be directly related to improvement of the rheological properties of the blood.
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A total of 43 patients with primary pulmonary hypertension were examined. The diagnosis was confirmed by invasive techniques and echocardiography. In addition to routine clinical studies, microcirculatory, central and pulmonary hemodynamic ones were used to examine the patients' status and to measure pulmonary pressure. Three groups of the patients were identified: (1) those who received UV-irradiated blood autotransfusion (n = 14); (2) those who underwent hemocarboperfusion with plasmapheresis (n = 15); (3) those who had their own drug therapy (n = 14). The immediate and long-term outcomes of the therapy were analysed. Indications were defined for the usage of extracorporeal techniques in the multimodality treatment of patients with primary pulmonary hypertension.
Bulboangioscopy, aggregate state of the blood, ultrastructural examination of the microcirculatory bed of the skin, ultrasonic examination of the heart revealed that patients with primary pulmonary hypertension and Eisenmenger's syndrome did not show essential differences in the hemodynamics and blood microcirculation. In the treatment of these patients the stage of chronic circulatory insufficiency, vascular and intravascular disorders of the microcirculation should be considered.
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