[Essential hypertension: pathogenetic studies continue].
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Biomedical subjects
Publications and source records attributed to S A Boĭtsov.
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The subjects of the study were 64 patients with coronary artery disease (CAD), and 38 healthy controls. The study included determination of Chlamydia pneumonia (CLPN), Toxoplasma gondii (TG), Herpes simplex virus (HSV) 1, 2, Epstein-Barr virus (EBV), and antibodies to these microorganisms. Diagnostically significant elevation of the serum levels of IgG antibodies to CLPN, HSV 1, 2, or TG was associated with CAD progression, and seropositivity to several of the agents strongly correlated with CAD progression. Moreover, the risk of future coronary events increased depending on the level of total pathogen burden. These results suggest that intracellular infectious agents are involved in the development of atherosclerosis and CAD.
AIM: To study efficacy of cytoprotector mexicor in patients with unstable angina (UA), acute myocardial infarction (MI), hypertensive crises (HC) in combined therapy with conventional drugs. MATERIAL AND METHODS: An open randomized study included 338 patients with acute forms of ischemic heart disease (IHD) and arterial hypertension running with crises. Combined therapy of 20 patients with UA, 90 patients with MI and 43 patients with HC (study groups) was supplemented with mexicor in a dose 6-9 mg/kg/day. The control matched patients (20, 86 and 79 patients, respectively) received conventional treatment alone. The effects of the treatments were assessed by ultrasound investigation of the heart in M-, B- and Doppler modes, by ECG and arterial pressure 24-h monitoring, by activity of lipid peroxidation (LPO). RESULTS: Adjuvant therapy of urgent cardiological conditions with mexicor diminished oxidant stress, left ventricular dysfunction. In MI patients mexicor promoted reduction of the akinesia zones, recovery of disturbed segmentary contractility. In UA patients mexicor contributed to more pronounced decrease in the frequency, duration and severity of myocardial ischemia, enhanced stabilization of angina. In HC patients mexicor promoted earlier normalization of a 24-h AP profile and variability of cardiac rhythm, recurrence rate of HC decreased 2-fold. CONCLUSION: The addition of mexicor to conventional therapy of UA, MI, HC improves clinical course of these diseases, reduces oxidant stress, accelerates recovery of cardiac contractility and left ventricular diastolic function, normalization of central hemodynamics.
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AIM: To evaluate sympathetic nervous system activity of the heart in patients with bronchial asthma (BA) given beta-adrenomimetics (BAM). MATERIAL AND METHODS: 27 patients with moderate BA (13 patients in an acute phase and 14 patients in remission) treated with BAM and 13 healthy people were examined by using 123I-metaiodobenzylguanidine (MIBG) myocardial planar scintigraphy and estimating the washout rate, early (15-min) and late (240-min) uptake; single-photon emission computed tomography; assessment of MIBG distribution in the left ventricular myocardium, catecholamine excretion with urine. RESULTS: It was found that the MIBG washout rate was significantly higher in asthmatic patients especially in the acute period. The cardiac MIBG uptake was significantly lower in the group of patients with impaired cardiac sympathetic activity. More inhomogeneous myocardial MIBG uptake also occurred in the asthmatic group. Norepinephrine and epinephrine excretion was significantly higher in patients with bronchial asthma and cathecholamine and MIBG excretions correlated. CONCLUSION: Cardiac functional sympathetic activity impairment in asthmatic patients was shown by increased MIBG washout rate and reduced myocardial MIBG uptake, more inhomogeneous substance distribution in the left ventricular myocardium and higher catecholamine excretion levels reflecting sympathetic nervous activity intensification.
Relationship between polymorphisms of ACE and ATR1 genes to morphological and functional states of cardiovascular system was studied in young men with borderline hypertension living in north-west region of Russia. Prevalences of ACE DD and ATR1 AC genotypes were 46 and 54%, respectively. There were no significant correlations between genotypes studied and parameters of central, intracardiac, ophthalmic hemodynamics, as well as presence and severity of albuminuria. Compared with other gene combinations simultaneous carriers of DD and CC genotypes had significantly more pronounced changes of target organs.
Parameters of systemic and intracardiac hemodynamics, characteristics of metabolism, and structural polymorphisms of angiotensin converting enzyme (ACE) and angiotensin II type 1 receptor (ATR(1)) genes were studied in women of childbearing age and men of the same age both with first degree hypertension. Women had lower mean 24-hour blood pressure (BP), greater BP variability, preponderance of "dipper" variant of 24-hour systolic and diastolic BP profile, higher prevalence of left ventricular hypertrophy, lower blood levels of cholesterol, triglycerides, urea and potassium. Among women A allele of ATR(1) gene was significantly more frequent than C allele. Comparison of ATR(1) gene polymorphisms in women and men showed that frequencies of AA genotype and A allele were higher in women. Presence of DD genotype of ACE gene in women was related to parameters of both hemodynamics and metabolism, whereas that of II genotype of ACE gene as well as AA and AC genotypes of ATR(1) gene were linked with parameters of hemodynamics.
The authors' studies demonstrate that 87.5% of patients with exacerbation of moderate bronchial asthma have cardiac arrhythmias most of which have favorable prognosis. Most of the arrhythmias were supraventricular. Hypercatecholaminemia is considered one of the mechanisms contributing to development of arrhythmia in bronchial asthma exacerbation. Administration of diltiazem proved that this drug is highly effective in the treatment of both supraventricular and ventricular arrhythmias in asthma patients.
AIM: To characterize peculiarities of arterial hypertension course in citizens of sieged Leningrad. MATERIALS AND METHODS: 2000 case records of hypertensive patients treated in 6 hospitals of sieged Leningrad have been analysed. RESULTS: Arterial hypertension (AH) was verified as the basic disease in 69 cases. Of them, only 47 patients were eligible for analysis. Mean age of the patients was 45 years. AH duration before hospitalization was less than 1 year in 35% of the cases. Hypertensive crises, hypertensive angiopathy, cerebral atherosclerosis, cardiac hypertrophy were documented in 25, 15, 15 and 64% of the cases, respectively. In hospital, no specific antihypertensive therapy was given. At the discharge, systolic blood pressure decreased significantly, diastolic blood pressure decreased insignificantly. CONCLUSION: Clinical data evidence for rapid affection of target organs in hypertensive subjects exposed to unfavourable conditions of the war time.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
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To compare efficacy of conventional therapy, antihypoxants olifen and amthizol (groups 1, 2 and 3, respectively) 49 patients with congestive heart failure stage IIb according to the Vasilenko-Strazhesko classification were treated. In hospital the pre-hospital scheme of treatment was not changed except the following positions: group 1 patients received strophanthin instead of oral digoxin, group 2 and 3 patients received adjuvant olifen and amthizol, respectively. Stabilization of the condition occurred in 10 days, on the average, in each group. In the 1st group good results were obtained due to stroke volume increase, in the 2nd and 3d due to the ability of olifen and amthizol to prevent tissue hypoxia.