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Aim: To study the relationship between laboratory markers and echocardiography (EchoCG) parameters in heart failure with preserved ejection fraction (HFpEF) depending on the results of the diastolic stress test (DST)., Material and Methods: The diagnostic algorithm provided by the current guidelines for the assessment of left ventricular (LV) diastolic function was used to select patients. If there were not enough criteria to make a conclusion about increased LV filling pressure (FP) based on standard resting echocardiography data in patients with arterial hypertension and ischemic heart disease, DST was performed to detect HFpEF. 80 patients (50.0% men, mean age 66.3±5.4 years) were included. Group 1 consisted of 41 patients with a positive DST, and group 2 included 39 patients with a negative DST. Concentrations of the markers of immune inflammation, endothelial dysfunction, collagen homeostasis, and myocardial stress were measured., Results: The DST showed significant differences in the E/e' ratio (15.1 [13.4; 15.9] in group 1 and 9.5 [7.9; 10.3] in group 2, respectively, p<0.001) and the diastolic functional reserve index (DFRI) (9.8 [6.8; 14.0] and 21.0 [13.0; 29.0], p < 0.001). Resting EchoCG revealed significant differences in the left atrial reservoir strain (LASr) (22.8 [19.6; 25.6]% and 28.0 [24.8; 30.2]%, p<0.001) and the left atrial stiffness index (LASI) (0.50 [0.40; 0.57] and 0.34 [0.27; 0.41], p<0.001). In patients with HFpEF, the laboratory parameters of collagen regulation had the greatest number of relationships. Correlations were found between the concentrations of matrix metalloproteinase-9 and other biomarkers, including interleukin-10 (IL-10) (r=0.311; p=0.048), myeloperoxidase (r=0.382; p=0.014), N-terminal propeptide of procollagen type I (procollagen I N-terminal propeptide, PINP) (r=0.722; p<0.001) and type III (r=0.591; p<0.001), C-terminal propeptide of procollagen type I (r=0.330; p=0.035), tissue inhibitor of metalloproteinases type 1 (r=0.410; p=0.008), EchoCG parameters, including left atrial volume index (LAVI) (r=0.414; p=0.007) and DFRI (r=0.354; p=0.025). In addition, correlations were found for the concentrations of PINP with IL-10 (r=0.401; p=0.009) and endothelin-1 (r= -0.337; p=0.031); PINP with LAVI (r=0.498; p=0.001) and DFRI (r=0.420; p=0.007)., Conclusion: Patients with HFpEF have a greater number of relationships between markers of collagen homeostasis disorders and EchoCG parameters characterizing an increase in LV FP.

Objective: To study special characteristics of the course of arterial hypertension (AH) among native and nonnative population of Yamalo-Nenets autonomous district., Material and Methods: We examined 100 residents of Far North with AH (men and women aged 21-55, mean age 44.08 ± 1.15 years). All patients were divided into 2 equal groups by 50 subjects: group I consisted of representatives of native and group II--nonnative population. Examination was carried out in outpatient clinic in Salekhard and included 24-hour ambulatory blood pressure monitoring (ABPM), registration of heart rate variability, duplex scanning of brachiocephalic arteries, and assessment of blood lipid profile. The groups were matched by age, gender and disease duration., Results: Analysis of heart rate variability detected significant degree of strain of regulatory systems in most patients of both groups. According to results of ABPM "non-dipper" patients prevailed in group I compared to group II (p = 0.01). Common carotid artery intima-media complex was significantly greater compared to normal value in all patients; it was thicker in group I (p < 0.03), but number of carotid artery stenoses was similar in both groups. No dyslipoproteinemia was detected., Conclusion: Compared with group of representatives of nonnative (adopted) population group of native subjects with AH was characterized by greater carotid intima media thickness and prevalence of "non-dipper" patients.

Aim: To elucidate effect of nebivolol on parameters of cerebral hemodynamics and 24-hour blood pressure (BP) profile in patients with hypertension., Material and Methods: Patients with hypertension of 2nd degree (n=55, age 35-50 years) were divided into 2 groups with similar age, sex, duration of hypertension, and office BP level. Thirty one patients received nebivolol (5-7.5 mg/day), 24 -- atenolol (75-100 mg/day) for 8 weeks., Results: Nebivolol affected positively 24-hour BP profile (decreased variability and morning increase of BP), improved parameters of cerebral hemodynamics (increased index of cerebrovascular reactivity which reflected the state of adaptation of cerebral arteries). Atenolol exerted similar antihypertensive action but did not alter variability and morning increase of BP. Effect of atenolol on cerebral hemodynamics comprised increases of cerebrovascular reactivity index and vasoconstriction reserve., Conclusion: Compared with atenolol nebivolol exerts more favorable effect on 24-hour BP profile and improves cerebral hemodynamics at the account of increased vasodilatation reserve.

Efficacy of combination of trimetazidine (60 mg/day) and enalapril in patients with stable effort angina and metabolic syndrome was assessed in a randomized placebo controlled study of 64 patients. Anti-ischemic activity of trimetazidine was found to be significant. It was most pronounced in patients with abnormal 24-hour blood pressure index, waist/hip circumference ratio >1.0 at the background of satisfactory clinical and laboratory compensation of type 2 diabetes.

Echocardiography and 24-hour BP monitoring were carried out in 177 men with stage 1 and 2 essential hypertension aged 25-59 years when they worked the Far North shift (group l) and in 75 patients with essential hypertension living in moderate climatic zone (group 2). Normal left ventricular geometry was found in 10 and 39% of subjects in groups l and 2, respectively. Left ventricular hypertrophy (LVH) was 2 times more frequent in group 1 where it was predominantly concentric. Contrary to group 2 significant correlations between parameters of 24-hour BP monitoring and echocardiography were found in group 1. All variants of left ventricular geometry in group 1 were characterized by lower systolic BP, high variability of systolic and diastolic BP, impaired 24-hour BP rhythm because of decreased night-day difference. Group 1 subjects with concentric left ventricular hypertrophy had significantly increased left ventricular mass index. Diastolic nocturnal hypertension was the factor most closely related to the structural state of the myocardium in group 1.

A total of 110 young males suffering from hypertensive disease (HD) were studied. Out of them 21 patients had concurrent HD. As HD progresses, there is an accumulation of free cholesterol in the lipid bilayer of erythrocytic membranes, which promotes the limitation of higher membrane permeability for calcium ions. The excessive accumulation of cholesterol also results in an additional decrease in Na+K+. ATPase activity and Ca(2+)-ATPase inhibition in the erythrocytic membranes in hypertensives, which produced atherogenic effects.

In 76 untreated patients with Stages I-II hypertensive disease, spectrophotometry with lipid specific pyrene fluorescence probe revealed higher microviscosity in the lipid phase of neutrophilic membranes, which was induced by elevated levels of cholesterol and enhanced activation of lipid peroxidation. This resulted in increased functional and metabolic neutrophilic activity which was determined by luminol-dependent zimozan-induced chemiluminescence of whole venous blood. The correlation coefficient between the microviscosity of membranes and the chemiluminescence of neutrophils is 0.82 (p).