[Function of the brain venous system and a 24-h profile of arterial pressure in hypertensive patients].

AIM: To study blood flow along the internal jugular veins (IJV) in the initial state and under the action of nitroglycerin in patients with essential arterial hypertension (EAH) with reference to characteristics of a 24-h profile of blood pressure. MATERIAL AND METHODS: A 24-h monitoring of blood pressure (MBP), duplex scanning of IJV, venous IJV outflow were studied in 26 patients with EAH stage 2 (mean age 39 +/- 5.0) before and after sublingual intake of nitroglycerin (0.5 mg). RESULTS: By 24-h MBP findings, two groups of patients were identified: with unaffected blood pressure profile (group 1) and affected profile (group 2). Nitroglycerin produced a unidirectional reaction of IJV (increased outflow) in group 1 and multidirectional changes of venous outflow along the IJV in patients of group 2. CONCLUSION: Nitroglycerin test showed different venous cerebral hemodynamics in EAH patients with different variants of 24-h MBP.

[Diagnosis of structural changes] of the brain in patients with coronary and asymptomatic carotid atherosclerosis]. / Daignostika strukturnykh izmenenii golovnogo mozga u bol'nykh koronarnym i bessimptomnym karotidnym aterosklerozom.

AIM: To compare echomorphostructure of atherosclerotic plaques and vascular stenosis degree with structural changes of the brain according to MR image in patients with combined atherosclerotic affection of coronary and carotid arteries in an asymptomatic course of carotid atherosclerosis. MATERIAL AND METHODS: MR imaging was made in 53 men aged 44 to 78 years with stenosing atherosclerotic affection of the internal carotid arteries. Vascular obstruction reached 30-80%. Neurological examination detected no signs of focal brain lesions. Hypertension, myocardial infarction, permanent atrial fibrillation were diagnosed in 19 (36%), 20 (38%) and 12 (23%) patients, respectively. RESULTS: Ultrasound investigation has established that carotid arteries contain more frequently spongy and heterogenic plaques than dense and calcinated. MRI registered structural alterations of cerebral tissue of various degree in 96% cases. CONCLUSION: Significant correlations were established between ischemic affection of the brain with myocardial infarction, arterial hypertension, cardiac fibrillation, type of atherosclerotic plaque.

[Cerebral microcirculation and structural changes in the brain in essential hypertension]. / Tserebral'naia mikrotsirkuliatsiia i strukturnye izmeneniia golovnogo mozga pri essentsial'noi gipertonii.

The purpose of the study was to examine cerebral microcirculatory and structural changes in 32 patients (20 males and 12 females whose age varied from 37 to 63 years) with moderate arterial hypertension (AH). All the patients underwent single-photon emission computed tomography of the brain, using (99m)Tc-hexamethylpropyleneaminoxylfor the evaluation of perfusion, as well as magnetic resonance imaging for the examination of cerebral structures. Cerebral structural changes and perfusion impairments were detected in patients with AH, even if they had no clinical signs of cerebrovascular insufficiency. Inadequate blood flow most frequently occurred in the parietal and temporal regions of the brain. There was a reduction in the cerebrovascular reserve in the frontal lobes in AH.

[Carotid atherosclerosis detectability in patients with coronary heart disease and arterial hypertension]. / Chastota vyiavleniia u bol'nykh ishemicheskoi bolezn'iu serdtsa i arterial'noi gipertoniei.

AIM: To assess detectability of carotid atherosclerosis in patients with coronary heart disease (CHD) and arterial hypertension (AH) by the data of ultrasonic screening, to study location and detectability of atherosclerotic lesion of common carotid arteries, internal carotid arteries, external carotid arteries in correlation with basic disease. MATERIAL AND METHODS: Ultrasonic screening of brachyocephalic arteries was made in 469 patients: with CHD (n = 239), AH (n = 230) including patients with concomitant postinfarction cardiosclerosis (PICS) and moderate chronic cerebrovascular failure (CCVF). RESULTS: Ultrasonic angiography detected atherosclerotic carotid artery lesion in patients with CHD and PICS (81.6%) or CCVF (76.9%) or angina pectoris (64.2%). In hypertension subjects carotid artery atherosclerosis was encountered in 28.1%. CONCLUSION: It is justified to make ultrasonography of carotid arteries in all patients with CHD and AH irrespective of age, gender, underlying clinical diagnosis.

[Abnormal cerebrovascular reactivity in patients with asymptomatic atherosclerosis of the carotid arteries]. / Narusheniia tserebrovaskuliarnoi reaktivnosti u bol'nykh s asimptomnym ateroskleroticheskim porazheniem sonnykh arterii.

The study included 53 patients (males at the age of 44-78 years) with ischemic heart disease and arterial hypertension with asymptomatic unilateral atherosclerotic affection of carotid arteries (CA). Ultrasonic investigation registered 30-80% stenosis of carotid arteries in the absence of neurological deficit. Cerebrovascular reactivity was assessed by means of the hypercapnic hypoxic test (HHT) including breathing via additional "dead space" for 3 min. Initial and peak linear velocity of the blood flow in the middle cerebral artery was measured with ultrasonic transcranial dopplerography. By HHT results, three types of cerebral vascular reactions in patients with combined atherosclerosis of coronary and carotid arteries were identified: subnormal dilatation on the side of stenosed internal carotid artery, increased dilatation and paradoxical vasoconstriction on the affected side. Cerebrovascular reactivity and the type of atherosclerotic plaques did not collerate.