[THE TEST OF GENERATION OF THROMBIN IN DYNAMICS IN PATIENTS AFTER TRANSCUTANEOUS CORONARY INTERVENTION].

The article presents results of observation of generation of thrombin in patients with ischemic heart disease in different terms after transcutaneous coronary intervention. The sampling included 37 patients with stable ischemic heart disease. The control group included 30 healthy individuals. To study system of hemostasis of this category of patients the test of generation of thrombin and its modification with added thrombomodulin were applied for evaluating anti-coagulant activity of system of protein C. The comparison of indicators of test of generation of thrombin in patients with ischemic heart disease before operation and in individuals of control group revealed no reliable differences (p > 0.05). The observation of patients with stable ischemic heart disease in various time-frame after mechanical re-vascularization of myocardium established significant increasing of generation of thrombin and decreasing of anticoagulant activity of system of protein C at 1-3 day after operation (p < 0.05). The positive correlation was established between endogenous thrombin potential and annexin 5, an early marker of dysfunction of endothelium in mentioned time-frame after operation (p = 0.0008; r = 0.57). The significant increasing of content of anti-inflammatory markers of C-reactive protein and fibrinogen was observed at 1-3 day after transcutaneous coronary intervention (p < 0.05). In that way, the study data give evidence to hyper-coagulation in patients with stable ischemic heart disease in early time-frame after operation despite normal values of activated partial thromboplastin time, prothrombin time, D-dimer and applied standard disaggregant therapy.

[Effects of long-term therapy with losartan on baroreflex regulation of cardiovascular system]. / Vliianie dlitel'noi terapii lozartanom na sostoianie baroreflektornoi reguliatsii serdechno-sosudistoi sistemy.

To assess dynamics of structural-functional parameters of the circulatory system including the state of the cardiopulmonary baroreflex (CPBR) in patients with ischemic heart disease (IHD) and cardiac failure (CF) on losartan treatment, we studied 14 IHD men with CF (NYHA functional class II-III), mean age 54.6 +/- 7.1 years. Before and after losartan treatment the patients were examined using echocardiography, radiocardiography with 131-I albumin, occlusion plethysmography, 131-I hippuran clearance. CPBP was estimated by the change in circulation flow rate in the forearm in low body rarefaction by means of low pressure camera. Losartan was given in maximal tolerance dose (25-100 mg/day). Examination in the end of the treatment demonstrated diminished venous tone, increased blood flow in the forearm, reduced volume of circulating plasm, elevated hematocrit, higher ratio of early to late filling peaks of the left ventricle, progression of baroreflex dysfunction. Thus, long-term losartan treatment promoted improvement in peripheral vascular tonicity, diastolic function of left-ventricular myocardium, reduction in circulating plasm volume, progression of baroreflex dysfunction.