[Blood pressure profile in patients with hyper- and hypotension: effect of physiological stresses]. / Profil' arterial'nogo davleniia u patsientov s arterial'noi giper- i gipotenziei i vliianie na nego fiziologicheskikh nagruzok.

Responses to physiological stresses, relationship between character and severity of these reactions and parameters of 24-hour blood pressure (BP) profile were studied in patients with arterial hyper- and hypotension. Disturbed regulation of BP in hyper-, and hypotension was associated not only with pronounced spontaneous BP variability but also with hyper- and hypotensive responses of BP to natural and modeled orthostatic, psychoemotional, physical and nutritional stresses. Frequency of hypotensive episodes in patients with hypertension was similar to that of hypertensive episodes in patients with hypotension. The use of stress tests facilitated assessment of BP responses to various loads, determination of clinical value of hemodynamic changes and possibilities of correction of detected disturbances.

Pulsometric study of the functional state of cardiovascular system under conditions provoking neurogenic syncopes.

The effects of passive and active orthostatic loads on the amplitude and temporal parameters of pulse waves were studied using an original computer assisted method of differential sphygmomanometry. Changes in the cardiac rhythm reflecting impairment of the autonomic regulation of the circulatory system and preceding neurogenic cardiovascular syncope were revealed and evaluated. Comparative analysis revealed similarity between these changes under conditions of both passive and active orthostasis, which confirmed the diagnostic value of differential sphygmomanometry.

[Efficacy of OSMO-Adalat in patients with arterial hypertension in combination with kinked precerebral arteries]. / Effektivnost' lecheniia OSMO-Adalat bol'nykh arterial'noi gipertoniei v sochetanii s patologicheskoi izvitost'iu pretserebral'nykh arterii]

AIM: To evaluate effectiveness of OSMO-adalat in combination of arterial hypertension (AH) with kinked precerebral arteries (KPA). MATERIAL AND METHODS: Before and after a 3-month course of OSMO-Adalat in a dose 30 and 60 mg, 28 patients with AH (degree 2-3) and KPA were examined for arterial pressure (AP), dyscirculatory encephalopathy, orthostatic stability, ischemic heart disease, transitory ischemic attacks, side effects of therapy. RESULTS: A complete normalization of AP was achieved in 9(32.1%) patients, in the rest patients the effect was partial. 24-h AP profile improved in all the cases. OSMO-Adalt relieved coronary insufficiency and dyscirculatory encephalopathy, improved tolerance of orthostatic loads. Syncopes, transitory ischemic attacks and strokes were not observed. Severe head ache was the cause of the treatment discontinuation in one patient. CONCLUSIONS: Therapy with OSMO-Adalat of patients with AH combination with KPA provides a good hypotensive effect and relieves symptoms of encephalopathy, myocardial ischemia and orthostatic insufficiency in low risk of side effects.

[Modelling of myocardial hypertrophy in vitro for solving problems of medicinal correction]. / Modelirovanie gipertrofii miokarda in vitro dlia resheniia voprosov medikamentoznoi korrektsii.

The work has been done on primary heart culture from neonatal rat ventricle. Cardiomyocyte hypertrophy was modelled using noradrenaline (NA), angiotensin II (AII) and fetal serum, respectively. Cell hypertrophy of primary heart cultures was assessed by measuring the surface area, the scope of protein synthesis estimated by 3H-leucine autoradiography and the contents of nucleic acids in gallocyanin-chromalum stained cardiomyocytes. The structure of myofibrillar apparatus was studied by rhodamine-conjugated phalloidin and indirect immunofluorescence of muscle alpha-actinin. Treatment with 10(-6) M NA increased 3H-leucine incorporation in 9-day old heart culture by 42% without changing cell size. AII in a dose 1 microM stimulated protein synthesis activity by 1.3 fold and the surface area by 1.7 fold, both in 2- and 9-day old primary heart cultures. The maximum stimulation of cell hypertrophy was provided by the medium supplemented with fetal serum. RNA contents in the cytoplasm of cardiomyocytes increased by 7.8 fold and the myocardial cell size by 2.9 fold in serum-supplemented culture by 9 days of cultivation. In the medium with fetal serum, amounts of cardiomyocytes with tetraploid nuclei reached 33%, against 14% in control. Coculturing of myocardiocytes and fibroblasts rendered effects of fetal serum on the growth of myocardiocytes. Cultivation in the presence of 1 microM enalapril, an ACE inhibitor, suppressed the development of cardiac muscle cells hypertrophy. The effect of enalapril depended on the degree of cellular hypertrophy. Addition of 10 microM amiloride to the medium lowered the protein synthesis by 29% independently on the initial cellular hypertrophy.

[Comparative study of the level of cardiomyocyte hypertrophy in patients suffering from ischemic heart disease with normal arterial pressure and in hypertension]. / Sravnitel'noe issledovanie urovenei gipertrofii kardiomiotesitov patsientov, stradaiushchikh ishemicheskoi bolezn'iu serdtsa pri normal'nom arterial'nom davlenii i v sostoianii gipertenzii.

A study was performed on the human atrial myocytes, isolated by means of alkaline dissociation of bioptates, obtained in clinics during open heart surgery, from two groups of patients. The first group consisted of 8 men aged from 40 to 62 years, with ischemic heart disease and normal arterial blood pressure. The second group involved 10 men, aged from 43 to 67 years, with ischemic heart disease and arterial hypertension. The nuclear DNA and the total protein in the cytoplasm of isolated cardiomyocytes were revealed by means of the two consecutive tests: the Feulgen and Naphthol yellow S staining. DNA and protein contents were determined by two wave-length scanning cytophotometry. It is ascertained that the temperate arterial hypertension exerted no appreciable influence on the polyploidy level of atrial myocytes, which correlated with the age of patient; in both groups (coefficients 0.7 and 0.4 for the first and second groups, resp.). The myocyte areas correlate with their ploidy (coefficients--0.7 and 0.7, accordingly). The protein contents in myocytes also correlate with their ploidy (0.5 and 0.7). The average protein content in myocytes of patients in the second group is higher than in the first group, the difference is most distinct when calculating the protein quantity per 2c-genome (717 +/- 34 a. u. and 517 +/- 51 a. u., resp.). A comparison of cytochemical and morphometric indices with some clinical findings obtained by means of echocardiography allowed to reveal the presence of correlative connections among them. The protein contents in myocytes correlate with the left ventricle mass (coefficients 0.6 and 0.5 for the first and second groups, resp.). The correlation between the rate of transmitral blood flow and myocyte ploidy (0.8 and 0.9), and the correlation between the myocyte area and the rate of transmitral blood flow (0.8 and 0.8) look convincing.

Estudo multicêntrico comparativo de quatro diferentes tipos de sensores: atividade, acelerômetro, temperatura e período de pré-ejeçäo / Comparative study with different rate adaptive pacing systems

Recentemente diferentes princípios têm sido utilizado para estimular o coraçäo na tentativa de recuperar o débito cardíaco. Neste estudo multicêntrico, foram comparadas as respostas à estimulaçäo por 4 tipos de sensores, sendo 3 tipos de resposta de alça aberta (atividade física, acelerômetro e temperatura venosa central) implantados em 30 (SSIR-8 e DDDR-22), 9(SSIR-5 e DDDR-4) e 12 (SSIR) pacientes respectivamente. Um outro sensor do tipo alça fechada, sensível às variaçöes do sitema nervoso autôno, foi implantado em 57 pacientes, todos no modo DDDR. Os resultados obtidos durante a realizaçäo de atividade física diária, de teste ergométrico e de Holter de 24 horas foram comparados sendo possível observar uma maior fidelidade na curva de resposta de frequência frente a atividade física, nos pacientes submetidos à estimulaçäo de alça fechada

[Changes in the cytochemical and morphometric characteristics of the myocytes in the right heart of the rat in adrenal-regeneration hypertension]. / Izmeneniia tsitokhimicheskikh i morfometricheskikh kharakteristik miotsitov pravykh otdelov serdtsa krysy pri adrenalregeneratornoi gipertenzii.

A study was made on myocytes of the right atrium and the right ventricle of rats with experimental arterial hypertension due to adrenal regeneration. The nuclear DNA and the total protein in the cytoplasm were revealed using two consecutive tests: the Feulgen reaction and Napththol yellow S staining. A two-wavelength scanning cytophotometry was used for measuring DNA and protein contents. It has been ascertained that the polyploidy levels in the myocytes of the right atrium and the right ventricle, measured 6, 12 and 26 weeks after nephradrenalectomy by the Skelton technique, differ from the control level negligibly. A small increase in the share of tetraploid myocytes occurred in 12 weeks in the right atrium, and in 26 weeks in the right ventricle. The mean nuclear volume in atrial myocytes decreased gradually within 12 weeks, to increase afterwards but did not reach to control level in 26 weeks. The cytoplasm volume of atrial myocytes decreased in 6 weeks, and then was seen to increase gradually approaching the norm within 26 weeks. At the same time the mean cytoplasm volume of ventricular myocytes, which remained practically unchanged within 6 weeks, decreased within 12 weeks more than twice as compared to the control level, but in 26 weeks started to rise, although less quickly than the volume of atrial myocytes. The common protein content was seen to decrease 6 weeks after the operation both in atrial and ventricular myocytes, then gradually approached the control within 26 weeks, these changes in atrial myocytes being sharper than in ventricular myocytes.

[The effect of adrenal-regeneration hypertension on protein-nucleic acid metabolism in rat atrial cardiomyocytes]. / Vliianie adrenalregeneratornoi gipertenzii na belkovo-nukleinovyi obmen v predserdnykh kardiomiotsitakh krys.

A study was made on cardiomyocytes of the left atrium of rats with experimental arterial hypertension due to adrenal regeneration. The nuclear DNA and the total protein in the cytoplasm were revealed using two consecutive tests: the Feulgen reaction, and Naphthol yellow S staining. The two-wavelength scanning cytophotometry was used for measuring DNA and protein contents. It has been ascertained that the polyploidy level in the nuclei of the left atrium myocytes, measured 6 and 9 weeks after nephradrenalectomy, remained the same as in the intact animals. The increase in the share of tetra- and octaploid nuclei occurred by 12 weeks. The mean nuclear volume decreased gradually throughout 9 weeks and subsequently was seen to increase, but by 12 weeks it did not yet reach the control level. The cytoplasm volume decreased by 6 weeks, then started to increase by 9 weeks to reach almost the standard level. The common protein content in the atrial myocytes decreases also by 6 weeks, but restores more rapidly than the volume, and reaches the standard level by 9 weeks, exceeding the same by 12 weeks. Thus, the prolonged hyperfunction of the atrial cardiomyocytes, associated with arterial hypertension, results in their hypertrophy which becomes apparent both in the increased polyploidy and in the augmented protein mass of the cells.

[Changes in the concentration of atrial hormone in hypertensive crises]. / Izmeneniia kontsentratsii predserdnogo gormona pri gipertonicheskikh krizakh.

The paper presents concentrations of atrial sodium-uretic hormone (AH) in the plasma of hypertensive subjects during a hypertensive crisis and in stable blood pressure, in healthy subjects (12, 19 and 7 females, respectively). AH levels were the highest in hypertensives in the crisis. Mean AH concentrations in the crisis and short after the pressure normalization did not differ much. Mechanisms of these phenomena are discussed, relations between AH levels, clinical and hemodynamic characteristics of hypertensive crises are considered.

Atrial and digitalis-like natriuretic hormones in essential hypertension under functional loading.

To assess the relation of the two natriuretic hormones, atrial natriuretic peptide (ANP) and digitalis-like natriuretic factor (DLF), to hypertension, levels of ANP and DLF were measured under basal conditions and after salt and water loading in 31 normal subjects and 36 and 57 patients with Stage I or II essential hypertension (EH). DLF levels were higher in normal women than men; in EH-II patients, DLF levels were elevated among men but subnormal in women (P less than .02) and rose with water loading in both genders. In all groups ANP levels tended to be higher in women. Water loading increased ANP levels in EH-I patients (P less than .001) and caused less marked increases of ANP in control and EH-II women and men. ANP also tended to increase with salt loading. Both DLF and ANP were related to blood pressure in the subject groups (r = 0.75 to 0.96 and r = 0.27 to 0.75, respectively) and were also related to each other (r = 0.20 to 0.47). The role of ANP and DLF in hypertension are likely to be compensatory and directed against water-electrolyte metabolism disorders associated with elevated arterial pressure.

[Natriuretic hormones (atrial and digitalis-like) in patients with arterial hypertension during exercise]. / Natriureticheskie gormony (predserdnyi i digitalisopodobnyi) u bol'nykh s arterial'noi gipertenziei v usloviiakh funktsional'nykh nagruzok.

Blood levels of natriuretic hormones (atrial natriuretic peptide and digitalis-like natriuretic factor) were measured in 93 patients with Stages I and II essential hypertension and 31 healthy individuals. The baseline level of digitalis-like natriuretic factor was higher in the patients with Stage II essential hypertension than in the healthy individuals. This parameter was normal in the patients with Stage I hypertension. The concentration of atrial natriuretic peptide was not greatly different in the patients from that in the healthy persons. Water and salt loads were reported to affect the blood levels of natriuretic hormones. The levels of the hormones were shown to be correlated between them and with blood pressures and the activity of the renin-angiotension-aldosterone system. It was suggested that the natriuretic hormones might play a compensatory role in the pathogenesis of essential hypertension.