[Congestive heart failure--some current problems]. / Zastoina surdechna nedostatuchnost--niakoi aktualni problemi.

The congestive heart failure (CHF) has become one of the most common syndromes afflicting the population. The long-term prognosis of these patients is bad. The CHF shows a tendency toward fast progressive development. The aim of our study was a retrospective investigation on CHF patients, a determination of CHF functional class by NYHA and its type, a determination of the most important diseases leading to heart decompensation and of the reasons for dead in these patients. For a 6-year period we investigated 6428 patients. 1095 (17.03%) of them were with a different degree of CFH. More of them were with II and III functional class of CHF by NYHA. In the age decade from 61 to 70 years the frequency of CHF increased significantly. The most important diseases leading to CHF syndrome were chronic ischemic disease, arterial hypertension, COPD with chronic cor pulmonale and valve diseases. The average age of deceased CHF patients was 67.8 +/- 7.4 years. After the manifestation of the first group of symptoms the mean life duration of CHF patients was 13.2 +/- 4.1 years.

[Early hemodynamic changes in chronic obstructive pulmonary disease with initial respiratory failure]. / Ranni khemodinamichni promeni pri khronichnata obstruktivna belodrobna bolest s nachalna dikhatelna nedostat'chnost.

The chronic hypoxemia seems to play an important role in the pathogenesis of hemodynamic disorders in chronic obstructive pulmonary disease (COPD). The aim of the study was to follow-up the changes in pulmonary hemodynamics in COPD with mild respiratory failure. 78 COPD patients with Ist and IId degree of respiratory failure were investigated. The following investigations were carried out: two--dimensional echocardiography, spirometry, arterial blood gases and acid-base balance. In 18 of COPD patients a right heart catheterization was performed and the following indices were determined: mean pulmonary arterial (PA) pressure, pulmo-capillary resistance, teledyastolic right ventricular volume. The echocardiography showed significantly higher mean PA pressure values, an initial right ventricular dilatation and right ventricular wall hypertrophy. The indices of right heart catheterization were changed, too. The pulmo-capillary resistance was significantly increased. It was the most sensitive early parameter. The mean PA pressure was increased. There was no significant difference between the mean PA pressure determined by echocardiography and by right ventricular catheterization. A relationship between the degree of hypoxemia and the hemodynamic changes was found. The long development of COPD with mild respiratory failure leads to disorders in lung microcirculation and early changes in pulmonary hemodynamics. This process worsens the prognosis of COPD and the early prevention in the complex therapy of the disease is necessary.

[Lipid peroxidation in chronic lead exposure]. / Prouchvane vurkhu lipidnata peroksidatsiia pri khronichno olovno vuzdeistvie.

The state of lipid peroxidation, monitored by MDA concentration in the blood plasma of 46 battery workers with lead level in the blood in the 1.26-5.6 mol/l range is investigated. Higher MDA concentration (4.61 + 0.6) mol (ml in the blood plasma of exposed workers in comparison with the control sample of nonexposed workers is statistically established. The greater part of exposes workers (56.6%) have MDA concentration above the upper reference range. The significant correlation (r = +0.54) of the lipid peroxidation with the lead level in the blood is established. The investigation results show the rise of lipid peroxidation in workers chronically exposed to lead. This rise is more significant at lead levels above 1.92 mol/l.