Interstitial Edema of the Interatrial Septum in Patients with Atrial Fibrillation and Chronic Heart Failure.

We studied the presence of interstitial edema of the interatrial septum in patients with chronic heart failure (CHF) with atrial fibrillation (n=23) or without rhythm disturbances (n=9). The intensity of the MRI signal of the interatrial septum, interventricular septum, and skeletal muscle by T2-weighted MRI and the enhancement index of interatrial septum (the ratio of the signal intensity of the interatrial septum to the signal intensity of the skeletal muscle) were evaluated. The enhancement index of interatrial septum ⩾2 was regarded as an MRI sign of myocardial edema. The enhancement index of interatrial septum in patients with persistent atrial fibrillation was 2.4 (2.21; 2.69) and was higher than in CHF patients with paroxysmal atrial fibrillation and in CHF patients without arrhythmias and surpassed the control values (p<0.05), which indicates the presence of MRI signs of edema of the myocardium of the interatrial septum. The obtained data confirm the presence of myocardial edema of the interatrial septum in CHF patients and persistent form of atrial fibrillation, which expands the understanding of the pathogenesis of this condition.

COVID-19 dynamic model: balanced identification of general biological and country specific features.

Typical tasks of scientific research include breaking down a complex phenomenon into its components, considering the processes that determine its dynamics, formalizing the accepted hypotheses in mathematical equations, selecting appropriate experimental and statistical material, and ultimately, constructing a mathematical model. This paper explores a complex bio-social phenomenon (COVID-19 epidemic) using a specific data processing method (balanced identification) as part of data driven modeling approach. Combined with appropriate information technology, the method made it possible to consider a number of models, describe the general biological laws of the virus vs. human interaction (common to all populations), and the country specific social epidemic management in the populations under consideration. As statistical data, only new cases were used. Data from different countries was taken from official sources and processed in a uniform way.

The level of NT-proBNP in ambulatory patients with chronic heart failure with preserved ejection fraction of the left ventricle.

AIM: The prevalence of chronic heart failure (CHF) remains high. Echocardiography is a reliable method of diagnosing heart failure. Determination of brain natriuretic peptide allows to identify patients with the most probable diagnosis of heart failure, which requires further instrumental examination of patients. To study the level of the brain natriuretic peptide in patients with diastolic chronic heart failure with preserved left ventricular ejection fraction. MATERIALS AND METHODS: The study included 96 outpatients with diastolic chronic heart failure I-III functional class with a preserved left ventricular ejection fraction at the age of 65.06 ± 1.15 years and 50 practically healthy people aged 39.90 ± 1.64 years as a control group who underwent a preventive examination. The level of the N-terminal fragment of the medullary natriuretic peptide (NT-proBNP) in serum was determined using a test system (Vector-Best, Russia). RESULTS: The concentration of NT-proBNP in patients with diastolic heart failure with a preserved left ventricular ejection fraction was 108.18 ± 21.64 in the range from 0.0 to 1212.3 pg/ml compared to the control of 7.6 ± 1.38 pg/ml, p<0.05. A positive correlation was found between the concentration of NT-proBNP and the area of the left atrium (r=0.35), left ventricular E/e '(r=0.6), and left ventricular end-systolic volume (r=0.48). The level of NT-proBNP had no correlation with the functional class of CHF (r=0,23), as well as with the stage of CHF (r=0,23). CONCLUSION: Thus, patients with diastolic CHF with a preserved ejection fraction in 67% of cases had a level of NT-proBNP in the blood less than the diagnostic threshold. The concentration of NT-proBNP in the serum positively correlates with increased pressure in the cavity of the left ventricle, the end-systolic volume in it and the area of the left atrium.

[Biological age as an index of human health level, aging and ecological well-being].

Methodology of estimating the integral health and aging level is based on the system index of biological age (BA). The paper introduces the reader to the BA principles and structure, search for meaningful aging biomarkers, useful tests, and applications in present-day biomedicine. The concept of BA is directly linked with the theory of organism vitality. BA biomarkers must provide a detailed picture of the process of aging. Number of biomarkers cannot be large, while their changes with aging must be uniform in every population member and fairly distinct though with moderate interindividual variations. Prognosis of the vital trajectory requires estimation of risk factors, i.e. hereditary and acquired factors that affect lifespan, and also longevity factors, i.e. genetic and environmental factors crucial for clinical medicine and gerontological prophylaxis properly. At present, BA gains wide recognition in clinical and preventive medicine, physiology and biology as a method to evaluate the general state of health, ecological well-being, adaptation to extreme factors, as well as the rate and degree of organism aging.

[Evaluation and management of occupational health risk in industrial complex workers of Arkhangelsk city].

The article covers data on occupational risk of occupationally mediated and occupational diseases, according to periodic medical examinations in 53251 workers of industrial enterprises in Arkhangelsk city. The authors justify a system of health risks management.

[Scientific basis for system evaluating and managing occupational risk in contemporary production and environment].

The authors gave scientific basis for system evaluating occupational risk and managing workers' health disorders, according to periodic medical examinations data, to ambient levels of environmental (including occupational) hazards, exemplified by industrial complex in Arkhangelsk city. This scientific basis helped to define categories and levels of occupational risk, etiologic share of hazards in disease development, index of occupational diseases, cause effect relationships of disease development and work conditions and other environmental factors, to specify management solutions on lowering occupational risk.

[Peculiarities of regulatory mechanisms of autonomic nervous system in patients with arterial hypertension and disturbed 24-hour blood pressure profile].

BACKGROUND: Insufficient nocturnal blood pressure (BP) decline is associated with elevated risk of complications of hypertensive disease. Heart rate variability (HRV) reflects activity of sympathetic and parasympathetic parts of autonomic nervous system. AIM: To elucidate special characteristics of HRV in patients with various types of 24-hour BP rhythm. Material and methods. Bifunctional 24-hour monitoring and echocardiography were carried out in 42 men with stage I-II hypertensive disease and I-II degree of arterial hypertension (mean age 21.7+/-4.5 years) and 16 practically healthy young people (mean age 24.6+/-5.2 years). RESULTS: Subjects with insufficient (<10%) and adequate nocturnal BP decline (non-dippers and dippers) were distinguished (groups ND and D, respectively). Patients with hypertension in group ND had elevation of systolic BP variability during night and day time, augmentation of nocturnal and diurnal HRV low frequency power, lowering of nocturnal high frequency power, lowering of pNN50 and rMSSD values at night. HRV parameters of control subjects in this group did not differ from those of healthy people. All HRV parameters in group D were characterized by significant 24-hour rhythmicity. This rhythmicity was substantially disturbed in patients of group ND. Parameters of central hemodynamics were similar in groups D and ND. CONCLUSION: These results evidence for the presence of enhanced activity of sympathetic part of autonomic nervous system in non-dipper patients with hypertensive disease throughout 24 hours and during night time and for disturbed circadian rhythm of autonomic nervous system activity. This can serve as a basis for increased rate of cardiovascular complications in this category of patients.

[Association of a polymorphic marker C825T of the beta(3) subunit of G-protein with myocardial hypertrophy in patients with hypertensive disease]. / Izuchenie assotsiatsii polimorfnogo markera C825T gena beta 3-sub"edinitsy G-belka s gipertrofiei miokarda levogo zheludochka u bol'nykh gipertonicheskoi bolezn'iu.

AIM: To elucidate association of a polymorphic marker C825T of the beta(3)-subunit of G-protein with myocardial hypertrophy in hypertension. MATERIAL AND METHODS: Alleles of polymorphic marker C825T of the CNB3 gene were identified by polymerase chain reaction with subsequent cleavage of the product by BseDI restrictase in 135 patients with hypertensive disease (essential hypertension). Left ventricular mass was determined by echocardiography. RESULTS: Patients with and without left ventricular hypertrophy had similar frequencies of T allele of the gene studied. Moreover patients with CC, CT and TT genotypes had similar left ventricular mass index (122.3+/-29.8, 118.8+/-29.9, and 115.2+/-18.3 g/m(2), respectively). CONCLUSION: No association exists between polymorphic marker C825T of the CNB3 gene and left ventricular hypertrophy in patients with essential hypertension.

[Epidemiological features of leptospirosis in Stavropol' region]. / Epidemiologicheskie osobennosti leptospiroza v Stavropol'skom krae.

The data on leptospirosis morbidity among agricultural animals and humans in the Stavropol Territory for the last 10 years, as well as the serological picture of the causative agent of leptospirosis, are presented. The epidemiological importance of the main risk factors and their influence on the development and manifestations of the epidemic process are substantiated. As revealed in this investigation, the professional character of leptospirosis morbidity among humans has been almost completely lost under modern conditions, which requires further study with a view to the development of the rational complex of prophylactic measures.

[Clinico-hemodynamic characteristics of patients with initial signs of hypertension]. / Kliniko-gemodinamicheskaia kharakteristika lits s nachal'nymi stadiiami gipertonicheskoi bolezni.

Multifactor analysis was used to make clinical and hemodynamic comparisons in 42 patients with borderline arterial hypertension, 27 with Stage I hypertension, 40 with Stage II hypertension, and 40 healthy persons. Central hemodynamic parameters at rest and during graded bicycle ergometer exercise were measured by the Defares carbon dioxide return respiration method modified by V. L. Karpman. As compared with patients with hyperkinetic circulation, those with hypokinetic one were older, had a longer history of arterial hypertension, obesity, more common left ventricular hypertrophy, higher baseline diastolic pressures and total peripheral vascular resistance, less increase in cardiac index and greater enhancement of total peripheral vascular resistance during submaximal exercise. There was a clear-cut correlation between the progression of arterial hypertension and increase in values of factors I (clinical and hemodynamic) and III (cardiotonic).

[The osmoregulatory and natriuretic functions of the kidneys in the early stages of the evolution of hypertension]. / Osmoreguliruiushchaia i natriiureticheskaia funktsiia pochek na rannikh étapakh évoliutsii gipertonicheskoi bolezni.

Overall 78 men were examined. Of these, 30 presented with borderline arterial hypertension (BAH), 30 with stage I essential hypertension (EH), and 18 healthy subjects served as control. To assess osmoregulating and natriuretic renal functions, water and water plus salt were administered (at a rate of 22 ml water or isotonic sodium chloride per kg bw). Use was made of classic approaches in this case, with the determination of K+, Na+ excretion, blood plasma and urine osmolarity, calculation of the concentration index, clearance of osmotic-active substances and free water, total reabsorption of Na in the distal parts of nephron and intensity of that process. Besides, flame photometry was employed to measure blood K+, Na+ concentration and RIA to examine plasma renin activity. The data obtained indicate the heterogeneity of the patients with BAH and stage I EN according to the response to water and water and salt administration. Approximately 1/3 of the patients showed a tendency towards water retention in the body as well, which is common to patients with the volume-dependent form of arterial hypertension. In that case the compensatory potentialities of modulating renin-angiotensin system activity were preserved.

[Prospective evaluation of hemodynamic changes in patients with hypertension]. / Prospektivnaia otsenka izmenenii gemodinamiki u bol'nykh gipertonicheskoi bolezn'iu.

Central hemodynamic changes were investigated in 88 patients with essential hypertension after 5-year supervision. With adequate treatment the circulation type common to a given form of hypertension was basically preserved so that no hemodynamic changes were noted. The natural course of the disease was associated with considerably increased total peripheral resistance, while eu- and hypokinetic, instead of hyperkinetic, circulation gradually began to prevail in patients with labile hypertension. Plasma renin activity and renal cortical blood flow decreased. These changes are conducive to the stabilization and progress of arterial hypertension.

[Peripheral blood renin-angiotensin system indices and the kallikrein-kinin system of the kidneys in hypertension]. / Nekotorye pokazateli renin-angiotenzinovoi sistemy perifericheskoi krovi i kallikrein-kininovoi sistemy pochek pri gipertonicheskoi bolezni.

In III patients with hypertension the activity of renin in blood plasma and excretion of kallikrein and kinins in urine and in 53 the activity of carboxycatepsin were determined. Hypertensive patients showed enhanced renin activity and excretion of kallikrein and kinins with urine. A more significant rise of these figures is noted during the early stage of illness, with labile arterial hypertension. In stable hypertension renin activity is lower than in the labile form, however this index remained higher than in the control group. Activity of kallikrein-kinin system and of carboxykatepsin in stable hypertension drops below normal.