Features of the Left Ventricular Functional Geometry in Patients with Myocardial Diseases with Varying Degrees of Systolic Dysfunction.

We revealed some features of the left ventricular functional geometry in patients with myocardial diseases with different degrees of left ventricular systolic dysfunction. A negative correlation was found between the spatio-temporal heterogeneity of the kinetics of the left ventricular wall during systole and ejection fraction in normal heart and in systolic dysfunction. The differences in the quantitative characteristics of the functional geometry between patients and normal subjects and between different groups of patients depended on the severityof left-ventricular systolic dysfunction. In particular, spatial heterogeneity index that characterizes heterogeneity of systolic movement of the wall segments and end-systolic Fourier shape-power index characterizing complexity of the left ventricle shape during systole differed significantly in the examined groups of patients and have the greatest diagnostic power.

[Ultrasound markers of the genetic pathology and early hemodynamic changes in human embryo].

First trimester nuchal translucency (NT) and ductus venosus reverse blood flow (DVRBF) are used as ultrasound markers (UM) to determine the risk of fetal aneuploidy, heart defects and subsequent maternal preeclampsia. One pathophysiological explanation for these UM, encompassing both normal and pathological outcomes, is the development of transient heart failure due to increased vascular resistance (afterload). Left ventricular isovolumic relaxation time (LV IRT) was demonstrated as sensitive index of afterload increase in the second and third trimester fetus. The objective of study was to determine LV IRT in normally developing embryos and embryos with early UM of chromosomal and cardiac abnormalities and to test the hypothesis of embryonic hypertension as a cause of transient heart failure. An ultrasound study in 122 normally developing and 27 human embryos with increased NT (>3 mm) and DVRBF at gestational ages 11-14 weeks was perfomed. Mean LV IRT (41 +/- 3 ms) was 36.6 percent longer in embryos with UM as compared to the normal subset (30 +/- 2 ms) (p < 0.001).

[Perinantal programming of arterial hypertension in child].

There is a growing number of evidence linking fetal intrauterine malnutrition, other adverse events or exposures and arterial hypertension during the following life. After important epidemiological studiesfrom many countries, research now focuses on mechanisms of organ dysfunction and on refining the understanding of the interaction between common elements ofadverse perinatal conditions and normal development. This review focused on advances in comprehension of the influence of intrauterine malnutrition on developmental programming of hypertension. Significant decrease in nephrons number was demonstrated as a result of fetal asymmetrical growth restriction syndrome both in human and experimental animal model. The role of malnutrition and dexametasone induced rennin-angiotensin system inhibition in fetal and newborn nephrogenesis is discussed. Recent studies have revealed important mechanisms of altered vascular function and structure as well as sympathetic regulation of the cardiovascular system in perinatal hypertension models. Some of adverse effects on nephrogenesis and blood pressure regulation could be reversed by special diet and treatment during first two years of life. While the complexity of the interactions between antenatal and postnatal influences on blood pressure is increasingly recognized, the importance of early postnatal life in modulating developmental programming offers the hope of a critical 1000 days window of opportunity to reverse programming and prevent or reduce child hypertension.

[The intrauterine programming of adult and children's disesases].

The intrauterine programming hypothesis proposed that cardiovascular and metabolic disease originate through developmental plasticity and fetal adaptation arising from failure of the materno-placental supply of nutrients. The hypothesis is supported by experimental data in animals indicating that maternal nutrition can program long term effects on the offspring. The intrauterine conditions in which the fetus develops have an important role in regulating the function of its physiological systems later in life. Intrauterine programming of physiological systems occurs at the gene, cell, tissue, organ, and system levels and causes permanent structural and functional changes, which can lead to overt disease, particularly with increasing age. The physiological prevention of disease programming is discussing.

[Compensatory hypertension and fetal heart remodeling: from adaptation to pathology]. / Kompensatornaia gipertenziia i remodelirovanie serdtsa ploda, ot adaptsii do patologii.

Left ventricular (LV) isovolumetric relaxation time (IRT), shape and LV wall movement uniformity were assessed in 102 appropriate for gestational age (AGA) human fetuses and 36 fetuses with intrauterine growth retardation (IUGR). In 28 AGA newborns and 26 IUGR infants rennin and angiotensin 1 concentrations were assessed in umbilical cord blood by radioimmunoassay. Systolic blood pressure (BP) was also measured in these infants. The IRT in IUGR fetuses was more (50.9+/-8.6 ms) than in the AGA fetuses (42.8+/-6.7 ms, p < 0.01). The mean BP in the IUGR newborns was greater (76+/-5 mm Hg vs 60+/-6 mm Hg, p < 0.01) than in the AGA fetuses. Rennin and angiotensin 1 concentrations were 1.61- and 1.56-fold greater in the blood of the IUGR newborns than in the AGA infants. A chronic hypertension in placenta perfusion increase in the IUGR fetuses was proposed. The changes in LV shape and uniformity of wall movement (remodeling) are considered to be the result of chronic increase in afterload. Rennin-angiotensin activation and LV remodeling as an adaptive reactions of antenatal period could promote the arterial hypertension development in later life.

[Contraction-relaxation dynamics and mechanical restitution in the developing myocardium of the chick embryo]. / Dinamika tsikla sokrashchenie-rasslablenie i mekhanicheskaia restitutsiia v razvivaiushchemsia miokarde émbriona tsyplenka.

Parameters of the contraction-relaxation cycle and mechanical restitution (MR) were assessed in isolated ventricular preparations of 3- and 4-day chick embryos (EM) and posthatched (PH) chicks. Ryanodine reduced the relaxation rate in the EM but increased it in the PH chicks. It also suppressed a rest-induced potentiation and the MR in all the preparations. Low Na superfusion significantly suppressed the relaxation and decreased the rest potentiation in the myocardial preparations all ages. The findings substantiate existence of a sarcolemmal Ca pool which participates in regulation of twitch parameters and Ca outflux via the Na-Ca exchange.

[Hemodynamic status of the mother and fetus in pregnant women with gestosis during abdominal delivery under different anesthesia methods]. / Gemodinamicheskii status materi i ploda u beremennykh s gestozom pri abdominal'nom rodorazreshenii v usloviiakh razlichnykh vidov anesteziologicheskogo posobiia.

Pregnants in the third trimester with medium- and severe gestosis were divided into 3 groups according to types of maternal and fetal hemodynamics: 1) controls (n = 58 pts); 2) eukinetic type (n = 54 pts); and 3) hypokinetic type (n = 55 pts). Each group was subdivided into 3 subgroups according to administered types of anesthesia for cesarean section (epidural, spinal, and general). Central hemodynamics of the mother, fetus, and fetoplacental complex was studied. Use of different anesthesias in woman with normal pregnancy did not affect the hemodynamics, and therefore any type of anesthesia can be used in cesarean section. In pregnants with gestosis, the eukinetic hemodynamic and compensated or subcompensated placental insufficiency the optimal anesthesia was epidural and spinal. For pregnant with hypokinetic circulation and subcompensated or decompensated placental insufficiency epidural anesthesia is preferable.

[Anesthetics and the developing heart]. / Anestetiki i razvivaiushcheesia serdtse.

Effects of various anesthetics on the myocardium of developing heart are reviewed. Anesthetics suppress myocardial contractility in a fetus and newborn more intensively than in an adult. This is due to immature cell mechanisms regulating cardiomyocyte contractile activity and specific effect of the autonomic nervous system on the heart. It is obvious that the problem of interactions between anesthetics and developing cardiovascular system remains important because of constant introduction of new drugs with new cell and organ effects into practical anesthesiology.

[Experimental-theoretical study of the force-interval relationship in the developing chicken myocardium]. / Eksperimental'no-teoreticheskoe issledovanie sviazi interval-sila v razvivaiushchemsia miokarde tsyplenka.

The force-interval relationship was studied on myocardium preparations from chick embryos and hatched chickens. It is shown that the force-interval relationships of myocardium change during ontogenesis. A negative staircase (a decrease in the isometric force with increasing stimulation rate) in the chick embryo myocardium and a positive steady-state relationship in hatched stage myocardium were revealed. Changes in the force after switching from one stimulation frequency to another, the effects of poststimulation potentiation, as well as responses to the introduction of pauses and extrasystols at a constant stimulation rate were recorded. All the effects observed in the transient processes in preparations from hatched stage myocardium were more pronounced than in embryo myocardium. Our previous mathematical model of calcium recirculation in cardiomyocytes was adapted for simulating the main features of force-interval relationships in embryonal and relatively developed myocardium. The main source of regulatory calcium in the model of hatched stage myocardium is sarcoplasmic reticulum. In the model of embryo myocardium, it was postulated, based on data available in literature, that the main regulator of contractile response of the muscle is calcium that enters cardiomyocytes from extracellular medium. To describe force-interval relationships, by this model, the decreasing dependence of the entry of extracellular calcium on the intervals between stimuli was introduced.

[The role of intra- and extracellular calcium sources in the rhythmic inotropic regulation of isometric contractions in the chick embryo myocardium]. / Rol' vnutri- i vnekletochnykh istochnikov kal'tsiia v ritmoinotropnoi reguliatsii izometricheskikh sokrashchenii miokarda émbriona tsyplenka.

Isometric contractions and force-frequency relationships (FFR) were assessed in isolated ventricular preparations of 3- and 4-day chick embryos (EM) and posthatched (PH) chicks. Pacing protocols for the FFR assessment were applied in normal buffer, buffer with 50% and 25% of normal Na+ concentration, and in buffer with ryanodine. PH myocardium showed greater peak force and more prominent FFR than EM. 50% low Na+ superfusion induced positive inotropic effect and increase in the FFR in PH and EM. 25% low Na+ superfusion induced negative inotropic effect and suppressed FFR more prominent in EM. Ryanodine more suppressed FFR in PH myocardium. The observed age-dependent differences substantiate the fact that Na-Ca exchange plays a leading role in the FFR regulation in early embryonic myocardium and sarcoplasmic reticulum plays a leading role in PH myocardium.

[Non-invasive evaluation of systolic and diastolic functions of the left ventricle in newborn infants]. / Neinvazivnaia otsenka sistolicheskoi diastolicheskoi funktsii levogo zheludochka u novorozhdennykh detei, perenesshikh gipoksiiu.

To assess possible changes in myocardial contractile function and relaxation occurring after mild perinatal asphyxia, maximal blood pressure and M-mode echocardiograms should be registered simultaneously in 32 normal term newborns (group 1) and in 22 term asphyxiated newborns (group II). The slope of end-systolic pressure-dimension relation (ESPDR) was used as a reliable index for evaluation of the myocardial contractility. The slope of ESPDR and some indices of ventricular relaxation decreased in newborns from group II. It is suggested that ESPDR and parameters of left ventricular relaxation and filling can serve as early and sensitive indices of hypoxic myocardial damage.

[A spectral analysis of the periodic components in the heart rhythm structure of newborn infants]. / Spektral'nyi analiz periodicheskikh sostavliaiushchikh v strukture serdechnogo ritma novorozhdennykh detei.

Spectral analysis of spontaneous heart rate fluctuations were assessed in 12 healthy newborn infants and in 14 low birth weight newborns. The orthostatic test was performed by the change of newborns posture. High-frequency fluctuations at the respiratory rate were detected in healthy infants and orthostatic reactions of heart rate resembled the same reactions in healthy adults. High-frequency (respiratory) fluctuations were diminished in low-birth weight infants. It is supposed that respiratory fluctuations can be used as a sign of newborn infants well-being and maturation.

[Pre-clinical diagnosis of toxemia in the second half of pregnancy in a day-care hospital]. / Doklinicheskaia diagnostika toksikoza vtoroi poloviny beremennosti v usloviiakh odnodnevnogo statsionara.

In this study +the purpose to improve diagnostic precision in preclinical forms of late toxemia, the central and peripheral circulation and hemostasis have been evaluated in women during their four day-stay visits scheduled for a pregnancy. Transition of normal pregnancy to "++pre-toxemic" was most commonly seen in the second trimester. Platelet counts and levels of fibrinogen and beta-fibrinogen proved to have the highest predictive value. A decision-making rule was designed for categorization of pregnancies into normal and "++pre-toxemic" and was found to have a 90% efficiency.

[Evaluation of ontogenetic changes in the chrono- and inotropic functions of the rat myocardium under a random stimulation regimen]. / Otsenka ontogeneticheskikh izmenenii khronoinotropnoi funktsii miokarda krysy pri sluchainom rezhime stimuliatsii.

The relationships between isometric contractions and duration of interstimulus intervals, which were changed randomly, were assessed in myocardial strips of adult (AR) and newborn rats (NR). The highest coefficients of variation of contractions amplitude were seen in AR and lowest those in preparations of 1-3 day of life NR. The "force-interval" autoregression coefficients were estimated in different Ca2+ concentrations, their differences being due, probably, to ontogenetic changes.