[A comparison of the effect of Capoten (captopril) and ramipril on the circadian profile of the arterial pressure and peripheral hemodynamics in patients with hypertension combined with diabetes mellitus]. / Sravnenie vliianiia kapotena (kaptoprila) i ramiprila na sutochnyi profil' arterial'nogo davleniia i perifericheskuiu gemodinamiku bol'nykh gipertonicheskoi bolezn'iu v sochetanii s sakharnym diabetom.

20 patients with essential hypertension and diabetes mellitus (DM) type II were given Capoten (100-125 mg/day for 6 weeks) followed in a 2-week interval after its course termination by ramipril (10.0-12.5 mg/day). 50% of patients were sensitive to Capoten, 50% were resistance: 35 and 40% to ramipril, respectively. Ramipril was discontinued because of toxicity in 25% of patients. Hypotensive effects of ramipril were weaker than Capoten, though the former drug appeared more potent in lowering of peripheral vascular resistance at rest and at reactive hyperemia. Vasodilatation did not differ much.

[The circadian profile of the arterial pressure and the structural-functional changes in the cardiovascular system in the initial stage of hypertension]. / Sutochnyi profil' arterial'nogo davleniia i strukturno-funktsional'nye izmeneniia serdechno-sosudistoi sistemy pri nachal'noi stadii gipertonicheskoi bolezni.

24-h blood pressure (BP) monitoring conducted in 52 patients with mild to moderate essential hypertension have shown that the average 24-h systolic and diastolic BP correlates with left ventricular (LV) mass index, while at casual clinical measurements only systolic BP correlates with LV mass index. In non-dippers (patients with a nocturnal BP decrease less than 10%) LV hypertrophy is observed 2 times more often than in dippers (patients with a nocturnal BP decrease more than 10%). In the group of dippers 24-h variability of systolic BP and daily systolic BP correlate with LV mass index. Increased variability of night BP correlates with increased venous tone in the calf, increased structural component of vascular resistance and a reduction of blood flow reserve in lower extremities.

Magnetic resonance imaging of cardiac hypertrophy in malignant arterial hypertension.

The major target organs that become damaged as a consequence of long-standing arterial hypertension are the kidneys, heart, and brain. Left ventricular hypertrophy (LVH) cannot be considered only as an adaptive process to elevated blood pressure (BP), and the heart is also a major target organ in malignant arterial hypertension (MH). Magnetic resonance (MR) was used as a method for visualization of the heart in 68 patients with MH including 18 with essential hypertension, 16 with chronic glomerulonephritis, 13 with chronic pyelonephritis, 16 with renovascular hypertension, eight with adrenal tumors, and in 20 healthy volunteers (as a comparison group). Electrocardiogram-gated, double spin-echo magnetic resonance imaging was performed to image the right and left ventricles (RV and LV), interventricular septum, apex and LV posterior wall, left atrium, and aortic root. In all the patients, symmetric LV hypertrophy was registered and in the most severe cases LV wall thickness was more than 20 mm. There was no LV cavity enlargement or local contractility abnormalities. There was close correlation of LVH and diastolic BP. The degree of LVH and diastolic dimensions of the LV differed between etiologies of MH. These findings show that different pathophysiologic mechanisms of development of MH influence the processes of myocardial hypertrophy. The highly informative yield of MR tomography for evaluating structural and functional changes of the heart under MH must be underlined.

[Clinical use of magnetic resonance tomography in the assessment of vital organs in malignant arterial hypertension]. / Klinicheskoe primenenie magnitno-rezonansnoi tomografii v otsenke sostoianiia zhiznenno vazhnykh organov pri zlokachestvennom techenii arterial'noi gipertonii.

Magnetic resonance tomography was performed to examine the kidneys, brain, adrenals, vessels, and heart in 110 patients with malignant arterial hypertension (MAH). The findings were compared with those of the examination of healthy subjects and patients with benign hypertensive disease (BHD). As compared to the controls, all the MAH patients had changes in the target organs, however, their nature and magnitude varied with under underlying MAH disease. Renal alterations were most profound in chronic glomerulonephritis. All the patients displayed signs of concentrated cardiac hypertrophy: its maximum degree being noted in renovascular hypertension, the least, in MAH of adrenal genesis. Examination of the central nervous system in MAH patients revealed that the ventricular system and subdural space were dilated. It was shown that it was feasible to diagnose hypertrophic encephalopathy in the prehospital period by employing magnetic resonance tomography.

[Functional state of blood platelets in arterial hypertension and the changes in serotonin-containing cellular granules]. / Funktsiona'lnoe sostoianie krovianykh plastinok pri arteria'lnoi gipertonii i izmeneniia serotoninsoderzhashchikh granul kletok.

The study was undertaken to examine the status of the granular apparatus and platelet aggregability in 9 healthy donors and 18 patients with arterial hypertension (AH), including 14 with essential hypertension (EH) and 4 with symptomatic forms of AH. Among the patients, a group of 8 EH patients was singled out, who had, compared with normal, reduced relative volumes of electron dense platelet granules (from 17.9 +/- 2.0 to 5.3 +/- 0.6%). The group also showed lower platelet serotonin levels (from 67.3 +/- 5.3 to 17.6 +/- 3.7 ng per 10(8) cells; p less than 0.001) and a 2-fold decrease in the transport factor of acridine orange across the cytoplasmic and granular membranes as compared to normal. A positive correlation was established between the amounts of cellular serotonin and the relative volume of platelet granules (r = 0.850; p less than 0.001).

[A MR tomographic method for studying heart function in malignant arterial hypertension]. / Izuchenie metodom MR-tomografii sostoianiia serdtsa pri zlokachestvennoi arterial'noi gipertonii.

To study the value of magnetic resonance imaging (MRI) in the determination of heart morphology and function, 47 patients with malignant arterial hypertension (MAH) were examined. The images of the both ventricles, ventricular septum (VS), left ventricular (LV) apex and posterior wall (LVPW), aortic root and left atrium were studied. In all the patients, symmetric LV hypertrophy was found and the thickness of LVPW was 1.46 cm, IVS, 1.53 cm. The heart chambers were not enlarged. The diameter of aortic root was 3.36 cm. There was a close correlation between LV hypertrophy and blood pressure. We conclude that the development of LV hypertrophy in MAH is not merely a compensatory process response to high blood pressure.

[Case of segmental aglomerular hypoplasia of the kidney]. / Sluchai segmentarnoi aglomeruliarnoi gipoplazii pochki.

A rare condition known as "segmental aglomerular kidney hypoplasia" was observed in a woman with arterial hypertension. The pathogenetic link of this condition with arterial hypertension is discussed.

[Use of surgical biopsy of the kidney in the differential diagnosis of various forms of arterial hypertension]. / Primenenie operatsionnoi biopsii pochki v differentsial'noi diagnostike razlichnykh form arterial'noi gipertonii.

To make a more precise diagnosis, kidney biopsy was performed in 17 patients with a severe course of blood hypertension due to a mild urinary syndrome. Taking into account the high risk of hemorrhagic complications in such patients, an operational biopsy was performed (in 13 patients in a open way and in 4 patients in a semiopen one). As a result of the histologic investigation of kidney bioptates, the diagnosis was changed in more than half patients. In the postoperative period, almost all the patients had microhematuria, 1 subject having massive bleeding into the retroperitoneal cavity that required nephrectomy. In 3 subjects the postoperative period was complicated by wound suppuration.