[The soluble fibrin monomer in patients with instable angina].

The purpose of the study was to measure the blood level of thrombus precursor protein (TpP), a soluble fibrin monomer, in patients with stable exertional angina (SEA) and healthy people. The study included the examination of 33 patients with SEA (functional class II and III) and 29 practically healthy volunteers (control group). The detection of TpP in blood plasma was performed by solid-phase immune-enzyme analysis ("sandwich" type) using commercial diagnosticum "Kit" ("ABS", USA) and a microplate reader "IEMS Analyzer\Dispenser, with automatic result calculation in "Logistic fif" mode. TpP level in patients with SEA on the average was slightly higher than in control group, but the difference was not significant. TpP blood level was independent of the patients' gender, age, angina functional class and an old myocardial infarction. TpP blood level in patients with SEA depended on the duration of the illness, and proved to be significantly higher (compared with that in control group) in patients with SEA during the first 5 years of the illness, i.e. at early stages of CHD. Solid-phase immune-enzyme analysis ("sandwich" type) is a highly informative and affordable clinical method. TpP level in patients with SEA on the average was slightly higher than in healthy people (1.21 +/- 0.06 mkg/ml and 1.01 +/- 0.12 mkg/ml, respectively), but the difference was significant only in patients during the first 5 years of having SEA (1.41 +/- 0.11 mkg/ml).

[Effect of emotional stress on catecholamine and dopa levels in some central nervous regions and in the heart of experimental animals]. / Vliianie émotsional'nogo napriazhenia na soderzhanie katekholaminov i dofa v nekotorykh otdelakh tsentral'noi nervnoi sistemy i serdtse éksperimental'nykh zhivotnykh.

The paper presents the results of examining the levels of dopamine, norepinephrine, epinephrine and precursors of their DOPA biosynthesis in the hypothalamus, hypophysis, medulla oblongata, adrenals and heart in miniature pigs exposed to acute stress. The acute emotional stress was shown to be characterized by a significant increase in the activity of the brain hypothalamic region, adrenals, peripheral portion of the sympathoadrenal system, as evidenced by higher norepinephrine release and hence lower neurotransmitter levels in the above structures. This resulted in abnormal physiological norepinephrine/epinephrine ratios in the central nervous system and heart, predisposing to myocardial metabolic and electric instability.

[Clinical value of determining the levels of renin, aldosterone and vasopressin in newborn infants in critical conditions]. / Klinicheskoe znachenie opredeleniia renina, al'dosterona i vazopressina pri kriticheskikh sostoianiiakh u novorozhdennykh detei.

The concentrations of aldosterone, vasopressin and plasma renin activity were measured in cord blood and on days 1, 3 and 5 of life in 71 newborn infants from the risk group at the development of critical conditions. Vasopressin was discovered to play a substantial role in the development of critical conditions. The lack of a considerable vasopressin ejection in response to a delivery trouble and the growth of its concentration by day 5 of life are prognostically unfavourable. Hyperactivity of the renin-aldosterone system determines the newborns' proneness to liquid and sodium retention.

[The sympathetic-adrenal system in mitral heart defects in patients of different ages studied by the use of a specific L-DOPA test]. / Izuchenie simpatiko-adrenalovoi sistemy pri mitral'nykh porokakh serdtsa u bol'nykh raznogo vozrasta s primeneniem spetsificheskogo testa s L-DOFA.

As many as 59 patients aged 35 to 74 years suffering from mitral valvular disease (MVD) were examined for excretion of dopamine (DA), noradrenaline (NA) and adrenaline, parameters indicating the activity of the sympathoadrenal system. Administration of L-DOPA brought about a significant increase of excretion of all catecholamines in all the patients under 59 years and in those aged 60 to 74 years. In patients with stage I and IIA heart failure, DA excretion rose 50-fold in response to L-DOPA administration, in those with stage IIB and III, 17-fold (p less than 0.001). In patients suffering from MVD, no age-associated differences were revealed in the levels of catecholamines and ICM. In patients suffering from MVD with the predominance of stenosis and in those with stage I and IIA heart failure, background excretion of NA was significantly higher than in patients suffering from MVD with the predominance of heart failure (p less than 0.01). Administration of L-DOPA was followed by an appreciable increment of NA exactly in patients suffering from MVD with the predominance of stenosis (p less than 0.001). In the majority of patients with stage III heart failure refractory to multimodality treatment, the L-DOPA test revealed the smallest increment of DA; its excretion rose only 12-fold. Therefore, the progress of heart failure entails a decrease of the reserve potentialities of the sympathoadrenal system, marked by less output of its mediators.

[Evaluation of the excretion of vanilmandelic acid using paper and cellulose acetate electrophoresis]. / Otsenka ékskretsii vanililmindal'noi kisloty metodom élektroforeza na bumage i atsetate tselliulozy.

The authors compare the results of vanillylmandelic acid (VMA) excretion measurements by high-voltage electrophoresis on paper and by microelectrophoresis on cellulose acetate. Transverse scanning of electrophoregrams has been used for quantitative evaluation of the results of microelectrophoregrams on cellulose acetate. The results of VMA excretion measurements by the two methods have been in good correlation: r = 0.93, n = 15, y = 0.17 + 0.78x, p less than 0.01. Electrophoresis on cellulose acetate is three times less labor consuming and can be performed with Soviet equipment and maintenance medium. The excretion intensity can be assessed visually by reference values of VMA concentration.

[The heart and catecholamines from the viewpoint of the adaptive-trophic function of the sympathetico-adrenal system]. / Serdtse i katekholaminy s pozitsii adaptatsionno-troficheskoi funktsii simpatiko-adrenalovoi sistemy.

Basal excretion of DOPA, dopamine, noradrenaline and adrenalin and its variation in response to oral administration of L-DOPA, a catecholamine precursor, were measured in 491 patients with essential hypertension, cardiomyopathy and myocardial infarction to assess catecholamine synthesis reserves at the systemic level. It is suggested that the development and progress of these diseases is associated with initial activation of the system, accompanied by increased noradrenaline release, which is followed by a gradual decrease in mediator synthesis reserves. The physiologic noradrenaline/adrenalin constant hypothesis, based on clinical and experimental evidence, is supported by the results of catecholamine studies in the heart and the central nervous system in cases of sudden human cardiac death, demonstrating an abrupt drop in noradrenaline. A conclusion is made that adaptive-trophic adrenosympathetic function is linked with biochemical events maintaining noradrenaline content within a normal range.

[Function of the kidneys and the renin-aldosterone system in women before and after use of intrauterine contraceptive devices]. / Funktsional'noe sostoianiia pochek i sistemy renin-al'dosteron u zhenshchin do i posle primeneniia vnutrimatochnykh kontratseptivov.

PIP: Conflicting opinions exist concerning the use of various birth control methods for women suffering from kidney diseases. Some researchers think kidney diseases are a contraindication for the use of IUD; since IUDs may cause inflammatory processes; others think that preventive therapy of extragenital diseases may make the use of IUD possible. The article studies the functional condition of the urinary system and various hormone levels (renin, aldosterone, vasopressin, cortisol) in women using an IUD. The selections of hormones was based on their role in regulating the water-salt exchange before disturbed in pathologic kidney patients. 43 women aged 19-30 were monitored before insertion and 6 months after insertion of an IUD. 20 women suffered from chronic pyelonephritis, 13 from a latent form of chronic glomerulonephritis; the control group consisted of 10 healthy women. All had previously borne children or had an induced abortion. Besides radioisotopic and radio-immunologic testing, such clinical indicators as bilirubin concentration, cholesterol, and urea in the blood, were determined. Some dependencies were found: for chronic pyelonephritis a positive correlation between the concentration of vasopressin and aldosterone, vasopressin and cortisol, and cortisol and the amount of leukocytes; for chronic glomerulonephritis, a positive correlation between aldosterone concentration and arterial pressure, cortisone level and amount of protein in the urine and concentration of vasopressin and amount of erythrocytes in the urine. The reaction of the kidneys to IUD-induced aseptic inflammatory processes in the uterus is more pronounced for healthy women and women suffering form chronic pyelonephritis, than for women with latent chronic glomerulonephritis, as demonstrated in the test by a reduction in cortisol concentration. The minor changes of the renal functions noticed in healthy and, to a somewhat larger degree, in women from chronic pyelonephritis do not constitute a contraindication for IUD usage and, for latent forms of chronic glomerulonephritis, the IUD is preferred. The functional condition of the kidneys of women suffering from chronic pyelonephritis who use an IUD should be tested by using dynamic scintigraphy.^ieng

[Experimental cardiomyopathy and the sympathetic-adrenal system]. / Eksperimental'naia kardiomiopatiia i simpatiko-adrenalovaia sistema.

Along with viral-immunological theory of cardiomyopathy development there is also an opinion on a possible role of neurohumoral regulatory disturbances in this process. Cardiomyopathy in ACB rats was induced by immunization of animals with hemolytic streptococci supplemented by 20% myocardial homogenate. The animals developed hypertrophy of all heart compartments. The reduction in dopamine, noradrenaline and adrenaline levels in the myocardium and a rise in DOPA content have been observed. A significant decrease in labelled noradrenaline uptake by the atria and right ventricle was noted. Changes in catecholamine level in the heart and reduced reversed noradrenaline uptake are indicative of an active role of the sympathetic-adrenal system in the mechanisms of cardiomyopathy development.

Left ventricular function, haemodynamics and certain indicators of neurohumoral control during submaximal exercise in patients with essential hypertension.

The study was carried out in 22 men with essential hypertension, stage I B-II B, aged 25 to 46 years, and in 10 healthy volunteers of the same age. The authors investigated indicators of systemic and intracardiac haemodynamics by echocardiography, determined the blood plasma catecholamine concentration, catecholamine excretion, renin and cyclic nucleotides activity in plasma, both at rest and during continuous submaximal graded exercise on a bicycle ergometer. The haemodynamic response to exercise differed in patients with stable HPT from healthy subjects and patients with labile HPT by an increase in diastolic blood pressure, a lesser drop in end-systolic volume and in total peripheral vascular resistance, a lesser rise in cardiac output, and by a substantially higher left ventricular mass. The left ventricular ejection fraction did not rise in patients with stable hypertension. In these patients, no statistically significant concentration of urine catecholamines and their urine excretion was observed, in contrast to the other two groups where these indicators were increased. A negative correlation was found between the left ventricular mass and the ejection fraction during exercise, which attests to a negative influence of left ventricular hypertrophy on the pump function of the heart during exercise in patients with essential hypertension.

[Endogenous catecholamines and heart function in stimulation of the accelerator nerve]. / Endogennye katekholaminy i funktsiia serdtsa pri stimuliatsii usilivaiushchego nerva.

The role of catecholamines in realization of the effects of the augmenting cardiac nerve has been studied during acute experiments on dogs anesthesized with hexenal. Activation of pump function and myocardial contractility during nerve stimulation has been shown to be in good agreement with the increased noradrenaline concentration in the coronary sinus blood. The synthesis of adrenaline has not been found to lag behind its consumption upon the exposure described. Nerve stimulation has led to accumulation of myocardial adrenaline which takes part in realization of a positive inotropic effect to a far less extent than noradrenaline, and exerts no adverse action on cardiac function.

[New data on the state of the sympathetic-adrenal system in hypertension]. / Novye dannye o sostoianii simpatiko-adrenalovoi sistemy pri gipertonicheskoi bolezni.

Levels of catecholamines in blood, excretion of DOPA, dopamine, adrenaline and noradrenaline were determined in 99 hypertensive patients and 22 healthy persons. Walking for an hour and intake of L-DOPA in a dose of 3 mg/kg of body mass were used as functional tests. There was noted an increase in activity and reactivity of the sympathoadrenal system at early stages of the disease with its gradual reduction in the courses of the disease. In all the patients, with the exception of stable hypertensive patients with crisis, there was noted an increase in the biosynthesis of dopamine which is considered as a possible compensatory protective mechanism opposing pressor actions. An increase in the biosynthesis of noradrenaline was found at early stages of the disease in people with hyperreactivity and, in particular, in hypertension with crisis. Stable hypertension was characterized by the tendency to a decrease in the biosynthesis of noradrenaline, more expressed in patients with crisis.

[Hypothalamic characteristics in sudden human cardiac death]. / Osobennosti gipotalamusa pri vnezapnoi serdechnoi smerti cheloveka.

The hypothalamus was examined in cases of sudden heart death in 50 persons of both sexes whose ages ranged from 25 to 55. The microscopic and biochemical findings were compared with those in cases of heart death which had not occurred suddenly in patients with myocardial infarction of different duration (50 cases). It is shown that in sudden heart death diffuse edema of the white matter and dystonic changes in the microcirculation vessels develop in the hypothalamus. Biochemical examination discloses in the tissue of the hypothalamus in such cases a sharp decrease in the content of noradrenalin and the precursor of catecholamine synthesis DOPA and a marked increase in the level of adrenalin. It is assumed that there is a causative connection between vascular dystonia and the decrease in the noradrenalin level. An increase in the adrenalin content may be conducive to the intensification of cerebral hydrophilism.

[Administration of the catecholamine precursor, L-DOPA, for evaluating their in vivo biosynthesis in hypertension]. / Vvedenie predshestvennika katekholaminov L-DOFA dlia otsenki ikh biosintez in vivo pri gipertonicheskoi bolezni.

The activity of the sympathetico-adrenal system was studied in 19 healthy individuals and in 40 patients with grade IB and IIA hypertensive disease. The excretion of free and conjugated forms of catetcholamines (adrenalin, noradrenalin and dopamine) and the precursor of their synthesis DOPA was determined. Comparison of these values in the control period and after per os administration of L-DOPA (levodopa) showed that administration of the precursor makes it possible to appraise catecholamine biosynthesis in vivo on the level of the intact organism. The results indicate that in patients with hypertensive disease of the early stages the production of dopamine is increased, whereas that of noradrenaline is reduced.