Interrelation of daily blood pressure profile with left ventricular myocardial hypertrophy in men of working age with hypertension.

OBJECTIVE: Aim: To analyze the relationship between daily blood pressure biorhythms and left ventricular myocardial hypertrophy in working-age men with arterial hypertension. PATIENTS AND METHODS: Materials and Methods: Fifty-seven men with AH (mean age: 44.6±1.3 years) underwent Echo-CG and daily ABPM. Non-dipper and night-peaker patterns indicated BP biorhythm disturbances, while normal dipper and over-dipper patterns indicated undisturbed BP biorhythms. LVH was defined as LMMI > 115 g/m^2. RESULTS: Results: About 60% of participants exhibited diurnal BP rhythm disorders, with a higher prevalence of LVH in this group compared to those with normal BP biorhythms (32% vs. 22%, p>0,05). Patients with normal daily BP biorhythms had significantly higher circadian indices of HR, systolic and diastolic BP, and double product compared to those with disturbed BP rhythms. CONCLUSION: Conclusions: In young men with "non-dipper" and "night-peaker" patterns, LVH appears to be more pronounced than in those with normal daily BP biorhythms. This approach may optimize the timing of antihypertensive drug administration.

HEART RATE VARIABILITY AS AN OBJECTIVE CRITERION FOR THE PSYCHO-EMOTIONAL STATE OF COMBATANTS.

OBJECTIVE: The aim: To evaluate the functioning of the autonomic nervous system in combatants, the relationship between the heat rate variability (HRV) and ques¬tionnaire indicators, to improve the diagnosis of post-traumatic stress disorder (PTSD) and to evaluate the effectiveness of Transcendental Meditation (TM). PATIENTS AND METHODS: Materials and methods: 57 combatants and 30 civilians, with registering ECG and HRV-analysis, self-questionnaire testing. RESULTS: Results: The combatants' group showed an increase in heart rate, in the degree of centralisation of heart rate control and the R. Bayevsky stress index, a decrease in the total HRV value. PTSD score was negatively correlated with pNN50. The indicator «Stress¼ (by DASS-21), revealed negative relationships with the TP, (LF+HF), RMSSD, HF, HFn. The effects of TM on HRV are to save the work of the cardiovascular system (reduced heart rate), reduce the level of nervous and emotional stress, increase the overall adaptation reserve. After TM, the HRV spectrum retains the same proportions of very low, low, and high frequencies as in the baseline state. CONCLUSION: Conclusions: The study objectively proved the presence of neuro-emotional stress and depletion of autonomic regulation reserves in combatants, both by questionnaire surveys and HRV analysis. The high level of correlation between HRV and questionnaire indicators gives grounds for the introduction of HRV analysis for the initial assessment of the psycho-emotional state and tracking its dynamics, as well as for assessing the effectiveness of its correction. Our use of TM has confirmed its effectiveness in correcting the psycho-emotional state.

FEMOROPOPLITEAL ANGIOPLASTY VS OPEN SURGERY FOR CHRONIC LIMB-THREATENING ISCHEMIA.

OBJECTIVE: The aim: To compare the results of femoro-popliteal PTA vs open surgery in chronic limb-threatening ischemia (CLTI) and analyze clinical efficacy long-term results. PATIENTS AND METHODS: Materials and methods: Between 2018 - 2019, 145 patients with CLTI who underwent femoro-popliteal arterial segment steno-occlusive lesions (SOL) unilateral revascu¬larization. Open surgery were performed for - 48 (33, 1℅), percutaneous transluminal angioplasty (PTA) for - 73 (50.3%), and were treated with hybrid surgical interventions for - 24 (16.6%). RESULTS: Results: During the analysis, no statistically significant difference was found among the three groups patients indicators. According to the diabetes patients indicator, the differences among the groups are statistically significant (p<0.001), diabetes was present in only 16.7% of open surgical intervention group patients, 45.8% of PTA group patients, 54.8% of the hybrid surgery group patients. In the overall comparison 2-year limb preservation after open surgery 93.8%, after PTA 91.7%, and after hybrid surgery 91.6%; amputations: open surgery - 6.2% PTA- 8.2 %, hybrid surgery -8.3%; exemption from surgical re-intervention: open surgery - 68.7%, PTA- 58.9%, hybrid surgery - 75%. There were no differences in limb preservation and amputation between open surgery, hybrid intervention, and PTA. A difference was found only in reintervention tactic among the open surgery and PTA groups as opposed to the hybrid surgery. CONCLUSION: Сonclusions: Limb salvage and CLTI patients survival after open surgery and PTA who were not performed major amputation in 2 years term after revascularization were comparable regardless of treatment method.

ASSOCIATION OF FRACTIONAL FLOW RESERVE WITH CLINICAL AND ANGIOGRAPHIC CHARACTERISTICS OF PATIENTS WITH STABLE CORONARY ARTERY DISEASE.

OBJECTIVE: The aim: To identify clinical and angiographic factors, associated with fractional flow reserve (FFR), in stable coronary artery disease (CAD) patients. PATIENTS AND METHODS: Materials and methods: The study consecutively enrolled 68 patients with stable CAD (mean age (63±8,0) ys) and angiographically intermediate coronary lesions (diameter stenosis 50-90 %), with FFR assessment. Stable angina of CCS classes II and III was diagnosed in 42 (62 %) and 15 (22 %) patients, respectively; left ventricular hypertrophy (LVH) - 27 (40 %); severe coronary stenosis (SCS) (70-90 %) - 46 (68 %). The overall CAD complexity was assessed by SYNTAX score. FFR «negative¼ group (FFRNEG) included the patients with non-significant FFRs (>0,80) (n=28 [41 %]). In case of at least one significant FFR (≤0,80), a patient was assigned to FFR «positive¼ group (FFRPOS) (n=40 [59 %]). RESULTS: Results: FFRPOS (vs. FFRNEG, respectively) was characterized by the higher frequency of angina class III (32 % vs. 7 %; p<0,001), LVH (53 % vs. 21 %; p=0,010) and SCS (98 % vs. 25 %; p<0,001). The SYNTAX score was strongly associated with FFR ≤0,70 and ≤0,65, and moderately - with FFR ≤0,65. CONCLUSION: Conclusions: In patients with stable CAD and intermediate coronary artery stenosis, the presence of at least one functionally significant lesion (FFR ≤0,80) was associated with the higher prevalence of angina class III, LVH and more advanced coronary stenosis (≥70 %). The greater overall CAD complexity increased the probability for the angiographically significant coronary lesions to be more functionally compromised.

The characterization of headache in patients with dyscirculatory encephalopathy of different genesis.

OBJECTIVE: The aim of the study was to study the headache features in patients with dyscirculatory encephalopathy of different genesis. PATIENTS AND METHODS: Materials and methods: Clinical-neurological and clinical-instrumental examination of 90 persons aged 40 to 68 was performed. The first group consisted of 60 patients with dyscirculatory encephalopathy and arterial hypertension (DE and AH), the second group - 30 patients with dyscirculatory encephalopathy and cerebral atherosclerosis (DE and CA). RESULTS: Results: In the study of headache in patients with DE + AH and DE + CA, the frequency of detection, the intensity on the VAS scale, and the nature of the headache, no significant difference was found between study groups. CONCLUSION: Conclusions: According to the results of the study, it was proved that patients with DE + CA had headache in the root area, with the circumstances of headache being significantly outweighed «for no apparent reason¼ (p = 0.007) and with changing weather conditions (р = 0.001). Arterial hypertension was a major factor in headache (p = 0.008) and in patients with DE + AH.

VISIT-TO-VISIT BLOOD PRESSURE VARIABILITY AND TARGET ORGAN DAMAGE IN RURAL DWELLERS WITH UNCOMPLICATED ARTERIAL HYPERTENSION.

OBJECTIVE: The aim: To examine the association of hypertensive mediated target organ damage with blood pressure visit-to-visit variability in Ukrainian rural dwellers with uncomplicated hypertension. PATIENTS AND METHODS: Material and methods: The cross-sectional study enrolled 160 adult males with uncomplicated primary hypertension (mean age 50±6 yo). We analyzed office systolic and diastolic blood pressure levels, obtained at four consecutive visits. We used standard deviation (SD) value to assess blood pressure visit-to-visit variability. The patients were referred to the group with high (n=82; 51.3%) vs low (n=78; 48.7%) blood pressure variability (HBPV, LBPV). RESULTS: Results: HBPV patients were characterized by higher left ventricular myocardial mass indexed to height 2.7: median, interquartile range: 70.9 (61.3-78.2) vs 50.9 (44.9-54.4) g/m2.7, respectively p<0.001. The cases of severe left ventricular hypertrophy prevailed in HBPV group (vs LBPV): 68% vs 5%, respectively, p<0.001. HBPV group was characterized by larger common carotid artery intima-media complex thickness, advanced hypertensive retinopathy, higher urine albumin/creatinine ratio value and worse kidneys' glomerular filtration rate. The obtained results might be helpful in the context of global monitoring of vulnerable high risk population of hypertensive rural males. CONCLUSION: Conclusions: The HBPV in rural hypertensive males was associated with more pronounced target organ damage. Further regional research on the various clinical aspects of hypertension, including blood pressure variability, might be useful in extending the existed evidence on prevention of hypertension-related complications.