[Gastrointestinal hemorrhage in cardiosurgery in patients with endothelial dysfunction].

AIM: To estimate the prognostic value of the hypoxic test, intragastric pH-metry, and endothelial dysfunction in cardiosurgical patients at risk of gastrointestinal hemorrhage. MATERIALS AND METHODS: This prospective study approved by the ethical committee was performed based at the Department of Anesthesiology and Resuscitation, Research Institute of Cardiology, Tomsk, in 2012-2013. It included 30 patients who had previously undergone myocardial revascularization with artificial circulation. Gastroduodenal complications were predicted based on the results of the general hypoxic test, monitoring intragastric pH, and determination of endothelial function markers (endothelin-1, nitric oxide metabolites) intra- and postoperatively. RESULTS: 17 (56.7%) patients with negative results of hypoxic test were referred to the group at low-risk of gastrointestinal complications and given no antisecretory therapy. Plasma ET-1 level in the patients with gastric hemorrhage was almost 10 times that in the absence of complications. Multiple organ insufficiency was associated with a rise in RT-1 levels by the end of the first postoperative day. High ET-1 levels suggested the predominance of vasoconstrictive effect that eventually resulted in a break of the vascular wall and hypoperfusion of gastric mucosa. CONCLUSION: High ET-1 levels and disbalance of nitric oxide metabolites in blood are the main predictors of postoperative complications that characterize the functional state of vascular endothelium and may cause vascular rupture in case of the atherosclerotic process. The use of hypoxic test and gastric pH-metry in the preoperative period make it possible to distinguish patients that do not need preventive antisecretory therapy.

[Influence of the long-term administration of torasemide on morphometric characteristics of cardiac muscle under conditions of developed experimental postinfarction cardiosclerosis].

The possible antifibrotic effect of torasemide used for the treatment of model chronic heart failure (CHF) has been studied in rats aged 12 months with developed postinfarction cardiosclerosis (PICS). The antifibrotic effect was evaluated of the course of torasemide administration in a daily dose of 0.13 mg/kg. A comparative analysis showed that torasemide did not affect the state of connective tissues in cardiac muscles of both intact rats and those with PICS. It was concluded that manifestations of the antifibrotic effect of torasemide can be related to the nosological form of CHF.