Dyslipidemia in pediatrician's practice.

Atherosclerosis ranks first among cardiovascular system diseases. It is the "disease of the century", and more than 50% of people with circulatory pathology die of it. The clinical manifestation of atherosclerosis is observed at the middle and older ages, but it is known that the pathological process develops much earlier. There has been a clear trend in theoretical and practical cardiology in recent years to study the earliest atherogenic markers. Epidemiological, clinical, and morphological studies have proved the presence in children and adolescents of sexual, endogenous, exogenous, primary, and potentiating risk factors contributing to an early formation of a pathogenic foundation for atherosclerotic cardiovascular diseases. Disorders of lipid metabolism - dyslipidemias are attributed to the most significant risk factor for atherosclerotic cardiovascular diseases. The DLP prevalence in the pediatric population is extremely high. According to the results of conducted global studies, lipid metabolism disorders occur in more than 70% of children and adolescents. It causes the need for timely diagnostic, therapeutic and preventive measures. The need to extrapolate the risk factor concept to childhood age is justified by several reasons, the main of which include the broadest spread of atherosclerosis that has become a global pandemic, genetic determinism, and low variability of the lipid spectrum of blood serum: the levels of lipids and lipoproteins discovered in childhood are stable throughout life and have an independent prognostic value. That is why the most practical significance is inherent to the study of lipid and lipoprotein metabolism, starting in the early periods of lipid and lipoprotein ontogenesis. Since risk factors can be identified at the preclinical stage of the atherosclerotic process, dyslipidemia phenotyping will facilitate identifying children and adolescents at risk of developing cardiovascular pathologies in the future. The study objective is to examine the pathophysiological aspects of lipid and lipoprotein metabolism and examine DLP epidemiology - as the leading atherosclerotic cardiovascular disease risk factor in children and adolescents, DLP classification, modern approaches to DLP diagnosis and management.

Cardiorespiratory synchronism in estimation of regulatory and adaptive organism status.

The proposed method of quantitative estimation of regulatory and adaptive status (RAS) of human organism is based on complex responses of two major vegetative functions - breath and heart rates under organism exposure to a number of factors and diseases. It has been evidenced that during the follicular menstruation stage and during optimum readiness of female organism for childbirth RAS increases, however, stress impact can also cause RAS set off to decrease. Likewise, the possibility of quantitative organism stress resistance estimation is also presented. Under some pathological conditions (myocardial infarction, hypo-and hyperthyroidism, diabetes type 2), RAS goes down, and the degree of its restoration depends on the attained therapy effect. It is shown that RAS dynamics provides an innovative methodological approach to medication efficiency estimation based on its influence not only on the body organ or target function, but also on adaptive abilities of the organism.

On the conscious control of the human heart.

This study describes methods of volitional management of heart rhythms and proves that it is possible by means of management of its operations, subject to arbitrary control, which also has a strong functional connection to the center of the heart rhythm formation in the brain. Experiments demonstrate that it is possible for arbitrary changes in the heart rhythm to be made through conscious control of the breathing rhythm, and even a short-term cardiac arrest by means of contracting abdominal muscles. We postulate that the management of human heart rhythm is indirectly regulated through arbitrary controlled operations. The present article describes and analyzes ways that enable a human to consciously and purposefully manage the frequency of heart contractions. Common principles of arbitrary management of the heart rhythm in humans are uncovered through analysis.

Interaction of brain and intracardiac levels of rhythmogenesis hierarchical system at heart rhythm formation.

A single-stage bilateral conduction blockade of the vagus nerves (functional denervation) by constant anodal current was carried out in 13 dogs which are under anesthesia and 3-5 days after operation in chronic experiments. In anesthetized animals, "functional denervation" led to acceleration of the heart rhythm from 102.4+/-3.2 bmp to 123.8+/-4.4 bmp. In chronic dogs "functional denervation" led to transient stoppage of the heart--a preautomatic pause with duration of 2.7+/-0.2 sec. The heartbeats recommenced with the frequency of 89.0+/-3.4 bmp versus an initial rhythm of 118+/-1.5 bpm, i.e., a rhythm deceleration took place. We conclude that in a whole organism the heart rhythm pacemaker is determined by a brain level of the hierarchical system of rhythmogenesis, while the sinoatrial node plays the role of a latent pacemaker.

Hierarchy of the heart rhythmogenesis levels is a factor in increasing the reliability of cardiac activity.

Along with the existence of an intracardiac pacemaker a generator of cardiac rhythm exists in the central nervous system - in the efferent structures of the cardiovascular center of the medullar oblongata. Neural signals originating there in the form of bursts of impulses conduct to the heart along the vagus nerves and after interaction with cardiac pacemaker structures cause generation of the cardiac pulse in exact accordance with the frequency of the neural bursts. That the intrinsic cardiac rhythm generator is a life-sustaining factor that maintains the heart pumping function when the central nervous system is in a stage of deep inhibition. The brain generator is the factor that provides the heart with adaptive reactions to changes in the environment. The hierarchy of the two duplicating levels of rhythmogenesis provides reliability and functional perfection of the cardiac rhythm generation system in the whole organism.

Integration of the heart rhythmogenesis levels: heart rhythm generator in the brain.

We propose that along with the intracardiac pacemaker, a generator of cardiac rhythm exists in the central nervous system--in the efferent structures of the cardiovascular center of the medullar oblongata. Signals in the medulla oblongata arise as a result of the hierarchic interaction of the brain structures. Neural signals originating there in the form of bursts of impulses conduct to the heart along the vagus nerves and after interaction with cardiac pacemaker structures, cause generation of the cardiac pulse in exact accordance with the frequency of "neural bursts". The intrinsic cardiac rhythm generator (the sinus node) is a life-sustaining factor that maintains the heart pumping function when the central nervous system is in a stage of deep inhibition, (e.g., under anesthesia or during unconsciousness). The brain generator is the factor that provides heart adaptive reactions in behaving organism. The integration of the two levels of rhythmogenesis in the brain and heart provides reliability and functional perfection of the cardiac rhythm generation system in the whole organism.

Alternative view on the mechanism of cardiac rhythmogenesis.

BACKGROUND: This article advances an hypothesis that there is duplication of the heart rhythmogenesis system. METHODS AND RESULTS: The following article reviews available data and advances an hypothesis to suggest new ideas about the mechanisms of cardiac rhythm generation. The hypothesis is that along with the existence of an intracardiac pacemaker, the generator of cardiac rhythm exists in the central nervous system - in the efferent structures of the cardiac centre of the medulla oblongata. Originating in the medulla oblongata, neural signals in the form of brief bursts of pulses are conducted to the heart along the vagus nerves and, by interacting with the cardiac pacemaker structures, cause generation excitement in the heart in exact accordance with the frequency of the bursts. The intracardiac rhythm generator is a life-providing factor that maintains the heart pumping function when the central nervous system is in a stage of deep inhibition (e.g. under anaesthesia or when unconscious). The central generator is the factor that provides the heart with adaptive reactions in natural conditions of the organism. CONCLUSIONS: Multi-leveled organisation of the mechanisms responsible for rhythmogenesis guarantees reliability and functional perfection of the cardiac rhythm generation system.