[Clinical and prognostic effect of repeated ten-day courses of low-intensity laser exposure in patients with coronary heart disease]. / Kliniko-prognosticheskii effekt povtornykh desyatidnevnykh kursov nizkointensivnogo lazernogo vozdeistviya na patsientov s ishemicheskoi bolezn'yu serdtsa.

The deterioration in the prognosis of coronary heart disease (CHD) is due to the influence of numerous pathophysiological factors, which is almost impossible to handle with only medication. Positive results obtained after one course of laser therapy (LT) in patients with angina pectoris substantiate the possibility of prolonging the effect when using repeated courses of low-intensity laser exposure. PURPOSE OF THE STUDY: To assess the clinical and prognostic value of repeated courses of low-intensity LT in patients with CHD for 24 months. MATERIAL AND METHODS: The study involved 40 men (mean age 56.6±8.2 years) with exertional angina pectoris with high (0-I functional class - 40%) and lower (II-III functional class - 60%) exercise tolerance (according to the classification of the Canadian Heart Association). Duration of the study was 24 months. All patients underwent 10-day courses of skin LT in the infrared radiation range every 6 months. Initially and after each course of LT, a bicycle ergometer test was performed with an assessment of the threshold values of blood pressure (BP), double product (DP=systolic BP×heart rate) and the ratio of DP to load power (DP/W). The blood levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) were studied after each course of LT. RESULTS: Patients had an improvement in their well-being during LT: a decrease in the number of angina attacks, the need for nitroglycerin, antianginal and antihypertensive drugs. A statistically significant increase in exercise tolerance by 33.2-40.1% was revealed since 1 month after each course of LT, according to the results of stress tests. At the same time, the threshold values of blood pressure remained at the initial level, which was regarded as a manifestation of the hypotensive effect. The decrease in the DP/W index by 18.2-29.6% compared with the initial data indicates the energy economization of cardiac activity. LT was accompanied by a statistically significant decrease in blood cholesterol from 6.15±1.26 to 4.84±1.28-5.25±1.53 mmol/l and LDL-C from 4.70±1.16 to 3, 29±1.26-3.96 mmol/l. CONCLUSION: Long-term clinical and preventive effect, good tolerability, availability, absence of side effects substantiate the possibility of widespread use of repeated courses of laser exposure in coronary heart disease.

[Clinical effect, changes in the lipid structure of the erythrocyte membrane and microcirculation in patients with arterial hypertension in combination with coronary heart disease under the influence of laser therapy]. / Klinicheskii effekt, izmenenie lipidnoi struktury eritrotsitarnoi membrany i mikrotsirkulyatsii u bol'nykh arterial'noi gipertoniei v sochetanii s ishemicheskoi bolezn'yu serdtsa pod vliyaniem lazeroterapii.

The high prevalence of the combination of arterial hypertension (AH) with coronary heart disease (CHD) suggests the improvement of their treatment methods. In this regard, it is of interest to assess the dynamics of the clinical picture of patients against the background of pathogenetically determined subcellular and systemic changes under the influence of laser therapy (LT). OBJECTIVE: To evaluate the clinical effect of LT in patients with hypertension in combination with coronary artery disease and trace its relationship with the dynamics of the structure of the lipid bilayer of the erythrocyte membrane and changes in the microvascular bed. MATERIAL AND METHODS: We examined 65 male patients (mean age 50.9±6.3 years) with II-III degree AH in combination with coronary artery disease with angina pectoris. Among them, 40 patients received a 10-day course of LT, and 25 patients underwent simulated laser irradiation. At the initial stage and after 1 month, all patients underwent a bicycle exercise test, a study of the lipid composition of the erythrocyte membrane, including the main fractions of phospholipids and free cholesterol, as well as the level of intracellular Ca2+ and lipid peroxidation products - malondialdehyde and diene conjugates. Microcirculation was assessed using the method of conjunctival biomicroscopy. RESULTS: One month after the course of LT, patients showed a significant increase in exercise tolerance by 37.8%, a decrease in systolic blood pressure with a standard load by 9.9%. The improvement of the clinical picture occurred against the background of a decrease in the activity of lipid peroxidation and structural changes in the cell membrane: an increase in polyunsaturated fractions of phospholipids and a decrease in the cholesterol content, as well as a decrease in the Ca2+ level in the cell from 0.23 [0.19; 0.32] to 0.20 [0.16; 0.26] mmol/l. The results of the analysis of conjunctival biomicroscopy demonstrated a statistically significant decrease in the ratio of arteriolovenular calibers, a limitation of the severity of sludge syndrome by 59%, and an almost twofold (from 3.9±0.52 to 7.2±1.23 cap/mm2) increase in capillary density. CONCLUSION: The data obtained showed that in patients with hypertension in combination with coronary artery disease, LT causes positive changes in the lipid structure of the cell membrane and microcirculation parameters, which is accompanied by a hypotensive effect and an improvement in the clinical and functional state of patients.