Aim. To study the presence and nature of correlations between the level of Insulin-like growth factor-1 (IGF-1) and structural and functional parameters of the heart in the development of myocardial remodeling and fibrosis in patients with chronic heart failure (CHF) of ischemic origin. Material and methods. The study included 120 men with class II-IV CHF who have history of myocardial infarction, which are divided into 3 groups depending on the CHF class. The control group included 25 healthy men. Assessment of left ventricular (LV) structural-functional state was carried out by echocardiography. Investigation of IGF-1 and N-terminal precursor indices of cerebral natriuretic peptide (NT-pro BNP) was performed by enzyme immunoassay. Results. Patients with class II CHF were hyperexpression of IGF-1, with class III CHF were registered low-normal level, with class IV CHF was established a deficiency of IGF-1. The most significant structural-geometric rearrangement of LV and significant deficit of IGF-1 recorded in patients with class IV CHF (95,6±7,02 ng/ml with class IV CHF versus 178,3±11,36 ng/ml and 124,3±9,14 ng/ml with class II and III CHF; р<0,05). In patients of class III-IV CHF, correlation relationships between IGF-1 level and echocardiographic parameters (LV myocardial mass index are established: r=-0,59, p=0,05; end systolic volume index: r=-0,55, p=0,05; value of LV ejection fraction: r=0,61, p=0,05). Significant negative correlation are established in patients with class III-IV CHF between IGF-1 level and NT-pro BNP levels (r=-0,51; р=0,05). Conclusion. The intensity of myocardial remodeling and fibrosis processes in patients with a progressive course of CHF is related to deficit of IGF-1 and is associated with a high level of activity of natriuretic peptides.

Aim. To study the presence and nature of correlations between the level of transforming growth factor β1 (TFR-β1) and structural and functional parameters of the heart in the development of myocardial remodeling and fibrosis in patients with chronic heart failure (CHF) of ischemic origin.Material and methods. The study included 120 men with class II-IV CHF who have history of myocardial infarction, which are divided into 3 groups depending on the CHF class. The control group included 25 healthy men. Assessment of left ventricular (LV) structural-functional state was carried out by echocardiography. Investigation of TFR-β1 and N-terminal precursor indices of cerebral natriuretic peptide (NT-pro BNP) was performed by enzyme immunoassay.Results. Patients with class II-IV CHF were hyperexpression of ТФР-β1, the levels of which increased significantly as NYHA class increased and CHF progressed. The most significant structural-geometric rearrangement of LV and hyperactivation ТФР-β1 recorded in patients with class IV CHF (77.2±6.33 ng/ml with class IV CHF versus 46.7±3.74 ng/ml and 58.9±4.75 ng/ml with class II and III CHF; р< 0.05). In patients of class III-IV CHF, correlation relationships between ТФР-β1 level and echocardiographic parameters (LV myocardial mass index are established: r = 0.56, p = 0.05; end systolic volume index: r = 0.52, p = 0.05; value of LV ejection fraction: r = -0.48, p=0,05). Significant direct relationships are established in patients with class III-IV CHF between ТФР-β1 level and NT-rgo BNP levels (r=0,44; р=0,05).Conclusion. The intensity of myocardial remodeling and fibrosis processes in patients with a progressive course of CHF is related to ТФР-β1 hyperexpression and is associated with a high level of activity of natriuretic peptides.

Idiopathic pulmonary arterial hypertension (IPAH) is a severe chronic and rapidly progressive disease with increasing pulmonary vascular resistance (PVR) due to the ongoing pathogenic processes in the vascular wall that lead to obstruction of small pulmonary arteries and arterioles. IPAH takes a small part in the structure among all forms of pulmonary hypertension (PH), the median survival of patients with IPAH before any PAH-specific therapy became available were about 2,8 years, and the average time from the manifestation of the disease to its diagnosis took 2-3 years. This article is an attempt to present an unified data of adult patients with IPAH in Ural Federal district, and describe PH patients medical care service. The article presents the experience of PH Medical Centers across Ural Federal District.

Aim: to establish the role of insulin-growth factor (IGF)-1 in myocardial remodeling in female patients with arterial hypertension (AH) and metabolic syndrome (MS) and different stages of obesity Materials and methods. The study included 108 women with AH and MS, divided into 3 groups according to stage of obesity, and 28 healthy women. It was assessed the concentration of IGF-1, status of hemodynamic and types of left ventricle's remodeling. Results. Concentric remodeling and IGF-1 elevation prevailed in patients with AH and first stage of obesity. Concentric hypertrophy of left ventricle and normal level of IGF-1 were established in patients with second stage of obesity. Lack of IGF-1 were determined in women with obesity 3rd stage and eccentric hypertrophy. Correlation analysis in patients with 2-3 stages of obesity showed the linkages between concentration of IGF-1 and hemodynamic parameters. Conclusion. The level of concentration of IGF-1 in patients with AH and MS correlates with remodeling types and stage of obesity.

Цель. Оценить влияние b-адреноблокатора (b-АБ) и препарата магния в моно- и комбинированной терапии на показатели толерантности к физической нагрузке (ТФН) и вариабельности ритма сердца (ВРС) у пациентов с первичным пролапсом митрального клапана (ПМК) и нарушениями ритма сердца (НРС). Материал и методы. Пациенты с первичным ПМК и НРС были рандомизированы на 2 группы, сопоставимые по полу, возрасту, степени ПМК, частоте НРС, клинико-гемодинамической характеристике. Первую группу составили 40 больных, получавших монотерапию оротатом магния (Магнерот, «Верваг Фарма ГмбХ и Ко», Германия) в дозе 1-3 г/сут; во 2-ю группу вошли 38 пациентов, получавших комбинированную терапию оротатом магния в той же дозе и бетаксололом (Локрен, «Санофи Авентис», Франция) 10-20 мг/сут. Исходно и через 24 нед оценивали показатели ВРС и ТФН. ТФН анализировалась при проведении субмаксимальной велоэргометрической пробы в режиме непрерывно ступенеобразно возрастающей нагрузки с начальной ступенью 50 Вт на системе «Валента» (Россия). Анализировались параметры пороговой мощности нагрузки, двойное произведение, число метаболических единиц (МЕТ), длительность восстановительного периода. Всем обследуемым проводился тест PWC 170. Результаты. При длительной терапии комбинацией бетаксолола и оротата магния отмечено повышение параметров ТФН, что характеризовалось увеличением общей продолжительности нагрузки (8,8±0,7, 10,8±0,6 мин; 22,7%; p

Aim. To compare the efficacy of correction of modifiable risk factors for ischemic heart disease (IHD), and treatment compliance within 6 months of observation in group of men and group of women after acute coronary syndrome (ACS). Material and мethods. Patients (n=147: 100 men and 47 women) aged under 70 years who underwent ACS were examined. Prevalence of cardiovascular risk factors and frequency of basic drugs taking were evaluated at baseline and after 6 months. The efficacy of risk factors correction in men was compared with this in women. Results. A general number of patients with effective blood pressure (BP) control as well as patients who reached the target levels of total cholesterol (TC) <4.5 mmol/l and cholesterol of low>density lipoproteins (LDC) <2.5 mmol/l after 6 months increased significantly in comparison with this before observation. Taking of drugs from all main groups left unsatisfactory and did not>reach the advisable values. Women have better antihypertensive treatment compliance, but worse lipidemia level control; they more often have glucose metabolism disorders, arterial hypertension and obesity. Men smoked more often, but have better BP, TC and cholesterol LDC control. Conclusion. The high prevalence of cardiovascular risk factors requires intensification of preventive activity regarding IHD onset and progression among both men and women.

In our investigation we estimated spreading of main IHD modifiable risk factors in patients with acute coronary syndrome, living on the territory of Tumen region, and there compliance to therapy. 69 patients under age of 70 were included (average age 63 ± 0,5, 60% were men). 50,7 % were smokers at admittance to the hospital, or a month before the hospitalization; 12,5% among them were women. 21,7% had diabetes melitus and almost half of them hadn't known about there diagnosis and had been taking no hypoglycemic therapy. Glycosilated hemoglobin determination showed that only 19,7% of patients with diabetes controlled there glycemia for the previous 3 months (HBA1< 6,5%), and 33,8% of theese patients had HBA1>8%. 47,8 % of all patients were impaired glucose tolerance. Among all patients with hypertension (84,2%) only 17,1% effectively controlled there blood pressure. Despite high popularity in the last years of hypolipidemic therapy, 84,2% of our patients had total cholesterol above recommended level, while 14% were very hypercholesterolic (> 8 mmol/l). Only 16,4% gained LDLP target rates. More than a half (52,3%) of included into investigation were centrally obese and had exessive body mass. Compliance to therapy of the patients whose diagnosis of IHD had already been established before inclusion into investigation was rather poor. 54,1% of patients were using antiaggregates and long-term nitrates. Less preferable were ACEI/ARB and beta-blockers (47,9% and 43,8% respectevely). Calcium channel blockers and diuretic were taking 23% of patients. And only 10 used statins. In 6,25% of cases acute coronary syndrome was the result of clopidogrel intake cessation within 12 months after stenting with drug-eluting stents. 8,7% of patients were taking no medical therapy, having known of there diagnosis and having acute coronary syndrome in history. Our results showed that prevalent risk factor in Tumen rigion is hypercholesterolemia, central obesity and glucose metabolism disorders. This says about necessity of hypolipidemic therapy compliance intencification and timely detection of early glucose metabolism disorders.