The aim is to assess the relationship between systolic, diastolic, and pulse blood pressure (SBP, DBP, PBP) during ventricular extrasystoles (VE) and the individual characteristics of ectopic beats.Methods. The primary method of investigation was BP measurement for each heartbeat. Inclusion criteria were the presence of ≥10000 monomorphic VE per day. A total of 53 patients were included, either without structural heart changes or with minimal structural alterations. The mean of systolic, diastolic, and pulse BP (SBP, DBP, and PBP) during VE (SBP VE, DBP VE, PBP VE) and during post-extrasystolic sinus contraction (post VE SBP, post VE DBP, post VE PBP) were calculated for each patient as fractions of 1.0.Results. The QRS complex width in VE originating from the right ventricular outflow tract is greater than from the left ventricular outflow tract; fragmentation of the QRS complex is more commonly observed in these VE. Significant correlations were observed between SBP VE and mean coupling interval (CI), PBP VE and CI, and SBP VE and PBP VE, though not between DBP VE and CI. DBP VE was significantly associated with VE count and daily VE percentage, while PBP VE was associated with left ventricular ejection fraction. It has been shown that post-VE SBP and post VE DBP are lower, while post VE PBP is higher compared to the corresponding parameters of sinus beats preceding the VE. Significant relationships were found between post VE SBP and post VE PBP, the duration of the post-extrasystolic pause, and the presence of paired VE; between post VE DBP and post VE PBP, DBP VE, CI VE, the presence of non-sustained ventricular tachycardia, and daily VE percentage; between post VE PBP and DBP VE, the presence of non-sustained ventricular tachycardia, daily VE percentage, and post-extrasystolic pause duration. Post VE PBP was equally determined by values of post VE SBP and DBP.Conclusion. With the shortening of the VE coupling interval, its SBP decreases, while DBP increases slightly, which may determine its hemodynamic significance. In post-extrasystolic sinus beats, both SBP and DBP decrease.

Objective. The article discusses the advantages of performing stress tests with pressure control at each heartbeat. The question of increasing accuracy, informativeness and safety of the test is considered. Materials and methods. We performed 30 bicycle ergometric tests with ECG measurement, beat to beat blood pressure measurement and periodic blood pressure measurement by the Korotkoff method in the shoulder. Results. It was shown that arterial pressure registered by Korotkoff sounds in the shoulder corresponded with continuous pressure at the registration moment. Because of the impossibility to measure the dynamics, the underestimation of maximum systolic arterial pressure by the Korotkoff method exceeds 20 mm Hg in every 3 tests, and exceeds 30 mm Hg in every 5 tests. Therefore, the beat to beat measurement of BP significantly improves the accuracy and informativeness value of stress tests. Conclusions. Continuous BP signal in the finger increases reliability of noisy Korotkoff sounds extraction and the results of BP measurement in the shoulder by the classical method. The increased accuracy and reliability of the measurement provides greater patient safety. Continuous pressure corrected by Korotkoff sounds during reference measurements in the shoulder gives a detailed and accurate picture of BP variations, which allows to investigate in detail features of the patient’s cardiovascular system regulation, both during and after the load, which is not available with classical BP measurement.

Все большее значение для исследований в экстремальных условиях и при моделировании космических полетов приобретает комплексная оценка сердечно-сосудистой вариабельности, которая помимо вариабельности сердечного ритма включает в себя оценку вариабельности артериального давления. Использование спироартериокардиоритмографов (САКР) позволяет синхронно регистрировать работу проводящей системы сердца (ЭКГ), артериальное давление (АД) и дыхание, а также автоматически оценивать вариабельность ритмических осцилляций частоты сердечных сокращений и периферического АД. Материалы и методы. В этой работе мы анализировали напряженность регуляции сердечно-сосудистой системы организма человека при 21-дневной антиортостатической гипокинезии (АНОГ) на приборах САКР разных поколений, оценивая их релевантность для такого анализа. Результаты. В работе показано, что измерения на приборе САКР выявляют значимое снижение общей вариабельности АД вследствие длительной моделированной микрогравитации. Причём основной вклад в эти изменения вносит очень низкочастотная составляющая вариабельности систолического АД (VLFs). Известно, что именно VLF-компонента вариабельности АД может служить показателем предрасположенности к инсультам у крыс и собак, и, предположительно, может иметь прогностическое значение для оценки вероятности развития инсультов у человека. Заключение. Результаты этой работы говорят о большой важности адекватной оценки вариабельности АД с помощью неинвазивных приборов типа САКР для выявления и оценки преморбидных состояний, а также исследований адаптации при стрессе и в экстремальных условиях космических полетов. A comprehensive assessment of cardiovascular variability, which includes an assessment of blood pressure (BP) variability in addition to heart rate variability, is becoming increasingly important for research under extreme conditions, i.e., space, and during modeling of space flight. The use of spiroarteriocardiorhythmographs (SACR) allows synchronous recording activity of the cardiac conduction system (ECG), BP, and respiration, as well as automatic assessment of the variability of rhythmic oscillations of heart rate and peripheral BP. Methods. We analyzed the intensity of regulation of the human cardiovascular system during 21-day antiorthostatic hypokinesia (ANOH) using SACR devices of different generations, and we assessed their relevance for such an analysis. Results. Measurements on the SACR device revealed a significant decrease in the overall BP variability due to prolonged, simulated microgravity. Moreover, the main contribution to these changes was made by the very low-frequency component (VLF) of systolic BP variability. It is known that specifically the VLF component of BP variability indicates a predisposition to strokes in rats and dogs, and quite possibly it has a prognostic value for assessing the risk of stroke in humans. Conclusion. These results suggest adequate assessment of BP variability using non-invasive devices (e.g. SACR) is very important for the identification and assessment of premorbid states and can be applied to studies of adaptation to the stress and extreme conditions of space flights.

Aim. Blood pressure (BP) determination in atrial fibrillation (AF) patients remains challenging due to its high inter-measurement variability. The novel methodology of precise beat-to-beat BP determination may be used to guide the hypotensive therapy selection and adjustment, but along with that provides additional opportunity for the investigation of hemodynamics in patients with chronic AF.Material and method. The study sample consisted of 60 patients with the main diagnosis of grade II-III arterial hypertension; 30 of those were on sinus rhythm and 30 had chronic non-valvular AF. In all patients HR was within the limits recommended for left ventricular ejection fraction of >40%. Beat-to-beat systolic, diastolic, and pulse BP (SBP, DBP, and PBP, respectively) assessment at each heart beat within 15 minute interval was performed with “Kardiotekhnika-SAKR” system (NAO “Incart”, St.Petersburg, Russia).

Aim. Blood pressure (BP) determination in atrial fibrillation (AF) patients remains challenging due to its high inter-measurement variability. The novel methodology of precise beat-to-beat BP determination may be used to guide the hypotensive therapy selection and adjustment, but along with that provides additional opportunity for the investigation of hemodynamics in patients with chronic AF. Material and method. The study sample consisted of 60 patients with the main diagnosis of grade II-III arterial hypertension; 30 of those were on sinus rhythm and 30 had chronic non-valvular AF. In all patients HR was within the limits recommended for left ventricular ejection fraction of >40%. Beat-to-beat systolic, diastolic, and pulse BP (SBP, DBP, and PBP, respectively) assessment at each heart beat within 15 minute interval was performed with “Kardiotekhnika-SAKR” system (NAO “Incart”, St.Petersburg, Russia). Results. Mild RR-interval variations, observed on sinus rhythm, resulted in insignificant SBP, DBP, and PBP fluctuations. More prominent RR-interval irregularity, typical for AF, is accompanied by more significant SBP, DBP, and PBP deviations. As mean SBP of each patient was taken for 1,0, “normal” SBP (≥0,9) was seen in RR-intervals of 754±58 msec; “markedly decreased” ( 1,15) in 587±38 msec; “prominently increased” (>1,2) in 566±38 msec; “severely increased” (>1,2) in 539±41 msec. For PBP (mean PBP of each patient was taken for 1,0) “normal” PBP (≥0,75) was seen in RR-intervals of 770±58 msec; “markedly decreased” (<0,75) in 561±40 msec; “prominently decreased” (<0,5) in 520±33 msec; “severely decreased” (<0,25) in 510±52 msec. Proportion of heart beats with insufficient efficacy according to PBP level (sum of “markedly”, “prominently”, and “severely” decreased) was 16,4±5,1% with prominent individual deviations (5,9-25,7%). Mean range of RR-interval providing to “marked” PBP decrease was 147±26 msec, also with significant individual variations 55-235 msec. Conclusions. Beat to beat BP measurement is characterized by high level of accuracy. In addition to mean SBP and DBP, their beat-to-beat fluctuations can be determined, which might be significant in irregular rhythm. This might help in selection of individualized anti-hypertensive therapy. The study has shown that along with RR-intervals shortening the number of hemodynamically insufficient heart beats increased, which manifested by SBP decrease, DBP increase, resulting in decrease of PBP. However, this general consistent pattern masks the individual differences of heart rhythm structure in AF. This method can help to determine the optimal HR for each individual patient with AF.

An analysis of influence of functional tests (6 or 12 breathings per minute) and inhaled fenoterol on the heart rate variability (HRV) was performed in 64 moderate bronchial asthma (BA) patients with subsiding exacerbation and in 42 healthy individuals. We evaluated FEV 1 , PEF, FEF 50 , FEF 75 and HRV using the frequency analysis. Enhanced sympathetic (in the 6 breathings per minute test) and parasympathetic influences (in the 12 breathings per minute test) on the chronotropic cardiac function were noted. The sympathetic influence on the heart rate after the inhalation of fenoterol was shown in the BA patients. Combination of both the tests allowed to reveal latent disturbances of the sympathetic and parasympathetic components of the heart rate regulation in the BA patients (relative sympathetic and parasympathetic insufficiency). A reliable correlation was found between the parameters of the bronchial passability and HRV, which permitted to assume a united neuro-vegetative regulation of the cardiac-and-respiratory system.

Objective. To assess the clinical signifcance of auscultatory gap (AG) found by the 24-hour ambulatory blood pressure monitoring (ABPM) using the Korotkoff’s sounds (KS) and its potential causes.Design and methods. 24-hour ABPM was performed in 60 patients (mean age 51,3 years, range 22–85 years), including 24 women and 36 men. In 24 patients, hypertension was diagnosed. In total, 2333 blood pressure (BP) measurements without “noise contamination” were selected for subsequent analysis (38,9 measurements per patient; from 28 to 73 measurements). The simultaneous recording of electrocardiogram (ECG), brachial cuff pressure, and KS phonograms on the right hand, as well as continuous recording of non-invasive BP curve in the left fnger using the volume clamp technique were performed in 10 patients with AG.Results. Based on the 24-hour ABPM, AG was shown in 43 of 60 subjects (71,7%). The AG was found to be associated with a decreased amplitude of fluctuations of the cuff pressure; upon its termination, the amplitude recovered. The above synchrony of changes in KS and amplitude of pressure fluctuations was found in all 124 cases which demonstrated AG during BP measurement. We assume that AG is a true variation of BP rather than a feature of KS, as the fluctuation amplitude depends on the ratio of BP and cuff pressure but does not depend on the KS phase. To test the hypothesis, the cuff pressure and KS were compared to the continuously monitored arterial pressure. When the systolic arterial pressure exceeded the cuff pressure, the KS appeared. Later on, the BP fluctuations led to a decrease in systolic BP; the arterial pressure did not reach the cuff pressure and, therefore, KS were not recorded. Subsequent decrease in the cuff pressure led to re-appearance of KS.Conclusions. The auscultative gap phenomenon is associated with true (mostly respiratory) variations of systolic BP rather than with features of KS in individual patients. The initial and repetitive KS occur at certain systolic BP levels depensing on the BP respiratory fluctuations and may indirectly indicate the amplitude of fluctuations.

Целью данной работы явилась оценка информативности ряда показателей, оцениваемых методом спироартериокардиоритмографии, в функциональных пробах с дозированной физической нагрузкой, для изучения изменений в кардио-респираторной системе у пациентов с различными заболеваниями. Методы. Для реализации диагностического алгоритма был использован комплекс «Спироартериокардиоритмограф-01», сопряжённый с велоэргометром. Подобный подход обеспечивает воспроизведение различных режимов дыхания при объективном мониторинге показателей сердечно-сосудистого синхронизма. Результаты. Показано, что из всех изученных показателей наиболее информативным является пульсовое давление, которое, оставаясь резистентным к режиму дыхания, отличает пациентов всех групп нозологий от контрольной группы. При этом в условиях умеренной нагрузки этот показатель дифференцирует группу пациентов с ревматическим профилем. Не выявлено различий в величине ударного объёма сердца в группах пациентов разного профиля, хотя в контрольной группе данный показатель возрастает при увеличении физической нагрузки. Показатели минутного объёма дыхания и двойного произведения практически не различаются между группами пациентов в покое, и значимо возрастают при увеличении интенсивности воздействия во всех группах. Показатели минутного объёма кровообращения и объёма кровообращения за один дыхательный цикл, практически не отличаясь при режиме дыхания в состоянии покоя, при нагрузке изменяются в различной степени во всех исследованных группах. Значение коэффициента сопряжения сердечно-сосудистой и дыхательной систем снижается по мере возрастания нагрузки, дифференцируя пациентов различных нозологий от контрольной группы. Выводы. Предложенная методология применима для неинвазивной экспрессной и автоматизированной оценки индивидуального статуса кардио-респираторной регуляции у пациентов различных нозологий. The aim of this study was to assess the informative value of spiroarteriocardiorhythmographic indexes in dosed exercise tests to evaluate cardiorespiratory changes in patients with various diseases. Methods. To implement the diagnostic algorithm was implemented using the Spiroarteriocardiorhythmograph-01 complex coupled with a bicycle ergometer. This approach allows induction of different respiration modes during unbiassed monitoring of cardiovascular synchronism indexes. Results. Among the studied parameters, pulse pressure had the highest informative value. This index remained resistant to respiratory modes and at the same time, differs patients of all nosological groups from the control group. Moreover, in moderate exercise, pulse pressure differentiated a group of patients with the rheumatic profile. Cardiac stroke volume did not differ in groups with different profiles; however, the control group, this index increased with increasing exercise. Values of minute ventilation and double product were practically similar in the groups at rest and significantly increased with increasing exercise intensity in all groups. Values of cardiac output and volume of blood circulation during the one respiratory cycle practically did not differ during breathing at rest but changed in different ways during exercise in all groups. The coupling coefficient of cardiovascular and respiratory systems decreased as the exercise load increased to differentiate patients with different nosologies from the control group. Conclusions. The proposed method can be used for individualized, non-invasive, rapid and automatic evaluation of the cardiovascular and pulmonary regulation in patients with various nosologies.

Актуальность. В работе обоснован диагностический алгоритм, позволяющий объективно устанавливать критерии синхронизации в регуляции кардио-респираторной системы, обеспечивающей адекватный уровень адаптации организма при умеренных внешних воздействиях. Целью данной работы явилось изучение возможных параметров сопряжённости сердечного, сосудистого и дыхательного ритмов при выполнении функциональных проб: пробы с фиксированной частотой дыхания и ступенчато-возрастающей умеренной физической нагрузкой. Методы. Для реализации диагностического алгоритма был использован действующий макет комплекса «Спироартериокардиоритмограф-01», адаптированный под совместное использование с велоэргометром. Подобный подход обеспечивает объективный мониторинг сердечно-дыхательного синхронизма в динамике разнообразных внешних воздействий на организм. Результаты. На основе прямых динамических показателей обоснован алгоритм расчета отношения минутного объема кровообращения и минутного объема дыхания, отражающий степень функционального баланса сердечно-дыхательного гомеостаза. Выводы. Многопараметровость, быстрота и неинвазивность исследований обеспечат востребованность данной методологии в разнообразных направлениях предиктивной диагностики. The authors justified a diagnostic algorithm for establishing objective criteria of cardiovascular and respiratory synchronization, which provides an adequate adaptive response to different external factors. For evaluation of the diagnostic algorithm, the Spiroarteriokardioritmograf-01 complex compatible with a bicycle ergometer was used. This approach provides objective monitoring of cardiovascular and respiratory synchronism under the influence of various external factors. Multiparameter, fast, and non-invasive features of these studies will cover a demand for this method in predictive diagnostics. Based on direct dynamic indicators an algorithm was substantiated for calculation of the blood flow minute volume to respiratory minute volume ratio, which reflects the degree of functional balance in the cardiovascular and respiratory homeostasis.

The design and principle of operation of the SAKR-VELO stress system for examination of the functional state of a subject’s cardiovascular system under strictly dosed physical load with noninvasive measurement of blood pressure (at each heart beat), heart rate, and respiratory flows is described. A load control algorithm based on continuous monitoring of force applied to the pedal and the cycling speed is used. The protocol for stress testing is substantiated.

In spite of age and blood pressure values at rest,hypertensive response to moderate intensity stress testingis characterized by increasing ofprobable beginning of cardiac infarction, stroke or coronary disease in 1.36 times. The hypertensive response to stress test in people with normal blood pressure values at rest (independent of other risk factors) is characterized by increasing risk of future hypertension more than in 2 times. Antihypertensive drugs affect blood pressure values differently during the stress testing. The prognosis of blood pressure values during daily physical activity is necessary for antihypertensive treatment. Low availability of convenient instruments and methodological tools for continuous measurement of blood pressure (similar to Spiroarteriocardiorhythmograph, Finapres) duringthe dosed physical loads constrain wide use of stress tests with controlled blood pressure in medical practice.

Description of information-measuring system (including hardware and software components) used for functional diagnostics of nervous regulation of blood circulation is provided. The structure of SAKR device designed for continuous measurement of arterial pressure pulse wave and respiratory flows, as well as for ECG detection is considered.

The goal of this work was to describe the principle of operation and construction of KID apparatus for objective quantitative assessment of the state of brain structures responsible for programming, initiation, implementation, and sensory control of human motor activity. The apparatus provides automatic assessment of parameters of visual and motor coordination, adaptability, motion accuracy, and reactivity in subjects performing simple motor tests. The testing procedure based on multidimensional analysis of motor activity is theoretically substantiated. Multidimensional analysis makes it possible to separate contributions of various psychophysiological processes to motor activity. The psychomotor tests constituting the testing procedure are described in their sequence order.

The design and principle of operation of a spiroarteriocardiorhythmograph are described. The device provides continuous noninvasive measurement of arterial pressure, detection of inhaled and exhaled air flows with a high-sensitivity ultrasonic spirometr, electrocardiogram detection, and joint analysis of these dynamal processes. Continuous measurement of pressure is performed by the method suggested by Penaz. The method is based on assessment of the volume of blood vessels of patient's finger from photoplethysographic signal. An electropneumatic follow-up system produces essure counteracting the changes in the diameter of arterial vessels patient's finger under the cuff. Thus, the diameter of the finger arteries remains constant, and the pressure in the cuff is equal to blood pressure in the arteries. This provides a unique opportunity for long-term detection of the entire curve of arterial pressure. Previously, such measurements could be performed only by the invasive Oxford technique.

Experiments on rats showed that Noopept improved retention and retrieval of conditioned passive avoidance response after phototrombosis of the prefrontal cortex (a procedure impairing retention of memory traces). The impairment of mnesic functions was accompanied by changes in integral biochemical indexes of the plasma determined by laser correlation spectroscopy. Treatment of behavioral disorders with Noopepet normalized biochemical indexes.

The use of the KID-3 diagnostic set for a large-scale examination of 6- to 16-year-old children helped reveal substantial age-related differences in the mechanisms of the regulation of motor activity on the basis of correlation of the specified parameters: velocity, precision, smoothness, velocity of readjustment of motor tasks, etc. The study confirmed the leading role of visual control in the realization of the motor function in 6- to 9-year olds. The mechanisms of movement regulation, i.e., a transition from a primarily monitoring mechanism of control to one based on a preliminarily formed motor program, is changed substantially by nine–ten years. These changes are possible only at this age, since it is in this period that substantial shifts take place in the morphofunctional development of the frontal cortical areas, and they become more important in the control of the activation processes, which determine and regulate motor activity. The age of nine-ten years is transitional in the formation of the mechanisms of central commands. This efficient movement control mechanism only begins to form at this age, and its formation is completed at age 14.