Purpose. The study was examining of dynamics blood monocyte subsets from patients with different severity of Systemic Inflammatory Response Syndrome (SIRS) after coronary bypass surgery.

Materials and methods. In retrospect, all of the patients in accordance with severity of the SIRS were divided into three groups (1 – uncomplicated SIRS, 2 – complicated SIRS with compensated Multiple Organ Dysfunction Syndrome (MOD S), 3 – complicated SIRS with decompensated MOD S). SIRS confirmed by objective clinical and laboratory parameters, as well as the presence of hypercytokinemia. Each group was estimated dynamics of monocyte subsets (CD14hiCD16–, CD14hiCD16+and CD14dimCD16++) by laser flow cytometer before surgery and 1st and 7th day after surgery.

Results. On the first day after surgery patients of the all groups was detected the activation of monocytes with the redistribution of their subpopulation composition (decrease in the relative content subset of CD14hiCD16– and increase inCD14hiCD16+). At the same time, patients of the third group (SIRS with developed in the future decompensated MOD S) subset CD14hiCD16–was lower and CD14hiCD16 + was higher than in the other groups. Found correlation of the SOF A estimates and the relative proportions blood monocytes CD14hiCD16– andCD14hiCD16+.

Conclusion. In the first days after coronary bypass surgery relative proportion subsets CD14hiCD16+and CD14hiCD16–may be diagnostic and prognostic markers of the severe SIRS and developed in the future decompensated MOD S.

The purpose. To study clinical and angiographic status, N-terminal pro-brain natriuretic peptide (Nt-proBNP) level and treatment adherence in stable angina associated with hypertension patients (pts).

Materials and methods. 151 pts (men) divided into 3 groups were investigated. The 1st group was consisted of 43 men with uncomplicated angina without significant lesions of coronary artery. The 2nd group included 47 men with angina with history of coronary revascularization (percutaneous coronary intervention). The 3rd group included 61 men with angina after previous cardiovascular event (myocardial infarction or stroke).

Results. There were less number of current smokers in uncomplicated stable angina group. 3rd group pts took more alcohol drinks before cardiovascular events. Biochemical blood status were compared in three groups. Structure-functional heart parameters were more disturbed in pts with previous cardiovascular events. Coronary arteries were more lesion in complicated angina pts too. Nt-proBNP levels were significantly higher in patients undergoing cardiovascular events. Factors determining in stable angina associated with hypertension were extent of coronary artery lesion, left-atrium, and left-ventricular size, left-ventricular hypertrophy, and ejection fraction. The relationship between Nt-proBNP levels and left ventricular remodelling as well as between Nt-proBNP levels and extent of coronary arteries lesions were revealed. Adherence to treatment was higher in patients underwent percutaneous coronary intervention.

The purpose. To study the value of changes in blood pressure depending on the somatotype of men with hypertension stage I–II.

Materials and methods. Anthropometric, somatometric the definition somatotype on Bunak (1941), SMAD, statistical.

Results. Main results of research carried out by us revealed that in most cases among men with hypertension stage I–II prevailed abdominal somatic (47 %) and muscle (26 %), a smaller percentage of cases – the thoracic (15 %) and uncertain (12 %). According to the degree of reduction in blood pressure overnight – dominated patients «dippers» and «non-dippers» almost the same percentage (41 and 39 %), to a much lesser extent – «over-dippers» (15 %) and «night-peakers» (5 %). The findings showed that among men with hypertension stage I–II «dipper» was more common in patients thoracic somatotype (53,3 %), «non-dipper» – the representatives of the muscle (46,2 %), «over-dipper» – men indefinite somatotype (16,6 %), «night-peaker» in greater percentage of cases were from muscle (7,6 %) and breast somatotype (6,7 %).

Conclusion. Аccording to our data, about 50 % of men with hypertension stage I–II have an insufficient degree of reduction in blood pressure and night belong to the abdominal, thoracic and muscular somatotype. Normal degree of nocturnal blood pressure reduction over 50 % of cases were determined only in those breast-somatotype. Therefore persons abdominal, thoracic and muscular somatotype possible to presuppose an increased risk of cardiovascular and cerebrovascular complications, while persons of indeterminate somatotype – smaller.

The purpose. We compared second generation LMA I-gel (single-use supraglottic airway device without an inflatable cuff) with tracheal tube in anesthetized and paralyzed patients with high risk of cardiovascular complications.

Materials and methods. Ninety-six female patients (ASA III, 52–76 years) undergoing elective breast surgery were studied. Patients were allocated into two groups: airway management in one group was with a tracheal tube (n=48), and in the other, with an I-gel (n=48). We compared the hemodynamic changes (BP, HR, CI, TPR) before and after the airway management.

Conclusion. We suggest that the I-gel can be used as a reasonable alternative to tracheal tube intubation during the general anesthesia in the patients with high risk of the cardiovascular complications.

The report describes how to perform the new method of implanted antiarrhythmic devices endocardial leads replacement after ortotopic heart transplantation, which can reduce the risk of local infectious complications after removal of antiarrhythmic device and during subsequent reimplantation.

The report describes the results of a donor heart intracardiac electrophysiological study and subsequent catheter ablation of accessory pathway of allograft in patient suffering of orthodromic tachycardia in the early postoperative period.

Frequency of children with congenital heart diseases remains high in the Russian Federation. This pathology makes an essential contribution to perinatal and infantile mortality. Knowledge of epidemiology of various forms of congenital heart diseases will give the chance to develop new methods of forecasting, prenatal diagnostics and early effective surgical treatment of this pathology. Results of research of epidemiology of congenital heart diseases (according to recommendations of EUROCAT) are presented during 1993–2012 in Kemerovo. The trend of dynamics of various forms of congenital heart diseases was positive for the studied period. At extrapolation of the obtained data it is possible to expect them an annual gain on 7 ‰. The interrelation between factors of ecology and formation of congenital heart diseases at children is revealed in Kemerovo. Congenital heart diseases at children can be used, as indicator of externally environmental influence on health of the population Kemerovo

Purpose. The analysis of influence of occupational factors on prevalence of the arterial hypertension (AH) in occupational groups of men.

Materials and methods. One-stage studying of prevalence of AH in 13 occupational groups (3 842 men) is carried out. Working conditions were estimated according to cards of certification of workplaces of departments of labor protection of the enterprises and establishments.

Main results. It is shown that the increase in a category of working conditions on gravity of labor process is characterized by lowering of frequency of AH in occupational groups that is explained by preferentially occupational selection. On condition of similar levels it is production the caused physical activities, the increase in a category of working conditions on strength of labor process is accompanied by growth of frequency of AH. This influence, apparently, characterizes a direct negative impact of a occupational stress on prevalence of AH. On other factors of the working environment (noise, microclimate, etc.) communications with prevalence of AH it isn’t revealed. It is shown that prevalence of AH is connected to specifics of labor activities: underground miners are characterized by rather low frequency of AH, with insignificant distinctions depending on level of influence of unfavorable occupational factors.

Conclusion. Results of research testify that besides direct adverse influence of occupational factors on prevalence of AH essential value has also occupational selection.

This article reviews the new ESC guidelines on cardiovascular risk assessment and therapy for non-cardiac surgery, presented in 2014, discusses the management strategy changes and the questions the new guidelines haven’t answered. The guidelines can be used by a wide range of professionals who practice perioperative risk assessment and management.

Annually in the Russian Federation, as well as in other European countries and in the United States, the number of open-heart cardiac operations is increasing. However, despite the implementation of the latest technologies in cardiac surgery, the problem of infection remains highly actual. Infectious complications occurring in the postoperative period (nosocomial infections) have an adverse impact on its course and outcome, significantly worsening the results of surgical interferences and being additional, very significant item of expenses for inpatient hospital. Among nosocomial infections (NI) in patients of cardio surgical inpatient hospital nosocomial pneumonia (NP), surgical site infection (SSI), urinary tract infections (UTI), and sepsis are the most common.

The present research provides the data on the risk factors of nosocomial infection and suggests the necessary preventive measures conducive to the reduction of infectious postoperative complications number and in-hospital mortality. It is noted that an important condition for prevention of nosocomial infections in all operations with artificial circulation is the mandatory compliance of full range of measures aimed at reducing the microbial burden, which must be observed at all stages of perioperative period.

Liver failure is a major life-threating condition associated with the highest degree of mortality. The review provides the basic directions of the artificial liver replacement, the emphasis on the theoretical and practical possibilities of creating a biological artificial liver: modification of membranes, cell selection and creating a favorable environment for the functioning of biological cells.

The data on toxic and signaling properties of reactive oxygen species (ROS) in the cells of blood vessels are presented in this review. High concentrations of ROS are naturally characteristic properties of so-called professional phagocytes, the cells of innate immunity, whereas in other cells, the high concentrations of ROS is a sign of oxidative stress. At the same time, low concentrations of ROS are permanently generated in almost all the cells of an organism and perform signaling functions as the secondary messengers in redoxsensitive signaling pathways. Vascular endothelium plays a very important role in maintenance of homeostasis, and as a rule, it is a target and one of the sources of ROS. According to some data, the local concentration of both exogenous, and endogenous ROS can reach 500 uM. Oxidative stress enhances a permeability of blood-tissue barriers, and ROS contributes significantly to development of pulmonary and brain pathologies in hypoxia and hyperoxia. Disturbance in endothelial permeability can be associated with the influence of reactive oxygen or nitrogen species on key metabolic enzymes, as well as on various units of signaling and effector pathways. Which agonists cause the primary disturbance of intracellular homeostasis? What are the mechanisms of modulation of the primary disturbance? What is the role of endogenous and exogenous sources of ROS in disturbance of intracellular homeostasis? These are the most important questions, on the solution of which the efficacy of diagnostics and treatment of cardiovascular diseases largely depend.

The article presents the review of the literature dedicated to the problem of pathogenesis of such a severe complication as the heparin induced thrombocytopenia, clinical implications, methods of its diagnostics and modern management of such patients when performing treatment and diagnostic measures in cardiovascular diseases.