Vol 14, No 4 (2017)

Objective. Compare the effectiveness of treatment with nebivololum or sotalolum in patients with paroxysmal supraventricular tachycardia (SVT) on a background of essential hypertension (EH) taking into account quantitative evaluation of the regulatory adaptive status (RAS). Materials and methods. 49 patients with paroxysmal SVT against the background of EH of stages II-III took part in the research, they were randomized into two groups for treatment with nebivololum (7.4±1.9 mg/day n=25) or sotalolum (162.5±46.2 mg/day n=24). As part of combination therapy, patients were administered lisinoprilum (14.4±4.4 and 14.3±4.7 mg/day), when required also atorvastatinum (15.9±4.1 mg/day, n=9 and 16.0±4.8 mg/day, n=10), acetylsalicylic acid (93.1±16.2 mg/day, n=14 и 94.1±16.5 mg/day, n=14). Initially and 6 months after therapy, the following was done: quantitative assessment of RAS (by cardio-respiratory synchronism test), echocardiography, triplex scanning of brachiocephalic arteries, treadmill test, six-minute walk test, all-day monitoring of blood pressure and electrocardiogram, subjective assessment of quality of life. Results. Both drug regimens comparably improved structural and functional condition of the heart, controlled arterial hypertension, effectively suppressed paroxysms of SVT, improved the quality of life. At the same time, the use of nebivololum increased the RAS and increased exercise tolerance to a greater degree than the use of sotalolum. Conclusion. In patients with paroxysmal SVT against the background of EH of stages II-III, the use of nebivololum as part of combination therapy may be preferable to sotalolum due to its positive impact on the RAS.

Objective. To investigate the effect of the quantitative ratios of different types of white blood cells on the cardiovascular system in healthy individuals and patients with essential hypertension (EH). Materials and methods. The study was performed on 102 women suffering EH. The control group consisted of 30 healthy patients. Results. In women with EH, both non-engaged (EH-1) and regularly engaged in kinesitherapy (EH-2), compared with the control group, the total content of leukocytes was increased, as well as the ratios of NEUTR/EOS, LYM/EOS, LYM/BAS and EOS/BAS. In hypertensive patients increased stroke volume and end-diastolic left ventricular volume, cardiac output, increased mass and the index of left ventricular mass. In EH-1 patients group, the balance of velocity distribution in the microcirculatory bed changes to fast interlayer processes. In patients with EH-2, these changes are much less pronounced. In healthy women and patients with EH, significant relationships between leukocyte ratios and the level of systolic diastolic, mean, pulse pressure, cardiohemodynamics, hemodynamic indices were found. Conclusion. Regular practice of kinesitherapy brings the condition of cardiohemodynamics, hemodynamic indices, as well as the investigated correlations to the characteristic of healthy women. These data suggest an important role of the relationship of various leukocyte populations in the pathogenesis of EH.

The article touches upon the issue of brain as an end-organ target of essential arterial hypertension (AH). The article gives current information about the possibilities and potential clinical application of diffusion-tensor magnetic resonance imaging for the earliest assessment of white matter damage in patients with essential AH. Dataare presented upon the reduction of fractional anisotropy in hypertensive patients and its correlation with blood pressure level.