Objective. To evaluate the clinical and hemodynamic parameters in patients with ischemic heart disease (IHD) with use metabolic therapy without it. Materials. 74 patients with IHD, of whom 40 received metabolic drug trimetazidine MB in addition to the primary therapy for three months. The article analyzes the substrate IHD - hypoxia. We discuss the occurrence of oxidative stress, activation mechanisms such as lipid peroxidation and free radical oxidation. A comparative analysis of groups of drugs - antioxidants. Results. After three months, patients treated witht trimetazidine MB signiticantly decreased the number of angina attacks and nitroglycerin number of inhalations, hemodynamic parameters improved. Conclusion. Trimetazidine MB should be used for long-term use in patients with coronary artery disease.

In the review, which is based on the modern literature data and available clinical observations, the pathogenetic essentials of the nature of the coronary arteries disease forms are presented, the methods of clinical-instrumental diagnostic of cardiac syndrome Y and its difficulties are shown. In the present time there are possible methods of therapy that have changed the predictive clinical results of cardiac syndrome Y.

This paper describes new approaches to creation of individualized exercise training in patients with chronic heart failure. It shows the effectiveness of prolonged aerobic training in relation to development of the reverse remodeling of the left ventricular myocardium, contractile function of myocardium tolerance to physical load in heart failure patients with III NYHA class.

The observation of 71 patients during 1 year after percutaneous coronary interventions (PCI) (58 patients without complications and 13 ones with restenosis or clinical significant stenosis in a new site) is presented in the article. Three growth factors (FGF-ß1 - fibroblast growth factor ß1; VEGF - vascular endothelial growth factor; TGF - transforming growth factor) were investigated before operation, 3, 6 and 12 months after PCI. Decrease level of FGF-ß1, TGF and increase concentration of VEGF is common in patients with CAD. The concentration of growth factors has a regular changes during 1 year after PCI with worsening abnormalities, more pronounced in patients with complications.

The work is performed on autopsy material. Histological and immunohistochemical study of the myocardium 105 deaths from acute coronary syndrome. Histological study was performed according to standard methods used staining with hematoxylin and eosin, pikrofuksin by van Gieson, by toluidine blue, Mallory. Immunohistochemical study was conducted peroxidase-antiperoxidase method using markers desmin, actin sarcomere (SA), myogenin, VWF (factor VIII). Autopsy material was divided into two groups: the first group consisted of 30 (29.6 %) cases with ischemic dystrophy of myocardium, the second one consisted of 75 (71.4 %) cases with myocardial infarction. Of the 105 cases, 63.8 % were men, 36.2 % were women. In ischemic dystrophy of myocardium occurs granular dystrophy of cardiomyocytes, decreases the content of glycogen disappears transverse striations, observed fragmentation of the fibers, focal leukocyte infiltrates. Immunohistochemical study decreasing expression of desmin, actin sarcomeres, myogenin, factor VIII. In the second group monitoring is determined by the focus of coagulation necrosis. Immunohistochemical study of the expression of the above markers negative.

The article presents the results of a comparative cohort prospective study that was conducted to explore the nature of changes in the levels of circulating markers of endothelial dysfunction (ED), pro-inflammatory cytokines and the levels of antibodies to connective tissue components of the vascular wall at the stage of subclinical asymptomatic atherosclerosis in order to optimize the therapeutic and diagnostic approach to this category of patients from the position of more accurate stratification of the nearest risk of development of adverse cardiovascular events. ELISA tested the levels of endothelin-1 (ET-1), von Willebrand factor (fWB), concentration of endothelial nitric oxide synthase (eNOs), levels of total auto-antibodies to collagen I and III types (anti-K), auto-antibodies to hyaluronic acid (anti-HA) and chondroitin sulfate (a-HS) in persons with asymptomatic atherosclerotic lesion of the vascular wall according to the instrumental methods of the study and in persons without atherosclerotic vascular lesions. Significantly elevated levels of circulating markers of ED, auto-antibodies and pro-inflammatory cytokines were revealed in asymptomatic atherosclerosis in comparison with the control group. On the basis of statistical methods, we determined the most informative three-year markers of unfavorable course of cardiovascular pathology in asymptomatic atherosclerosis. Thus, the level of IL-1ß more than 110 pg/ml in subclinical atherosclerosis is associated with an increased 3-year risk of death from coronary heart disease, the total serum concentration of antibodies to collagen I and III types more than 0.23 μg/ml is associated with a significant increase in the risk of ACS, and serum ET-1 concentrations of more than 1.18 fmol/ml are associated with an increased likelihood of the debut of primary chronic forms of ischemic heart disease within the next three years.

The review on the basis of literature data and own long-term views describes in detail current data on the defeat of the cardiovascular system in hypertension. The clinical and prognostic significance of left ventricular hypertrophy in arterial hypertension based on echocardiographic data and ECG is substantiated. The progression of hypertension in the elderly is considerably complicated by concomitant diseases: coronary heart disease, diabetes, left ventricular hypertrophy etc. Therapy of patients with hypertension in addition to lowering blood pressure requires a reduction of the mass of the left ventricular myocardium, for the prevention of chronic heart failure. Drugs that reduce the activity of the renin-angiotensin-aldosterone system - ACE-I, sartans - have pathogenetic importance.