The effect of combined application of mildronate and inhibitor of angiotensin converting enzyme enalapril on blood lipid peroxidation products, endothelial function, daily profile of arterial pressure, intracardiac hemodynamics in patients with essential arterial hypertension was studied. It has been established that the use of mildronate combined with traditional antihypertensive therapy with an angiotensin converting enzyme inhibitor enalapril promotes more efficient correction of the daily blood pressure profile, promotes normalization of parameters of free radical oxidation, improves endothelial function, and the morphofunctional state of the left ventricle. The results of the study indicate the promise of using mildronate in the complex treatment of hypertensive disease.

Various forms of atrioventricular blockades, their diagnosis, clinical symptoms are described. Modern methods of conservative therapy are presented. Indications and contraindications for implantation of ECS, resuscitation aids.

According to the European (2009) and American (2017) guidelines for syncope, syncope is a transient loss of consciousness due to transient global cerebral hypoperfusion characterized by rapid onset, short duration, and spontaneous complete recovery. One of the leader in examination of patients with reflex syncope it is passive orthostatic test or tilt-test. In the article classification of syncope, indicataion for tilt-test, diagnostic yield and approaches to treatment syncope in children and adolescents are shown.

Introduction. Percutaneous coronary intervention (PCI) with stent-ing of the coronary arteries is a common method of treatment of stable coronary artery disease (CAD), however, in the postoperative period, there may be complications of thrombotic and stenotic nature. The thrombin generation test (TGT) is an integral method for assessing the pre-thrombotic state of the hemostatic system, but there are no data on its predictive value in this group of patients. Aim. To select the most informative parameters of TGT for constructing prognostic models of distant thrombotic complications in patients with CAD after stenting of the coronary arteries. Objective. 75 patients (15 women and 60 men) aged 40-75 years who had indications for PCI and 23 patients who did not have clinical manifestations of coronary artery disease were included in the study. TGT was performed in platelet-poor plasma in standard modification and with the addition of thrombomodulin (TM). In both variants, the delay time (Lag time, min), endogenous thrombin potential (ETP, nmol/min.), peak thrombin height (Peak, nmol), peak time (ttPeak, min) were estimated. Based on the results of observation of the course of the postoperative period within 12 months, two groups of patients were isolated: group 1 - without complications and repeated operations (60 people) and group 2 - patients with complications in the form of acute coronary syndrome or scheduled revascularization (15 persons). Results. On day 3^rd after revascularization, the level of ETP with the addition of TM in patients with thrombotic complications is higher than in patients with a favorable postoperative period (95 %-probability of finding ET in the range 1328.80-1869.63 and 1013.19-1228.59 nmol/min., respectively). Later, by the 90^th day after PCI, they retained increased thrombin generation (1781.23-1831.28 nmol/min.), and with a favorable variant, a decrease in ETP was observed practically to the level of patients in the control group (1566.55-1605.62 and 1643,5-168.6 nmol/min., respectively). Conclusions. The most informative in the dynamic observation of the indicator of TGT is ETP. To model the direction of changes in the parameter ETP with and without addition of TM in patients of the two groups, one-factor regression changes can be used as follows: Y = b_o * t⁰¹ (J) - for patients of group 1 at 3^rd and 90^fh days after PCI; Y = J/(b₁ - b2/t) (2) and Y = b_o + b₁/t (3) - for patients of group 2 on days 3^rd and 90^th after the operation, respectively (Y - values of parameter ETP, nmol/min.; t - time elapsed after the PCI, days; b_0-2 - coefficients). It is expedient to determine the ETP in the early postoperative period (on day 3^rd) in the modification of TGT with TM and in the late (90^th - 365^fhdays) without the addition of TM.

Mortality from cardiovascular diseases in Russia currently remains at a high level. The aim of this work was to study of new biochemical markers of probable complications cardiovascular diseases (apolipoprotein A1 - АроАІ), apolipoprotein В - ApoВ, ratio ApoВ/АроА1), as well as a ten-year fatal risk SCORE among residents of the Altai territory. It is shown that the content of ApoВ, ratio of ApoВ/АпоА1 in men is much higher, and the content АроАІ - significantly lower than in women. The contents of markers of possible cardiovascular complications in men and women with different levels of risk SCORE was not significantly different.

This article deals with echocardiographic assessment of thrombi in the left atrial appendage in patients with various cardiac disorders. The potential of transesophageal echocardiography in the evaluation of the spontaneous contrast enhancement effect is demonstrated. Spectral and pulse Doppler ultrasonography permits assessment of the function of the left atrial appendage, while three-dimensional echocardiography is valuable for identification of appendage thrombosis. A complex approach to the diagnosis of thrombi in the left atrial appendage with the help of various echocardiographic techniques will allow clinical practitioners to prevent the development of cardioembolic events in patients with various disorders, thus exerting a favourable effect on the prognosis and quality of life of this patient population.

The purpose of the study. The study of structural changes in the myocardium in experimental model of hypothyroidism. Materials and methods. The work was performed on experimental data. Experimental model of hypothyroidism in 66 white male rats by means of an operation of thyroidectomy. Duration of experience 45 days. In the postoperative period, rats were removed from the experiment after 5, 7, 21, 28, 35 and 45 days. The control group consisted of 22 rats thyroidectomy was carried out. For histological examination took pieces of myocardium were fixed in 10 per cent buffered formalin, prepared for histological sections via standard methods. The sections were stained with hematoxylin and eosin, pikrofuksin by van Gieson, Mallory, by toluidine blue, elective painting on fibrin, spent the pas reaction. Immunological study was conducted peroxidase-antiperoxidase method using markers desmin, myogenin and sarcomere actin. Results. Microscopic examination of the myocardium are observed hemodynamic disorders: hyperemia of the vessels, eritrociti, erythro-and leukodepleted, and interstitial edema. Marked degenerative changes of cardiomyocytes breach of contracture of myofibrils, focal lymphocytic infiltrates, areas of plasmolysis and fragmentation of fibers. In the stroma of the myocardium is observed mucous swelling with the formation of cavities. Immunohistochemical study showed a reduction in positive expression of desmin from 3 points to 1 points, the decrease in the expression myogenin with a 3 to 1 score, decrease of expression of sarcomere actin from 3 to 1 points. By the end of the experiment at the 45 th day on the background subpositions the expression of these markers there are areas of negative expression. Conclusion. In the simulation of hypothyroidism in laboratory animals develop pronounced structural changes, which are characterized by vascular disorders, diffuse edema of the stroma, dystrophic and destructive changes of cardiomyocytes according to the type of miotsitolizom, colliquation necrosis, fragmentation of the fibers, formation of focal lymphocytic infiltrates and sclerotic processes by the end of the experiment. Immunohistochemical study observed a decrease in the expression of desmin, sarcomere actin and myogenin.