Numerous studies of the recent decade detected a significant increase in the psychosocial stress level. Development of cardiovascular diseases (CAD) directly depends upon the psychosocial factors. Considering the heterogeneity of CAD, the principal aim of predictive medicine is to identify individuals of high­risk groups for developing multifactorial diseases before their clinical manifestations. The review presents the analysis of associations between polymorphisms of key candidate genes of the serotonergic and the dopaminergic systems and psycho­emotional characteristics such as depression, anxiety, and hostility, the traits determining tolerance to chronic stress factors. 

Aim: The aim of this study was to examine the state of cardiovascular reactivity (CVR) in healthy volunteers (HV) and CVR changes in young patients with essential hypertension by using the developed methods for integrated CVR assessment. Materials and Methods: Transcranial duplex scanning (TCDS) of the middle cerebral arteries (MCA) was performed in HV (n=27) and patients with grade 2 hypertension (n=32) aged 18–38 years by using expert class ultrasound machines in the presence of hyperoxia and hypercapnia according to standard TCDS method. Results: The formulas for mathematical calculations of two CVR phases were developed. For reserve phase based on reaction force, absolute or relative change coefficient (CCabs or CCrel) for blood flow velocity (BFV) were calculated as follows: CCabs.=V2 /V0 and CCrel.=(V2 –V0 )/V0 *100%. For reserve phase based on reaction velocity, test change velocity (TCV) of BFV was calculated: TCV=(V2 –V0 )/Т. For autoregulation phase based on reaction force, BFV recovery index (RI) was calculated: RI=V0 /V4 . For autoregulation phase based on BFV, recovery rate (RR) was calculated as follows: RR=(V2 –V4 )/Тr. Autoregulation response normalized by arterial blood pressure (NAR) was calculated as follows: NAR =(V2 –V0 )/(V0 *(SBP2 –SBP0 ), where V was BFV in MCA (cm/c); V2 was BFV after 2 min of inhalation (cm/s); T and Tr were times = 2 (min); SBP was systolic blood pressure (mmHg); and 0, 2, and 4 corresponded to initial values, values after 2 min of inhalation, and values 2 min after inhalation, respectively. Patients had significant decrease in reaction force (CCabs: 0.79±0.16 and 0.91±0.09; р=0.036) and significant slowing down in response velocity (TCV: 8.99±1.61 and 6.24±1.12, р=0.026) and in recovery velocity (RI: 2.59±0.54 and 1.63±0.76; р=0.011) in hyperoxia. No significant BFV abnormalities were found in hypercapnia compared with HV. NAR coefficient in hypertensives was the most effective in hyperoxia and hypercapnia. Differences were illustrated by clinical cases. Conclusions: The study demonstrated valid complex of qualitative CVR indicators. Young patients with arterial hypertension had early signs of abnormal CVR. Developed NAR elucidated bidirectional abnormalities in the adaptive MCA capabilities. 

Aim: The aim of the study was to elucidate relationships of intrarenal vascular resistance (IVR) with clinical­laboratory parameters and arterial blood pressure (ABP) depending on glomerular filtration rate (GFR) in patients with arterial hypertension (AH) and type 2 diabetes mellitus (T2DM). Materials and Methods: The study comprised 130 patients (40/90 m/f; 55.4±7.4 years) with AH and T2DM. Stage 3 chronic kidney disease (CKD) was documented in 11% of patients. 24­h ABP monitoring and ultrasound examination of intrarenal blood flow were performed; GFR was calculated by MDRD formula. Results: resistive index (RI) values in arciform arteries demonstrated positive correlation with patient age and pulse pressure and negative correlation with GFR and diastolic blood pressure during day and night hours (р<0.05). Compared with patients with normal GFR, patients with stage 3 CKD were older and had longer duration of AH (р<0.05). Significant increase in their RI at all levels of blood flow was caused by lower values of end­diastolic rate. Conclusions: In patients with AH and T2DM, the study showed close relationships between abnormal renal circulation, GFR, and increased values of mean 24­h pulse pressure due to decrease in diastolic blood pressure which was the most evident in patients with stage 3 CKD. Characteristic for patients with stage 3 CKD, an increase in intrarenal resistivity along the entire intrarenal circulation was caused by a decrease in its diastolic rate in the presence of low diastolic blood pressure.

The aim of the study was to elucidate gender­related differences in the effects of anxiety­depression disorders on the prognosis of myocardial infarction (MI) and to develop a complex of clinical­instrumental and psychophysiologic indicators predicting 1­year prognosis in MI depending on patient gender. Materials and Methods: the study included a total of 346 patients with Q­wave MI who were admitted to hospital during the first 24 hours after MI beginning and discharged for out­patient treatment. At day 5–7 of MI, the following studies were performed: clinical status evaluation, 24­h ECG monitoring with assessment of heart rate variability (HRV), echocardiography, and psychological testing for depression by Zung scale and for personal and reactive anxiety by Spielberg–Hanin scale. One year after MI beginning, cases of fatal outcomes, repeated MI, unstable angina, and repeated hospitalizations were studied. Results: In men with MI, unlike that in women, evaluation of the complex of unfavorable psychophysiological and clinical parameters resulted in increase in the prognosis efficacy. Association of high levels of personal anxiety and depression during an in­hospital period predicted unfavorable 1­year prognosis with 90% probability whereas the absence of these disorders predicted favorable course of disease. The use of psychological assessment scales together with assessment of left ventricular (LV) ejection fraction (EF) or HRV (SDNN) increased prediction efficacy to 100%. Conclusion: Significance of the prognostic factor complex in MI differs depending on patient gender. The presence of high levels of anxiety and depression during in­hospital period in men suggested unfavorable 1­year prognosis especially in the presence of a decrease in LV EF and HRV. However, development of other, more effective prediction models is required for women with MI. 

Aim: The aim of the study was to determine the ST2 and NT­proBNP contents in blood serum of patients with myocardial infarction (MI) during in­hospital follow up depending on the presence of hospital complications and to elucidate their relationships with the types of myocardial remodeling. Materials and Methods: A total of 88 MI patients aged 59±8.36 years were studied. At days 1 and 12, the ST2 and NT­proBNP contents were assessed in blood serum by the immunoenzyme method. Control group comprised 30 patients. Statistical analysis of data was performed by non­parametric criteria. Results: ST2 level was by 2 times higher in patients with unfavorable outcome at day 1 of in­hospital period than in patients with favorable MI course and by 3.7 times higher than in control. A decrease in the level of the marker was observed at day 12 in both groups. At day 1 of MI, the level of NT­proBNP was by 6.8 times higher in patients with unfavorable prognosis than in control and by 1.8 times higher than in group of favorable course. At day 12, the levels of NT­proBNP remained increased in both groups. Determination of ST2 in a combination with NT­proBNP enhanced their diagnostic value (OR 1.92; 95%CI (1.7–3.2) AUG=0.89; р=0.004). High level of ST2 at day 1 of MI was associated with disadaptive variant of remodeling and exceeded by 1.5 times the corresponding value in group of adaptive remodeling (OR=4.5, 95%CI=2.0­10.1; р=0.011; AUG=0.81) unlike the NT­proBNP content that was similar in both groups during the entire in­hospital period. Conclusions: (1) The course of in­hospital MI period was characterized by the high contents of ST2 and NT­proBNP in blood serum. (2) Complications of in­hospital MI period were associated with higher levels of ST2 compared with NT­proBNP. However, the combined use of the ST2 and NT­proBNP values demonstrated higher diagnostic sensitivity and specificity. (3) Increased content of ST2 in blood serum was accompanied by the development of disadaptive variant of heart remodeling. 

In this study, we attempted to demonstrate prospects of proper dual antiplatelet drug therapy in acute coronary syndrome (ACS) without ST­segment elevation in patients who required surgical coronary intervention during primary hospitalization. The existing problems and their possible solutions were taken into account according to the state of the art; the interests of both a surgeon and a cardiologist were identified in a way they presented no harm to a patient. Objective of the study was to compare the efficacy and the safety of therapy with study drug, Ticagrelor, and with Clopidogrel in patients with ACS without ST­segment elevation in the presence of continuing therapy with Aspirin when Ticagrelor and Clopidogrel were cancelled before surgical intervention. This study included 83 patients with verified diagnosis and predicted development of unfavorable cardiovascular events in the nearest 30 days. Patients were randomized into 2 groups by envelope method. Group 1 was administered with Ticagrelor; group 2 was administered with Clopidogrel; all patients additionally received Aspirin. All patients underwent surgical treatment: coronary artery bypass grafting (CABG). In this study, we evaluated the effects of stopping drug therapy with Ticagrelor 1 to 3 days before CABG and Clopidogrel 5 days before surgery. Both advantages and disadvantages of these drugs were taken into account in regard to unfavorable coronary events both in both preoperative and postoperative periods. The work demonstrated the potential problems associated with greater blood loss during surgical intervention and after the use of study drug. 

Aim: The aim of the study was to determine the factors associated with in­hospital complications of coronary artery bypass grafting (CABG) and to investigate the impact of multifocal atherosclerosis (MFA) on short­term results of coronary artery bypass. Materials and Methods: A total of 708 consecutive patients (564 men; median age of 59 years) underwent CABG from May 22, 2011 to March 22, 2012. Three groups were assigned based on the presence of one­ (n=350), two­ (n=241), and three­vessel disease (n=117). Groups were comparable in clinical characteristics, medical­history parameters, data of laboratory and instrumental examination, and incidence of post­operative complications. Predictors of unfavorable outcomes after CABG were determined based on logistic regression. Results: Patients with MFA were older than patients with one­vessel disease (p<0.001). Time of cardiopulmonary bypass and total duration of surgery were significantly longer in group with two­vessel disease compared with other patient groups (p<0.010 and p<0.001). In one­way logistic regression, the probability of complications increased along with MDRD glomerular filtration rate decrease (GFR) (OR 1.014 for decrease by every mL/min*1.73 м2, 95%CI 1.006­1.287; p=0.002), age increase (OR 1.029 for increase by every year 95%CI 1.003­1.059; p=0.033), and duration of cardiopulmonary bypass (OR 1.016 for increase by 1 min, 95%CI 1.010–1.022; р<0.001). Age and duration of cardiopulmonary bypass remained significant in multivariate analysis (p=0.044 and р<0.001, respectively). Probability of lethal outcome increased along with an increase in cardiopulmonary bypass duration (OR 1.035 for increase by 1 min, 95%CI 1.022–1.047, р<0.001), mitral regurgitation degree (OR 5.207; 95%CI 2.558–10.597, р<0.001), and decrease in left ventricular ejection fraction (LV EF) (OR 1.064 for decrease by 1%, 95%CI 1.013–2.184, р=0.012). Conclusions: In CABG surgery, the presence of MFA is associated with longer duration of cardiopulmonary bypass and surgery. The presence of MFA did not significantly increase the total number of complications and the lethality rate in CABG. Predictors of hospital complications are increase in age and duration of cardiopulmonary bypass and decrease in GFR; predictors of in­hospital lethality are duration of cardiopulmonary bypass, mitral regurgitation, and decrease in LV EF.

In recent years, the role of nutritional status in the development of complications and in the prognosis of patients with cardiovascular diseases was studied. This study included 70 patients with pulmonary embolism and 116 patients with acquired heart diseases before surgical and pharmacological treatment. Albumin concentration, absolute lymphocyte count, and BMI were determined to assess the nutritional status. Concentrations of brain natriuretic peptides were measured to assess the degree of heart failure. Association between increase in BMI and decrease in the BNP level were found in both examined groups. In acquired heart disease group, decreases in the albumin concentration and absolute lymphocyte count were associated with an increase in BNP, which may suggest that the degree of heart failure affects the development of nutritional deficiency. 

The role of genetically­associated and acquired forms of hemostasis pathology in the presence of nephropathy and kidney inflammation was studied taking into account severity of albuminuria and creatinine clearance to evaluate the prognosis and complications of the disease and to develop new approaches for the treatment of chronic renal disease. 

The polycaprolactone (PCL) vascular graft for tissue regeneration was evaluated in the long­term in vivo study. The grafts were fabricated by electrospinning with the further morphological assessment and mechanical tests. Grafts were implanted into rat abdominal aortas for 2 weeks, 1 and 10 months to evaluate the formation of blood vessels and graft biocompatibility. PCL grafts had a highly porous structure. Mechanical properties of the grafts differed from those of native vessels; however, grafts were able to withstand the mechanical stress created by a blood flow. Implanted grafts were infiltrated by the host cells. Thus, PCL grafts are biocompatible and can be used as temporary vascular prostheses. 

The article presents the results of a comparative study of hemodynamic state in patients with arterial hypertension (AH) depending on the presence of postinfarction cardiosclerosis (PCS). The parameters of central and peripheral hemodynamics were determined by the method of volumetric compression oscillometry (VCO). Data showed that patients with AH and PCS had pronounced hemodynamic disorders seen as an increase in pulse wave rate, an increase in blood flow linear velocity, and a decrease in vascular compliance. 

On the basis of archival materials and Internet sources the authors reconstructed the biography of Vasily A. Lyapustin, the doctor and the graduate of the Faculty of Medicine in 1894. A brief review of his medical, scientific and social activities is given.