Pulmonary hypertension (PH) is the group of diseases characterized by progressive increase of pulmonary vascular resistance leading to right heart failure and premature death of patients. This review represents the modern clinical and functional classifications, diagnostic algorithm with four main steps. The 1st step -PH suspicion- includes the analysis of clinical symptoms, physical examination, screening and occasional findings. The 2nd step - PH diagnosis verification- requires some instrumental methods performance, such as ECG, transthoracic echo, chest X-ray, right heart catheterization with acute pharmacological testing. The 3rd step means clinical class determination on the basis of lung function tests, ventilation-perfusion scan, CT and angiopulmonography. The 4th step task is PH type clarification (lab and functional testing, abdomen ultrasound). The PH treatment has always been a real challenge for physicians. Traditional therapy with calcium channel blockers, anticoagulants diuretics, oxygen often fails to help the patients effectively, to prolong their life, to improve its quality. Lately, on increasing of the number of randomized controlled studies in this field, the situation has been changed greatly. In the clinical practice there used the drugs for the treatment of pulmonary arterial hypertension-endothelin receptors antagonists, prostanoids, phosphodiesterase type 5 inhibitors.

Within 15 years observation 31 patients with prolaps the mitral valve, regularly accepting magnerot, in a dose of 1500 mg a day during all period of observation by 3-month's courses 2 times a year was spent. Features of dynamics of a clinical picture, their interrelation with phenotypic expression of a dysplasia of a connecting tissue, changes of an electrocardiogram, a structure of the valves apparatus of heart, a condition of a vegetative homeostasis, change of level and a daily profile of arterial pressure, a tonus of sympathetic and parasympathetic departments of vegetative nervous system are taped. Against treatment according to the retrospective analysis significant improvement of clinic-tool indicators at all surveyed patients isn't. After regular application of magnesium salt orotate acids authentic improvement of quality of life at patients with prolepses the mitral valve is established.

The aim is to develop and clinical test of the novel computer program for the identification of the prognostic markers for sudden cardiac death. Among them are T-wave alternans, duration and dispersion of the interval QT, heart rate turbulence. Material and methods: 79 pts with cardiomyopathy and life-threatening ventricular arrhythmias and 30 pts without arrhythmias. The methods of the precision digital processing of the ECG signal are used. Results: The significantly higher values of T-wave alternans, QT dispersion and heart rate turbulence in pts with ventricular arrhythmias were obtained (p<0,01). Conclusion: The identification of the predictors of sudden cardiac death is necessary for timely risk stratification and choosing the treatment strategy in pts with cardiomyopathy.

Under our observation were undergoing 141 patients with non-rheumatic AF. The study included patients with paroxysmal, persistent and permanent forms of AF and as a control group - patients without AF. The similar analysis of the obtained results showed that patients with paroxysmal and persistent AF types have a statistically significant increase in levels of CRP and IL-6 compared to pateints with chronic form and the control group. Therefore, we can suggest that the increased concentration of inflammatory markers such as CRP and IL-6 may serve as a predictor of the appearance of paroxysmal form or recurrence of AF.

This article is devoted to the pathomorphological reasons of arrhythmias at patients with chronic heart failure ischemic and non-ischemic aetiology. Also the short review of researches by efficiency of several groups antiarrythmic drugs, including allapynin, and implanted devices is presented. Authors conclude, that the sights concerning antiarrythmic therapy are not universal for patients with chronic heart failure of various aetiology, and implanted devices are most effective in improved prognosis.

Objective: to study the state of the autonomic nervous system (ANS), gene polymorphism of angiotensin-converting enzyme (ACE) and β₂-adrenergic receptors, and intracellular calcium metabolism in patients with essential hypertension (EH) with a complicated course of the disease (left ventricular hypertrophy (LVH ) and ischemic stroke). Materials and methods: A total of 250 Kirgiz male with EH, among them 180 patients without stroke, 70 patients who had ischemic stroke and 35 patients with LVH were examined. Control group -19 healthy peoples. It were performed daily blood pressure monitoring, echocardiography, duplex scanning of carotid arteries, the activity of calcium channels, spectral analysis of heart rate variability (HRV) during active tilt-test and genotyping on ACE and the β₂-adrenergic receptors. Results: It was observed a significant reduction of HRV and decreased response of LF (low frequency) component to tilt-test in hypertensive patients, compared to control. Tilt-test in patients with complications of EH had shown inverse response of LF to orthostatic test. It was found hyperactivity of ATP/ADP dependent calcium channels in platelets in patients with EH during the development of LVH. Patients with Gln27Gln genotype in compare to other variants of Gln27Glu polymorphism of β₂-AR were characterized by increasing meanings of BP and its morning raises which possibly may cause increasing of left ventricular mass in these patients. 3. Our data support an association between I/D polymorphism and stroke in patients with EH. Presence of DD genotype may be considered as independent from daily profile of BP and intima-media thickness predictor of ischemic stroke in patients with EH. Conclusion: We propose several possible clinical and genetic predictors of complicated EH (rigid response of LF-component during tilt-test, the presence of hyperactivity calcium channel, carrier of Gln27Gln polymorphism of β₂-adrenergic receptors and I/D polymorphism of ACE gene).

The article is devoted to primary prophylaxis of sudden cardiac death by influence on renninangiotensin-aldosterone and sympathetic systems. Results numerous trials with use beta-blockers, and ACE inhibitors are resulted. It is proved as early use of these groups of preparations at patients with myocardial infarction is possible.

Goal: Comparison of different classification of metabolic syndrome (MS) in Kyrgyz ethnic group. Materials and methods: 183 women, 140 men of the ethnic Kyrgyz, mean age 52,5 ± 8,5 years, were included in the study. Clinical examination, blood pressure, anthropometric data (weight, height, waist circumference, hip circumference), measurament, the analiysis of fasting glucose, lipid profile, insulin were perfomed in all examined persons. Diagnosis of MS was made using the criteria of ATP III (2005), IDF for European and asian populations (2005), Russian criteria (2009) and criteria of MS IDF and AHA / NHLBI (2009). Results: The sensitivity of detection of insulin resistance (IR) was high enough and did not differ significantly between the diagnostic criteria. The highest specificity 0,77 (0,72-0,83) occurred when criteria ATP III was used. The difference of specificity was close to significant between criterias of ATP III and IDF criteria for Asian populations and criteria MS IDF and AHA / NHLBI (2009), and reached statistical significance between the parameters of the ATP III, and Russian criteria. Conclusion: Based on these data, in Kyrgyz ethnic group for diagnosis of MS is preferebale the use of ATP III criteria.