In this review are outlined key points of pathogenesis, differential diagnosis and treatment strategy in cardiac pulmonary oedema. Are included table data of medical and respiratory assistance?

The analysis of quality of the survey and using of drug therapy in patients with coronary heart disease with concomitant hypertension in outpatient clinics of large cities in Ukraine was conducted in the PRESTIGE study. Methods for evaluation of patients included: ECG at rest (98.3%), echocardiography (83.7%), ambulatory ECG monitoring (47.8%), test with dosed physical load (24.4%), ambulatory blood pressure monitoring (28.7%), coronary angiography (20.0%), determining of microalbuminuria and glomerular filtration rate (21.9 and 13.8% respectively). Analysis of medical prescriptions in the PRESTIGE study suggests that the choice of the main groups of drugs and drugs used in clinical practice is very close to international standards. The frequency of use of antithrombotic and lipid-lowering (statin) agents, BB and ACE inhibitors (medicines that improve the prognosis of patients with coronary artery disease) are comparable with data from recent international registers. However, the effectiveness of therapy in the light of generally accepted criteria remains critically insufficient. Despite treatment, the target cholesterol was achieved in only 23% of patients, and target levels of blood pressure (130/85 mm Hg) in only 12.5% of patients. In 63.4% of patients, including those receiving BB, heart rate remained more than 70 bmp. Referai of patients with CHD to myocardial revascularization should be recognized as passive tactic and the number of interventions performed is inadequate. Factors that could enhance the efficacy of therapy would be the application of adequate doses of drugs, monitoring and control for achieving of target levels of key indicators (LDL cholesterol, blood pressure, heart rate), as well as increasing patients' adherence to treatment.

In the study 76 patients with acute coronary syndromes (ACS) were included: 52 patients with Q - and 24 patients with non- Q wave myocardial infarction (Ml) who underwent emergency coronary artery bypass graft surgery (CABG) because of early post-infarction angina. Intravenous Corvitin 1% -100,0 ml was added to the standard treatment 3 days before and 3-5 days after CABG. Investigated biochemical and hemostasiological blood analysis, cardio enzyme test, CRP, echocardiography, electrocardiography in 60 leads, ECG-monitoring, coronary angiography (CA). Use of Corvitin helps to improve the systolic and diastolic myocardial function in more earliest terms in patients with ACS with direct revascularization, reduces the effects of ischemic/reperfusion myocardial damages and also decreases risk of developing early postoperative cardiovascular complications: acute heart failure, perioperative Ml, cardiac arrhythmia and can be used for metabolic myocardial protection in case of CABG and

Objective. Analysis of a clinical picture and functional dysfunctions with ADRB2 gene molymorphism in patients with PHCM. Materials and methods. 89 patients with PHCM were included in the study (69 males and 20 females, mean age 46,7±15,7), among which 56 had been diagnosed with the obstructive form, 33 patients had a non-obstructive form of the disease. The control set included 104 healthy donors adequate in age, and gender with PHCM. The clinical picture of the disease was assessed, echocardiographic indicators and daily ECG monitoring parameters were specified. The ADRB2 gene polymorphism analysis was made in all patients. Results. The association of the clinical picture, structural and functional LV myocardial peculiarities with ADRB2 gene polymorphism in patients with PHCM. It was revealed that the combination of Arg16rg/Gln27Gln genotypes is a risk genotype and is associated with the appearance of adverse clinical manifestations of the disease. The combination of Gly16Gly/Glu27Glu genotypes is protective and is Conclusion. The results obtained have revealed the association of the ADRB2 gene polymorphism with clinical, structural and functional dysfunctions in patients with PHCM which will allow making prognoses of adverse clinical manifestations risk and improving β-adrenoblocker treatment of PHCM patients.

Aim. То study prevalence of Pro12Ala polymorphism of the PPARγ gene in Uzbek hypertensive patients and healthy men and its association with blood pressure and cardiovascular remodeling process. Methods. We observed 169 hypertensive patients and 50 healthy men Uzbek nationality. Metabolic syndrome (MS) was defined according to IDF, 2005. It has been performed oral glucose tolerance test, echocardiography, reactive hyperemia test, definition of common carotid intima-media thickness, lipids, microalbuminuria (MAU). Genotyping of Pro12Ala polymorphism of the PPARγ gene was determined by PCR amplification with allele-specific primers. Results. Analysis of frequency distribution of Pro12Ala polymorphism of the PPARγ gene has shown significantly greater accumulation of Proallele both among hypertensive patients (89.9%) and healthy subjects (83%). There was no association between Pro12Ala polymorphism of the PPARγ gene and blood pressure, left ventricular mass lipid and glucose levels in hypertensive patients with MS. It has been revealed higher heart rate and MAU in hypertensive patients with MS-carriers of Proallele as compared with Ala-allele carriers. Genetic risk assessment of MS by multiplicative model of inheritance has shown that availability of Pro-allele has associated with high risk of MS (OR 1.73, 95%CI 0.84-3.37) but presence of Ala-allele has associated with low risk of MS (OR 0.58 95%CI 0.30-1.13). Conclusion. It has been found high frequency of Pro-allele and Pro/Pro genotype of Pro12Ala polymorphism of the PPARγ gene both among hypertensive patients with or without MS and healthy subjects of Uzbek nationality. Probability of MS development is higher in hypertensive patients with MS-carriers of Pro-allele of Pro12Ala polymorphism of the PPARγ gene as compared with Ala-allele carriers.

The purpose of the given work was frequency and structure studing cerebrovaskular complications at sick suffering hypertensive illness and revailing of their interrelation with polymorphism of genes ACE and APOE. Patients of both sexes at the age of 25-75 years suffering arterial hypertension (AH) 1 and 3 stages are for this purpose surveyed. Clinic-neurologic, biochemical and molekular-genetic research for definition of polymorphisms of genes ACE and APOE is for this purpose conducted. Are revealed to associate some polymorphisms of the studied genes with the heaviest complications AH.

One hundred and eighty three male patients aged from 35 to 55 years were examined to study the heart rate variability and the QT dispersion at the metabolic syndrome complicated with cardiac arrhythmias. The diminution of the temporal pattern of heart rate variability, increase of the both sympathetic tone and sympathetic-vagal ratio were revealed in patients with supraventricular and ventricular rhythm disturbances. These changes were especially characteristic for patients with atrial fibrillation. QT dispersion was higher in patients with ventricular arrhythmias in comparison with other groups, although maximal corrected QT interval and its maximal dispersion was revealed in patients with combined cardiac arrhythmias (either ventricular and supraventricular arrhythmias).

The aim of study was to assess the efficacy of ivabradine (I, up to 15 mg) therapy on prognosis, right ventricular (RV) and atrial (RA) functional parameters, BNP, NT-pro-BNP and high sensitivity С reactive protein (CRP) levels in patients (pts) with III- IV NYHA FC systolic CHF. Methods. 76 pts with DCM (age 57.4) were randomly assigned to groups A (n=38, non receiving ivabradin, I) and group В (n=38, receiving I, 15 mg) in addition to ACEIs, diuretics, beta-blockers and digoxin. 1-, 2- and З-year mortality were 34.2, 39.5 and 50% in group A and 21.1, 28.9 and 39.5% in group B. Survival analysis revealed lower probability of 1-year, 2-year and З-year mortality (RR reduction at 38.3,26.8 and 21%) in pts, treated with I (p<0.05) compared to group A. Combined use of I and beta-blockers has resulted to significant improvement of symptoms and right heart functional parameters, decrease of BNP., NT-pro-BNP and CRP levels after 3 months of therapy with further improvement to 6, 12, 24 and 36 months. Conclusions. 1) Decrease of BNP, NT-pro-BNP >50%, hsCRP>40% and HR>40% and increase of RV EF and E/A at >25%, TAPSE>50% and RA functional index >60% after 1 year identified pts with cardiac events reduction. 2) Prognostic benefit, associated with I use, seems to be related to improvement of right heart parameters, neurohormonal and inflammation status and HR reduction.