The review summarizes new data on medical treatment of pulmonary arterial hypertension (PAH). Pulmonary arterial remodeling is known to be the main pathophysiological characteristic, involving cell proliferation, hypertrophy and migration, as well as apoptotic abnormalities and changes in extracellular matrix production and degradation. This makes promising the evaluation of drugs with not only vasodilatory, but also antiproliferative and anti-remodelling properties. There are two approaches to improvement of PAH therapy: 1) novel agents with higher efficacy or more convenience for use, acting on the above mentioned targets, and 2) agents aimed at new pathophysiological targets, discovered by the most recent research in PAH area. They have shown potential efficacy in experimental models as well as in early phase clinical trials and seem promising for further improvement of pathophysiologically oriented treatment of PAH.

The article is devoted to various aspects of the combined therapy of arterial hypertension. Given the complementary effects and advantages of the combination blockers receptors to angiotenzin II and calcium antagonists, are described clinical situation, where its use is a priority. Analyzed in detail the available literature data on the efficacy and safety of fixed combination telmisartan with amlodipine, including in patients with obesity, diabetes, severe arterial hypertension.

The research objective was aimed at the study of association of metabolic syndrome (MetS) and its components with coronary heart disease (CHD) among the population of Yerevan city (Armenia). Methods. During 2010-2011 in clinics of the Yerevan State Medical University and in the Center of preventive cardiology 320 patients with stable forms CHD (mean age 57.2±10.9 years) and 320 subjects without CHD (mean age 55.5± 11.7 years) were randomly selected. All patients have been surveyed according to current recommendations of clinical, instrumental and laboratory guidances. Diagnosis of MetS was defined by criteria AHA/NHLBI (2005). Biochemical analysis of blood made in hospital laboratories and anthropometrical indicators measured on standard procedures. Other data were obtained by use of the standard questionnaires. Study results were exposed to statistical processing by the parametric and nonparametric statistics methods, the zero hypothesis was rejected at p <0.05. Results. Obtained results indicated that among patients with CHD the blood plasma concentration of triglycerides (p<0.05) and systolic blood pressure (BP) (p<0.05) were considerably higher and waist circumference (p<0.001) as well was bigger in comparison with control group. The differences between indicators of high density lipoproteins and body mass index were not observed in both groups. High BP was the most frequent risk factor both in investigated and control groups (78% and 64% accordingly, p<0.001). By AHA/NHLBI criteria, prevalence of MetS amounted to 79.7% in investigated and 69.4% in control group, whereas the diabetes mellitus was more often observed in control group (27.1% against 15.5%). The authentic differences in prevalence of МetS between investigated and control groups were revealed only in combination of all components of МetS. In this respect significant difference between classifications of МetS according to AHA/NHLBI and IDF does not come to light. Conclusion. The prevalence of MetS was higher among patients with a CHD that was shown in full clusters. From practical point of view AHA/NHLBI and IDF criteria of a metabolic syndrome are equivalent.

The aim of study was to assess prognostic significance of left atrial (LA) functional parameters and levels of biomarkers in patients (pts) with severe chronic heart failure (CHF) and preserved left ventricular (LV) systolic function. Methods. Prognostic value of LA functional parameters, levels of BNP., NT-proBNP and high sensitivity C reactive protein (CRP) was assesed in 128 pts (age 63.2±1.7) with III-IV NYHA functional calss CHF and preserved LV systolic function (LV EF >50%). Results. During 37±0.8 months from cardiac causes died 43 (33.6%) pts. In Kaplan-Mayer analisys survival rate was 62, 63 и 64% in pts with levels of BNP >300 pg/ml, NT-proBNP ≥1500 pg/ml and CRP≥15 ng/ml and 85, 86 и 84% (p<0.01) in pts with levels of BNP<300 pg/ml, NT-proBNP<1500 pg/ml and CRP<15 ng/ml. Similar survival (p<0.01) was revealed in pts with LAKE≥40 kdyn/sm/sec (87%), EFakt≥25% (82%), LAF≥0.4 (86%), FAC≥50 (84%), PVSC≥60% (87%), S/D fraction≥55% (83%), Аrdur≤150 msec 30 msec (87%) compared to pts with LAKE<40 kdyn/sm/sec (62%), EFakt<25% (65%), LAFI<0.4 (63%), FAC<50 (65%), PVSC<60% (63%), S/D fraction<55% (63,5%), Аrdur>150 msec (63%) и Ar-A>-30 msec (62%), respectively. Conclusions: 1) LA functional parameters are powerfull independent predictors in pts with CHF and preserved LV systolic function. 2) Distribution of pts according to baseline levels of BNP <300 and ≥300 pg/ml, NT-pro-BNP <1500 and ≥1500 pg/ml and hsCRP <15 and ≥15 ng/ml allowed to identify (p<0.01) pts with low and high risk of cardias death.

Objective: set the activity limits the impact of vascular walls by aggregation ability of neutrophils in patients arterial hypertension with dyslipidemia patients. Material and methods. Under supervision were 34 sick arterial hypertension of 1-2 degrees with dyslipidemia II b type, risk 4, middle age. The control group was made by 26 healthy people of similar age. For the purpose of correction dyslipidemia all patients received a preparation simvastatin 10 mg for the night against appointment enalapril 10 mg two times a day. Results. In the conditions of an arterial hypertension with dyslipidemia decrease in control of a vascular wall over aggregative ability of neutrophils in many respects owing to infringements in lipidic an exchange, activation lipid peroxidation of plasma, easing of generation NO and formation prostacyclin is revealed. As a result of application simvastatin at sick the arterial hypertension with dyslipidemia notes improvement lipidic structure and processes lipid peroxidation in plasma and neutrophils, being accompanied by positive dynamics aggregative abilities of the last at the expense of optimization glycoprotein structure of their receptors. Conclusion. Use simvastatin hypertensive patients with dyslipidemia within 104 weeks can improve control of the vascular wall of platelet activity of neutrophils.

This report examines interest in compounds that normally prevent the toxic effects of ROS -antioxidants, namely reduced ubiquinone, which is only lipid soluble antioxidant synthesized in cells of animals and humans, and continuously recovered from oxidized form by enzyme systems of the body, to possibilities of the use of coenzyme Q10 in cardiovascular diseases, has a beneficial therapeutic effect on the body, resulting in improvement of the cardiovascular, immune system, significant improvement in rehabilitation period, a significant increase in body energy, the use of coenzyme Q10, including in pediatric cardiology and study its effectiveness in primary and secondary mitochondrial defects as a means of adjuvant therapy of diseases and pathological conditions, as vegetative dystonia, diabetic kardioneyropatiya, myocardial dystrophy, hypertension, metabolic syndrome, cardiomyopathy posthypoxic newborn, chronic pulmonary heart, hyperlipidemia, the recovery period after cardiac correction of congenital heart disease, minimally invasive correction of arrhythmias and pacemaker implantation, etc. reperfusion syndrome, ischemia, hypertension, heart disease, aging, childhood.

Nonalcoholic fatty liver disease (NAFLD) is one of the most common diseases in hepatology, which leads to a deterioration in the quality of life, disability and death. NAFLD occurs in all age groups, but the most vulnerable are women aged 40-60 years with signs of metabolic syndrome (MS). After being diagnosed NAFLD patients should be screened for the presence of their associated diseases, such as metabolic syndrome and cardiovascular disease. During the past years the role and function of adipose tissue was restudied, what leaded to the active scientific study of the molecular mechanisms of biosynthesis of fat producing hormones and their role in the development of obesity, insulin resistance and associated cardiovascular disease. All medical researches carried out in this area are promising and relevant, but the data are rather contradictory and require further research to produce new true facts that could form the basis for new diagnostic and therapeutic strategies for metabolic abnormalities in patients with cardiovascular disease.

Objective. To study the content of atherosclerotic plaques in the presence of Candida and analysis of some immunological and biochemical parameters in patients with acute coronary syndrome positive for Candida albicans. Materials and methods. To identify mushrooms in the atherosclerotic plaque-ray was used our method (patent number 531, priority of 28.06.2010). A study was conducted 47 atherosclerotic plaques, taken during the 20 autopsies. It was also examined 80 people with acute coronary syndrome, including 58 men and 22 women, aged 29-85 years, mean age 60,14 ± 10,78 years. All the patients underwent biochemical blood analysis, including TNF-α. Also measured IgG and IgM antibodies to Candida albicans. Results. In 31.9% of cases, the contents of atherosclerotic plaque are fungi of the genus Candida. In most predominant fungi Candida krusii and Candida grabrata, Candida tropicalis isolated colonies and a single colony of Candida albicans. Negative for IgM antibodies to Candida albicans were all 80 (100%) patients, the IgG - 30 (37.5%) patients. In patients negative for IgG, TNF-α was detected in a smaller number of patients (36.7%) than in patients in the positive group (70%), but its level was significantly higher (511,73 ± 195,80 pg / ml , 326,68 ± 259,91 pg / ml, p <0,05). Performance differences between ASAT and ALAT in patients positive for Candida albicans, in the absence of TNF-α was significantly higher than that of other patients. Conclusion. We can assume that Candida species are able to induce inflammation of the vessel wall, which in turn can lead to the development of atherosclerosis.