The aim of the study was to evaluate the response of arterial blood flow to the orthostatic load in young women with idiopathic arterial hypotension (IAH).

Material and methods. A comparative analysis of systemic hemodynamics and peripheral arterial blood flow parameters was performed for orthostasis between two groups of women aged 1825: test with IAH (n = 73) and control (n=37). The SBP level in the test group was 90-98 mm Hg, in the control group - 120-129 mm Hg. BP, heart rate and angio-scanning were performed twice: at rest, lying after 15 minutes rest and during the first minute of orthostasis. Blood flow was studied in the right vertebral, radial and posterior tibial arteries. The following parameters were evaluated: diameter during diastole, peak systolic and terminal diastolic blood flow velocity.

Results. In young women with IAH, as those with normal arterial pressure, orthostasis was accompanied by an increase in SBP, DBP and an increase in heart rate. With hypotension, an increase in the diameter of the vertebral artery and a decrease in the diameter of the posterior tibial artery were detected. In both groups, orthostasis was accompanied by a decrease in the rate of blood flow, both during systole and diastole.

The conclusion. Orthostasis with IAH is accompanied by an increase in SBP, DBP and heart rate. The response of peripheral arteries to orthostasis is characterized by a change in the diameter of the vessels, which indicates a pronounced adaptive response to the physiological stress load.

<strong>This study</strong> investigates the incidence of meteosensitivity (MS) and its manifestations among intellectual workers, and the correlation between MS and psychological states of the patients. Patients were administered a standardized questionnaire of risk factors (RF) of cardiovascular disease (CVD), including MS; CES-D questionnaire to reveal depression; and self-monitoring map. Incidence of MS was established in 99 of 196 intellectual workers (50.5%): 34 men (40%) and 65 women (58.6%). In a group of 33 volunteers with MS, 45.5% were revealed to have various degrees of depression. Among people who exhibited manifestations of depression, the number of days of feeling unwell Physiological meteosensitivity (MS) - the property of the body to maintain its health by harmonizing life-supporting processes with solar, geophysical, meteorological and other processes in the environment. In a healthy person with good reserve capabilities of adaptation mechanisms, internal processes caused by physiological MS do not cause any painful sensations. In the case of the weakening of the body due to illness, stress, or exhaustion person may experience pathological meteopathic reactions, often complicating the course of the underlying disease, reducing the effectiveness of treatment, and worsening the patient’s quality of life. Differences in atmospheric pressure, especially spasmodic, negatively affect the circulatory system, vascular tone, and arterial pressure. High humidity also has negative effects on health. During periods of so-called “magnetic storms”, a deterioration of wellbeing is even possible in a completely healthy person, manifested by disturbance in memory and concentration and occurrence of nervous breakdowns. Cardiac patients are most sensitive to various changes in weather conditions [1-5]. It is noticed that people living in cities suffer from meteorological dependence much more than those who live in rural areas. This is in relationship to weather conditions significantly exceeded that of people who exhibited no depressive signs. Most people in the observation group complained of worsening in self-perceived well-being during the days in which the combination of northern or southern winds, high atmospheric pressure, and high humidity was registered. Sensitivity to showers was recorded in 69.7% of individuals with MS. <strong>Results</strong> of this study confirm the potential utility of providing self-management education to patients with MS and development of personalized programs for alleviating severity of individual’s reaction to fluctuations in certain meteorological parameters.

Medical rehabilitation (MR) has become one of the important tasks of treatment in patients with arterial hypertension (AH).

The aim - assessment of the effectiveness of spa resort MR in patients with AH under spa resort treatment (SRT) in view of the provisions of the "International Classification of Functioning, Disability and Health" (ICF).

Materials and methods. The study included 103 AH patients treated with SRT at Yalta resort. Selection of patients for the study was carried out with informed consent of patients and duration of treatment of at least 18 days. Methods of investigation and treatment were applied in accordance with the features of the functional state of the patient, the individual indications and the standards of SRT at AH. Psychological research and evaluation of quality of life (by the tests of Reeder, Beck, Spielberger-Hanin, SF-36) were additionally conducted. The analysis of the results was carried out by methods of variation statistics.

Results and its discussion. Spa resort MR in patients with AH is characterized by high efficiency. Reliable positive trends were set for a number of domains: the sensation of pain and dizziness (b280 and b2401), heart function (b410), blood pressure (b420), tolerance to physical exercises (b455) and the sensations associated with the functioning of the cardiovascular and respiratory systems (b4601).

Conclusions. Statistically significant (p<0,05) reduction of six domain’s value by the end of the course of treatment indicates positive rehabilitation potential of SRT in patients with AH.

Electronic version of a patient’s individual card protocol forming “Analytic system for monitoring and predicting various clinical variants of ischemic heart disease (CHD DM2)” database № BGU 00314 is combined with the computer system № DGU 01035 to assess yearly risk of adverse events by diagnostic coefficients; up-to-date prognostic signs, such as pre-test probability, Duke treadmill score and ventricular ejection fraction participating in the formation of prognostic conclusion were added. The database is a complex of program products intended for automation of dynamic management processes for both inpatients and outpatients with various clinical IHD forms and concurrent type 2 diabetes mellitus based on assessment of the disease course dynamics, completeness of prescriptions and patient’s compliance. The proposed model is of high clinical practical significance since it can be transformed into electronic medical history or used as a database in chronic IHD registry to improve medical care quality.

<strong>The aim of this study</strong> was to identify possible ECG predictors of atrial fibrillation (AF) recurrence in the early period after radiofrequency catheter ablation (RCA). We compare P-waves parameters before and after radiofrequency catheter ablation. In total 12 lead surface ECG of forty-two patients with paroxysmal and persistent atrial fibrillation were analyzed before and after catheter ablation. The 12 lead surface ECG was recorded on sinus rhythm before and within 24-48 h after RCA . 13 patients out of 42 had atrial fibrillation recurrence. Patients with early AF recurrence were significantly older than patients with sinus rhythm. In the group of patients with AF recurrence, the duration of P wave was longer than in the group without AF recurrence. After RCA in both groups there were observed reducing of PQ interval and increasing of heart rate.

PAH associated with CHD according to the Russian Register of Pulmonary Arterial Hypertension (PAH) and Chronic Thromboembolic Pulmonary Hypertension (CTEPH) is highly prevalent and ranks second after idiopathic pulmonary hypertension (IPH) in terms of prevalence among all forms of PAH and the first among associated forms. With the development of PAH, patients with congenital heart disease (CHD) require the appointment of a constant PAH-specific therapy. The article presents an overview of clinical trials of medications currently registered in the Russian Federation for this cohort of patients, including endothelin receptor antagonists (bosentan, macitentan, ambrisentan), phosphodiesterase type 5 inhibitors (sildenafil), soluble guanylate cyclase stimulants (riociguat) and prostacyclin analogues (iloprost).

Most often acute myocardial infarction of the right ventricle is diagnosed in patients with acute left ventricular lesion and is associated with an atherosclerotic process in the coronary arteries. Isolated acute myocardial infarction of the right ventricle is rarely diagnosed and is often detected only during autopsy. Previously it was believed that in the absence of a significant lesion of the coronary arteries, an acute myocardial infarction of the right ventricle is associated with hypertrophy of the right ventricular myocardium. The results of a study in which acute myocardial infarction of the right ventricle were found in patients who died due to acute massive pulmonary embolism and who did not have right ventricular hypertrophy appeared later. There are many questions regarding the tactics of therapy for this complication, especially in patients with pulmonary hypertension who are on treatment with pulmonary arterial vasodilators. The article describes a rare clinical case of postmortem detection of myocardial infarction of the right ventricle against the background of small coronary arteries in a 41-year-old patient with a diagnosis of chronic thromboembolic pulmonary hypertension, the difficulties of intravital diagnosis and the restriction of drug therapy.

A patient with pulmonary arterial hypertension (PAH) associated with congenital heart disease (ventricular septal defect) and Eisenmenger syndrome was started on an endothelin receptor antagonist bosentan. With treatment, the patient's condition had been stable, however, by the second year, worsening shortness of breath, reduced exercise tolerance and an increase of the right heart were noted. Bosentan was switched to macitentan. After a year of this pathogenetic therapy, an improvement in functional status was registered. Moreover, while on macitentan, the patient has successfully undergone a gynecological surgical procedure under general anesthesia.

The article presents two clinical cases of successful reuse thrombolytic drug Fortelyzin® in the total dose of 25-30 mg observed by the authors in patients with acute coronary syndrome with ST-segment elevation, treated in the urgent cardiology department of the State budget institution of Ryazan region «Regional clinical hospital». Patients belonged to different gender and age groups and had various short term forecast on the scale TIMI or GRACE, different duration of ischemic damage of the myocardium until reperfusion. The above observations confirm the high safety and efficiency of Fortelyzin® in acute coronary syndrome.

The clinical case demonstrates the difficulties of differential diagnosis and the determination of treatment tactics in a patient with chronic thromboembolic pulmonary hypertension, recidivous cardiac myxoma and radiographic pattern of dissemination in lung tissue.