Features of changes in volume-impedance hemodynamic indicators during the tilt test in young males with a history of vasovagal syncopes

Background. The direction of changes in hemodynamic parameters during the tilt test (TT) nin individuals with history of vasovagal syncope (VVS) is a subject of discussion. Objective: to study changes of volume-impedance hemodynamic indicators in the process of tilt test in somatically healthy young men with history of VVS. Materials and methods. A total of 102 men aged 18–30 years were divided into 4 groups, taking into account the specific features of fainting history and response to TT. Persons of group 1 (n=14) had history of VVS and positive response to TT (syncope). Subjects of group 2 (n=14) had history of VVS and a pattern of postural tachycardia without fainting during TT. Persons of group 3 (n=42) had history of VVS and negative response to TT. Subjects of group 4 (n=32) had no history of VVS and negative response to TT. During TT, we studied dynamics of some indicators, including cardiac output (CO) and total peripheral vascular resistance (TPVR). Results. In individuals of all groups in the initial horizontal phase of TT values of CO and TPVR corresponded to the norm. Subjects of group 1 had significantly lower CO compared with subjects of groups 2, 3, 4 (p<0.05, p<0.01, p<0.05, respectively). Values of TPVR in subjects of group 1 were significantly higher than in subjects of groups 2, 3, 4 (p<0.05; p<0.05; p<0.05, respectively). In response to orthostasis CO values increased in groups 1, 2, 4 (by 18%, 10%, 5%, respectively) and did not change in group 3; TPVR values decreased in groups 1, 2 (by 8%, 0.5%, respectively), and increased in groups 3, 4 (by 8%, 4% respectively). In the final horizontal phase of TT, CO values in group 1 were significantly lower than in groups 3, 4 (p<0.05), while TPVR values did not significantly differ between all groups (p>0.05). Conclusions. In tilt-positive and tilt-negative subjects with history of VVS, standardized postural stress leads to unidirectional changes in cardiac output, but to multidirectional changes in total peripheral vascular resistance.

Correlation between heliogeophysical factors and osmotic pressure of blood plasma in patients with arterial hypertension with different temperament

The relation between heliogeophysical factors and the osmotic pressure of blood plasma in patients with arterial hypertension with different temperaments is analyzed. It is found that with increasing solar activity (Wolf numbers and radio flux wavelength 10,7 cm), is closely related increase in atmospheric pressure, air temperature and γ-background (within normal limits) in the workplace examinees. It was revealed that in choleric and sanguine patients there is a reliable high inverse correlation relationship between heliogeophysical, meteorological factors and total peripheral vascular resistance, while the phlegmatic and melancholic - the average direct and direct high correlation relationship. Antihypertensive therapy with diuretics with increased solar activity, combined with an increase in the atmospheric pressure, γ-background and the air temperature in the workplace, due a decrease in total peripheral vascular resistance at the choleric and sanguine and increase in total peripheral vascular resistance in healthy individuals and phlegmatic patients and melancholic. The presence of significant and reverse correlation relationship between the total peripheral vascular resistance and osmotic pressure of blood plasma in choleric and sanguine and significant, but a direct correlation - the phlegmatic and melancholic indicates the inclusion of an adaptive process various physiological mechanisms, which determines the need to consider the temperament at solar biospheric relations bonds.

Method for recurrent gastrointestinal bleeding prognosis

Aim. To assess the clinical value of continuous monitoring of rheographic parameters in patients with high risk of recurrent gastrointestinal bleeding for early pre-clinical diagnosis of recurrent bleeding. Methods. The study included 50 patients with upper gastrointestinal bleeding aged 50 to 70 years who were admitted having hemorrhagic shock III after endoscopic hemostasis. Continuous integral whole body rheography by «Diamant-M» computer complex was used for systemic circulation assessment. Results. Three types of hemodynamic reactions were revealed at integral whole body rheography: hypertonic (35 cases: increased integral tonicity coefficient up to 86 units and total peripheral vascular resistance over 3000 dyn/s·cm-5), hypotonic (35 cases: decreased integral tonicity coefficient down to 77 units and less, total peripheral vascular resistance less than 1500 dyn/s·cm-5, possible M-like waves of rheography curve) and intermediate (integral tonicity coefficient between 77 and 83 units, total peripheral vascular resistance between 1500 and 2000 dyn/s·cm-5). Integral tonicity coefficient between 80 and 113 units and total peripheral vascular resistance between 1500 and 3000±120 dyn/s·cm-5 were important indicators while monitoring for possible recurrent gastrointestinal bleeding. Conclusion. Blood loss compensation monitoring by continuous non-invasive rheography in patients at high risk for recurrent gastrointestinal bleeding allows not only diagnose recurrent gastrointestinal bleeding in a timely manner, but also to assess the effect of the treatment conducted.