The application of carbon dioxide baths and aquatic therapy in preventive programs for persons with circu latory illnesses risk factors

Due to the fact that cardiovascular diseases (CVD) are the leading cause of death worldwide, reducing risk factors and maintaining a healthy lifestyle play an important role in primary and secondary prevention of CVD development and improving prognosis. The purpose of the study. To study the eff ectiveness of carbon dioxide baths and water training in the primary prevention program for people with CVD risk factors. Material and methods. 60 patients (43 women and 17 men) with CVD risk factors were examined before and after a course of carbon dioxide baths and aquatic therapy. The hardware and software complex «Physiocontrol-R» was used. It includes, in addition to psychological testing (Spielberger, SAN, Lüscher tests, сardiointervalography (CIG) for the study of the autonomic regulation of the cardiovascular system, the study of the state of central and peripheral hemodynamics, Bioelectrical impedance analysis (BIA) for the study of body composition. Results. In the group of patients who took a complex of carbon dioxide baths and water training, in contrast to the control group, there was an improvement in the clinical condition, hemodynamic parameters, normalization of sympathicovagal balance and body composition. Conclusion. The aquatic therapy program in the pool and the use of HCV led to an improvement in the patients ‘ psychoemotional state, improvement of central and peripheral hemodynamics, and sympathico-vagal balance, which is associated with a reduced risk of developing CVD.

Rodent General Anesthesia Suitable for Measurement of Experimental Invasive Hemodynamics

In cases of experimentally performed invasive rodent cardiovascular measurements, selected general anesthesia for a non-recovery procedure and its proper pain control plays a fundamental role in obtaining good data recordings. Rodent anesthesia is challenging for several reasons including high metabolic rate with elevated possibility of hypothermia and hypoglycemia during the procedure, large body surface area to adjust drug medication and anticipate drug clearance. In this review article, suitable analgesia, and anesthesia to collect rodent hemodynamics is discussed with examples of commonly used methods and anesthetic combinations to assess rodent hemodynamics. In case of injectable anesthesia, hemodynamic parameters should be measured when HR and mean arterial pressure (MAP) becomes stable. If re-injection is necessary, re-evaluation of HR and MAP is crucial for data integrity. Likewise, to safeguard data quality, longitudinal collection of HRs, HR variability, MAP and body temperature should be provided. For this reason, creation of a rodent hemodynamic anesthesia protocol might be necessary. In many cases, to refine surgical anesthetic protocol suitable for hemodynamic study, pilot experiments might be required to find the correct dose, and to probe for adequacy and duration of anesthesia, anticipating technical and procedural problems. Additionally, ensuring repeatability of the hemodynamic exam, selected experimental anesthetics should not be extensively metabolized. If metabolized, the effects on central and peripheral hemodynamics (HR, pre, afterload and contractility) should be well-known and documented.

PERIPHERAL HEMODYNAMICS PECULIARITIES IN YOUNG AND MIDDLE-AGED MEN WITH A RECIDIVATING MYOCARDIAL INFARCTION

Relevance. Hemodynamics changes in recidivating myocardial infarction and early postinfarction angina are not well understood. In recent years, the frequency of these complications has been increasing. Aim. To evaluate peripheral hemodynamics changes in men under 60 years old with recurrent myocardial infarction and early postinfarction angina to improve prevention and outcomes. Material and methods. The study included men aged 19-60 years old with type I myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with recurrent myocardial infarction - 102 patients; II - control, without it - 541 patients. A comparative assessment of hemodynamics changes in first 48 hours (1) and the end of third week disease (2), also risk analysis of recurrent ischemia and poor outcome in selected groups were performed. Results. The study group was distinguished by a high level of total peripheral resistance1 (2055.5±965.2 (dyn×sec×cm-5)) from the control (2055.5± 965.2 (dyn×sec×cm-5); p=0.02). In both groups, a decrease in the values of all indicators was noted (p<0.05). A more pronounced decrease in total peripheral resistance was found in the study group, and in the parameters of blood pressure and heart rate - in the control group. The values of total peripheral resistance1 ≥1600 dyne×sec×cm-5 were the markers of the risk of ischemia recurrence. Predictors of poor outcome are blood pressure levels1 (systolic <97; diastolic <70; mean <93.3 (mm Hg)); total peripheral resistance1 <1746.2 dyne×sec×cm-5 and heart rate (˃92 per min). Conclusions. Patients with recurrent ischemia are characterized by higher levels of total peripheral resistance in the first hours of myocardial infarction. For both groups, a decrease in all studied indicators is determined. The above values of hemodynamic parameters should be used in the formation of groups with a high risk of early recurrence of ischemia and an unfavorable outcome, as well as for prognostic modeling of these complications.

Analysis of hemodynamic parameters and quality of life in patients with chronic kidney disease and arterial hypertension

Purpose. The work is devoted to study the effects of antihypertensive, lipid-lowering and metabolic therapy in office and the average hemodynamic parameters, the parameters of central pressure in the aorta, vascular wall stiffness and quality of life in patients with CKD stage 3 in combination with arterial hypertension of 1-2 degrees, and without it. Materials and methods. Were examined patients with arterial hypertension of 1-2 degrees and CKD stage 3. Measured hemodynamic parameters with the help of a daily BP monitor “BPLab”. The quality of life of patients was assessed by the questionnaire MOS SF36. Results. The greatest changes in the indicators of central hemodynamics and vascular stiffness were noted in the group of patients with comorbidity. Conclusion. The combination of antihypertensive therapy (losartan and diltiazem) with meldonium and rosuvastatin significantly decreases indices of central and peripheral hemodynamics and vascular stiffness. Add meldonium part of therapy significantly improves the quality of life of patients.

Management of Disorders of Homeostasis With Saline Enteral Solution in Acute Poisoning With Psychopharmacological Drugs

Background. In acute poisoning, accompanied by a violation of the parameters of homeostasis, the problem of its management by the enteral route has been insufficiently studied.Purpose of the study. To assess the possibility of correcting electrolyte and volemic disorders of the body using an enteral solution (ER) in case of poisoning with psychopharmacological drugs.Material and methods. The study involved 120 patients who underwent intestinal lavage (IL) with ER on the 1st day in complex therapy. In the following days, 40 of them received infusion therapy, and 80 — drank glucose enteral solution (GES), 3–4 liters per day.Results. IL had a corrective effect on the electrolyte composition of the blood, volemic and hemorheological parameters, as well as on central and peripheral hemodynamics. The subsequent administration of GER had a stabilizing effect on these indicators, comparable to that of infusion therapy.Conclusion. In case of poisoning with psychopharmacological drugs, the use of saline enteral solution in the form of intestinal lavage and subsequent oral administration of the same solution in a daily volume of 3–4 liters, but with the addition of glucose, provides correction of impaired homeostasis indicators and may be an alternative to infusion therapy.

­Heart Failure with Preserved Ejection Fraction Diminishes Peripheral Hemodynamics and Accelerates Exercise-Induced Neuromuscular Fatigue

This study investigated the impact of heart failure with a preserved ejection fraction (HFpEF) on neuromuscular fatigue and peripheral hemodynamics during small muscle mass exercise not limited by cardiac output. Eight HFpEF patients (ejection-fraction: 61±2%, NYHA II-III) and eight healthy-controls performed dynamic single-leg knee-extension exercise [80% peak workload] to task-failure and maximal intermittent isometric quadriceps contractions (8×15-s, 20-s rest). Controls repeated knee-extension at the same absolute workload as the HFpEF. During knee-extension, leg blood flow was quantified using Doppler ultrasound. Pre- to post-exercise changes in quadriceps twitch-torque (ΔQtw, peripheral fatigue), voluntary-activation (ΔVA, central fatigue), and corticospinal excitability were quantified. At the same relative intensity, HFpEF (24±5W) and controls (42±6W) had a similar time to task-failure (~10min), ΔQtw (~50%), and ΔVA (~6%) (P>0.3). This resulted in a greater exercise-induced change in neuromuscular function per unit work in HFpEF, which was significantly correlated with a slower leg blood flow response time (r=0.77). Knee-extension exercise at the same absolute workload resulted in a ~40% lower leg blood flow and greater ΔQtw (56±15 vs 11±10%) and ΔVA (5±3 vs 0±2%) in HFpEF than controls (P<0.05). Corticospinal excitability remained unaltered during exercise in both groups. Finally, despite a similar ΔVA, ΔQtw was larger in HFpEF compared to controls during isometric exercise (-49±9 vs -23±2%, P<0.05). In conclusion, HFpEF are characterized by a greater susceptibility to neuromuscular fatigue during exercise not limited by cardiac output. The patients' compromised peripheral hemodynamic response to exercise likely accounts, at least partly, for the attenuated fatigue resistance in this population.