Endothelial dysfunction is considered as a universal non-specific link in the pathogenesis of many diseases, primarily the cardiovascular system. This review is devoted to the discussion of the main functions of the endothelium and mechanisms for their implementation. One of the most striking features of endothelial cells is their morphological heterogeneity, which allows us to identify several typical forms of endothelial dysfunction (vasomotor, hemostatic, adhesion and angiogenous). Also, the review presents the most promising predictors of cardiovascular diseases and their complications among endothelial damage markers.

We compare the short- and long-term efficacy of endovenous laser oblitetation (EVLO) using a radial fiber with radial emission versus combined phlebectomy for the surgical treatment of varicose vein disease of the lower extremities. Participated 58 patients (46 females, 12 males) with ages ranging between 24 and 75 years with varicose vein disease of the lower extremities affecting the great saphenous vein (GSV) were prospectively enrolled in this observational trial. Patients were randomized to receive either combined phlebectomy - first group - 29 patients (33 extremities) or endovenous laser obliteration using a radial fiber-second group - 29 patients (36 extremities). A total of 69 extremities with functional classes C2 - 28 (40.58 %) cases, C3 - 30 (43.48 %) cases and C4 - 11 (15.94 %) cases according to CEAP classification were treated. Post-treatment CIVIQ-2 Questionnaire and VCSS scale, physical examination, duplex angioscan was conducted at 1st day, 1 week, 12 and 36 months later. The frequency of recurrence was assessed at one and three years after the surgery. 2nd group is characterized by higher quality of life in postoperative period. 100 % ablation in group with EVLO and 93.1 % - with combined phlebectomy. The frequency of recurrence presenting with new visible varicose veins was noted through 3 year in 8 patients (9 extremities) (34 %) from first group and in 4 patients (6 extremities) (21 %) from the second of 80 % examined patients. Endovenous laser obliteration has significant advantages in short-term efficacy: lower post-procedure pain, quicker rehabilitation period, possibility to carry out in outpatient settings, higher quality of life in long-term efficacy, lower frequency of recurrence.

Introduction. 7-33 % of women and 4-5 % of men have low blood pressure. Hypoperfusion of human s organs reduces the quality of life leading to myocardial malnutrition, and is associated with increased blood viscosity. The maintenance of a comprehensive study of the mechanisms of keeping blood pressure in the early stages of arterial hypotension effects on the body is of big interest. The aim of the research is to study the structural - functional characteristics of the myocardium and blood rheology of young women with low blood pressure. Material and methods. The object of the study were young women (age 19-23 years). Test group: 31 people with systolic blood pressure of 98 mm Hg and lower; Control group: 25 people with systolic blood pressure 120-129 mmHg. Study Type - single-step. Methods used: echocardiography, blood viscometry, quantitative analysis of hemogram and morphology of red blood cells. The test and control groups were similar in age, height, heart rate, blood volume circulating. Results and discussion. Women test group had a lower weight, a smaller thickness of the rear wall of the left ventricle to systole and septum to systole and diastole (p = 0.00-0.03). There were no difference between groups in the parameters of cardiac hemodynamics, minute volume of blood, quantitative indicators hemogram, blood viscosity, aggregation and deformability of red blood cells. In the test group, percentage poikilocytosis (23 %) is 4.5 times higher compared with the control group (5 %), p = 0.00. In the test group PWTs is correlated with blood viscosity at a shear rate of 20 s-1 (r = -0.38), the number of leukocytes (r = -0.36), red blood cells (r = -0.37), hemoglobin (r = - 0.44), hematocrit (r = -0.45), in the control group is correlated with erythrocyte aggregation index (r = -0.43), p <0.05. Conclusions. Reduction of the left ventricular wall thickness of young women with idiopathic arterial hypotension does not reduce minute volume of blood, but negatively correlates with blood viscosity and hematocrit. Young women with idiopathic arterial hypotension lack compensatory increase in blood viscosity. Being present increasing poikilocytes in the test group is a predictor of increasing the viscosity of the blood, which in course of time can lead to aggravation of perfusion abnormalities.

Pulmonary thromboembolism, combined with bronchial obstruction is the most difficult in the diagnosis, because it can be presented as a combination of unventilated and not perfused areas and this disorders can occur in the acute phase of embolism, and also in long-term period after the onset. Aim: To evaluate influence of different disorders of blood circulation in the lungs on the development of bronchial obstruction in patients with different forms of PE. Material and Methods: We analyzed of the results of radiological methods: perfusion scintigraphy, single photon emission computed tomography using the combined technology (SPECT-CT) and multislice computed tomography - high-resolution computed tomography (VRKT), functional tests, multislice computed tomography angiography (MSCTA) in 250 patients (without concomitant pathology of bronchopulmonary system) suspicious of pulmonary embolism. Results and conclusions: Bronchoconstriction in patients with pulmonary embolism of small branches pulmonary artery increases severity of the disease. Analyzing the patients data we founded out that distinct clinical effect was achieved only with additional treatment with bronchodilators. In chronic course of the pulmonary embolism development of emphysema was detected, at first local - in ischemic segments, then involving the adjacent lung regions. In this case, the severity of the disease is caused not by embolism itself, but also because of development of persistent bronchial obstruction. These changes are considered as «postembolic pulmonary disease», and determine severity of perfusion and ventilation dysfunction.

Introduction. Pseudoexfoliation syndrome (PEX) is a relatively widespread generalized age-related disease, in which abnormal fibrillar extracellular material is produced and accumulates in many tissues including vessels. Glaucoma occurs more commonly in eyes with PEX than in those without it. Episcleral venous pressure (EVP) is an important determinant of intraocular pressure (IOP). It seems reasonable to evaluate episcleral venous pressure in patients with PEX. Purpose. To evaluate episcleral venous pressure in patients with PEX. Methods. 540 eyes of 270 patients were enrolled in the prospective study. We evaluated episcleral venous pressure. Results. EVP in total vein compression in lower-nasal quadrant (mmHg) in main group(with PEX) was 14.0±3.29, in control group No. 1 (non PEX, adults) - 14.38±3.77, in control group No. 2 (non PEX, young) - 10.91±2.34. EVP in total vein compression in lower-temporal quadrant (mmHg) in main group was 15.1±3.31, in control group No. 1 - 15.76±3.45, in control group No. 2 - 11.00±2.16. Difference in episcleral venous pressure between main group and age-matched control group No. 1 was not significant, and between main group and control group No. 2 was significant. Conclusion. EVP level is not influenced by PEX, but is influenced by age.

The purpose of this study was to explore the relationship between the level of C-reactive protein and fibrinogen, and indices of cognitive function in patients with metabolic syndrome. As a result of this study, it was demonstrated that patients with metabolic syndrome and cognitive impairment compared with the group without cognitive disorders was higher parameters of inflammation. The increase in C-reactive protein was associated with reduced memory and increased speed of reaction and ability to concentrate, whereas an increase in fibrinogen levels was associated with lower indicators of the processes of storing, preserving and reproduction of information, logical memory and orientation in time and space. Activation of inflammation could reflect one of the possible pathophysiological mechanisms that affect the development of cognitive deficits in patients with metabolic syndrome.

Cardiovascular diseases are the leading cause of disability and mortality in Russia, which determines the topicality of investigations devoted to risk factors of their development and progression. Considering the complex physiological regulatory mechanisms of the circulatory system, that cause circadian changes of its functioning, light-induced desynchronosis may act as one of the risk factors for cardiovascular disease. The aim of this study was to investigate the effect of light desynchronosis on the microcirculation in white rats. Materials and methods. The study was carried out on 20 white male rats, which were divided into two groups: experimental - 10 rats exposed to the change light-mode and control - animals in natural light-mode. Microcirculation was measured by laser Doppler flowmetry. Main results. At the stage of temporary mismatch (the first day of the experiment) microcirculation disorders were mild and manifested by a moderate increase in myogenic tone, which did not lead to significant perfusion shifts. The decrease of skin perfusion was found at the stage of regulatory violations of light-induced desynchronosis, that was accompanied by changes of both passive and active flow modulation mechanisms intensity. Skin perfusion decrease was maintained up to 21st day of the experiment and at the stage of structural defects was accompanied by a marked inhibition of the total blood flow modulation due to reduction of endothelial, myogenic, cardiac and respiratory oscillations. Conclusions. Light-induced desynchronosis causes the microcirculatory disturbances occurrence and gradually development in association with violation of neurogenic and myogenic microvascular tone, as well as endothelial dysfunction. The progression of these disorders reflects its negative influence on the circulatory system regulatory mechanisms that suggests consideration of light-induced desynchronosis as a risk factor for cardiovascular disease.

A flap on the basis of the superficial inferior epigastric artery (SIEA) extended cranially was formed in 24 rats and replanted after 90-minute femoral artery clipping at the point of SIEA embranchment. Mexidol was injected intramuscularly 30 or 60 minutes before the operation with repeated injection in 2 hours after it (E1 or E2 groups). Control (C) - injections of physiological solution. Methods: ultrasound flowmetry, computer-assisted planimetry of digital images of outer and inner flaps surfaces, histomorphometry, immunohistochemistry. 12 days after surgery in E1 and E2 the per cent area of epidermal defects significantly smaller than in C. The vascular pattern in inter-angiosome zone provide evidence that in E2 the intussusceptive mechanism of angiogenesis was predominant, resulting in increased in comparison with placebo and E2 capillarity of skin vascular plexuses, better liability of skin appendages and hypodermal fat tissue.

Introduction and purpose. Disorder of coronary vessels' tone regulation is an important pathogenetic mechanism of diabetic macro- and microangiopathies. Evaluation of delicate mechanisms of such disorders will favour development of new approaches which may decrease patients' mortality rate from cardiovascular catastrophes. The aim of the research is to estimate of the role of nitric oxide produced by inducible NO-synthase in the mechanisms of regulation of the K_ATP- and BK_Ca-channels of coronary vascular smooth muscle cells in streptozocin-induced diabetes mellitus in rats. Material and methods. Diabetes mellitus was reproduced in female rats with single injection of streptozocin intraperitoneally (50 mg/kg). Coronary vessels' tone and myocardial contractility were investigated on isolated with Langendorff's method hearts. Activity of iNOS was blocked with S-methylisothiourea (S-MT, 10^-6M); K_ATP- and BK_Ca-channels - with glybenclamid (10 μM) and tetraethylammonia (1mM), respectively. Expression of iNOS and eNOS in the myocardium was detected with immunohistochemical method; concentration of the stable products of NO degradation (NO^2-/NO^3-) was determined spectrophotometrically; concentration of iNOS, eNOS, and IL-1β was detected with enzyme-linked immunosorbent assay; concentration of C-reactive protein was estimated with immunoturbidimetric method. Results. Experimental diabetes mellitus results in a decrease of coronary vessels' tone and myocardial contractility and a poor sensitivity of vascular smooth muscle cells to the blockers of their ion channels glybenclamid and tetraethylammonia. These changes associate with hyperproduction of IL-1β, increased lipoperoxidation in the blood and enhanced both expression and activity of iNOS. Oxidation and/or nitrozilation of sulphhydryl groups of redox-sensors in the molecules of the K_ATP- and BK_Ca-channels of the coronary vascular smooth muscle cells during experimental diabetes mellitus may be one from the number of pathogenetic mechanisms of the channelopathy. Conclusions. The functional activity of the K_ATP- and BK_Ca-channels of the coronary vascular smooth cells is significantly impaired in parallel with activation of iNOS in rats with experimental diabetes mellitus.

Current recommendations to develop new pharmacological agents influencing hemostasis system are limited to the studies carried out on healthy volunteers in vitro, healthy lab animals and animals with model thrombosis in vivo. However, specific and seasonal peculiarities of hemostasis system in laboratory animals may not always adequately represent processes that occur during an event of cardiovascular accident. In this context, the main objective of this work is to study hemostasis system in patients with thrombotic events and to use the received data as a model for assessing the effectiveness of pharmacological agents as exemplified by aspirin and pentoxifylline in ex vivo. Experimental work is carried out on the blood of healthy male donors and patients with acute thrombosis. The findings show that completed thrombosis in one of the regions of coronary blood stream is not always accompanied by systemic tension of the coagulation system. The method of polyregional thromboelastography was used to study hemostasis system and to find out that hyperaggregation of platelets is a responsible part in the development of system hyperactivity of hemostasis in cases where it is registered. Pulmonary embolism, mesenteric ischemia and acute coronary syndrome is most often accompanied by systemic hyperaggegatioin of platelets, which can be used to assess the therapeutic efficacy of medicaments under conditions ex vivo. Aspirin and pentoxifylline are taken as examples to prove the necessity of preclinical studies for potential correctors of hemostatic system aimed to assess therapeutic effectiveness under conditions ex vivo in patients with completed thrombosis.