Endothelial dysfunction is a pathological state, which is characterized by progressive damage of endothelial cells and is accompanied by disturbances of their functions. Endothelial dysfunction is an important pathogenetic factor of various diseases. So, development of its diagnostic methods is of great need. At present, there are various methodological approaches to the assessment of endothelial dysfunction. The purpose of this review is to consider the advantages and disadvantages of modern methods of endothelial dysfunction diagnosis. In this article different non-invasive methods of peripheral macro- and microvascular reactivity assessment aimed at identification of changes in vasomotor endothelial function are discussed. The spectrum of endothelial dysfunction markers-various substances produced by endothelial cells or affecting them - is reviewed in the special section dealing with biochemical diagnostic methods. In this section of the article, biochemical markers are divided into groups according to the functions of endothelium and disorders they characterize. The results of studies showing changes of these markers levels in different diseases are presented. In addition, data regarding factors of endothelial damage, which can be used to predict the development and subsequent progression of endothelial dysfunction and cardiovascular risk are discussed. Special section is devoted to the possibilities of using cytological study of circulating endothelial cells to characterize processes of endothelial damage and regeneration as a morphological substrate of dysfunction. Review and systematization of currently existing methods for detection of endothelial dysfunction is necessary for optimization of diagnostic algorithms.

The article presents the results of a comparative analysis of morphological and functional indicators of microvessels as response to the cold exposure at Aboriginal and natives Europeoids of the North-East of Russia. It was found that the Europeoid subjects demonstrated the blood flow intensity in the arterial part of the capillaries and its weakness in the venous part as response to the local cold exposure, while the Aboriginal ones had no similar reaction. The latter proved to have reliably shorter length of the capillaries. Such characteristics, apparently, provides Aborigines with less heat loss from the skin surface and keeps their temperature homeostasis. All the findings testify that Aborigines have a more perfect mechanism of adaptation and maintenance of optimal blood circulation in the extremities under the cold exposure than the Europeoids who were born in the North and have resided there for a long time.

Aim. To estimate the functional state of microvascular skin vessels depending on the stiffness of the main arteries vascular wall in middle age group of persons with arterial hypertension (AH) of I-II degree. Subjects and methods. We examined 28 patients with essential hypertension of I-II degree (21 w.) aged 43-59 years. All patients underwent assessment of the target organ damage, sphygmography, laser Doppler flowmetry (LDF) with amplitude and frequency wavelet analysis and capillaroscopy. Patients were divided into 2 groups in terms of cardio- ankle vascular index (CAVI), which reflects the morphological rigidity of the main arterial vessels. Results. In 68 % of patients pulse wave velocity (PWV) exceeded age norm. Changes in arterial stiffness were found only in 32 % of cases when CAVI index was used. In the group with high CAVI LVMI, EDD were significantly higher, while there were no differences in IMT and atherosclerotic lesions in CCA. According to the LDF and capillaroscopy, in patients with increased stiffness of the main arteries a significant decrease in dilatator response to neuropeptides from the afferent nerve endings was found, and other parameters were not different. Conclusion. The data indicate that the majority of middle age patients with hypertension of I-II degree have high values of PWV, while using index CAVI that excludes the effect of blood pressure, only 32 % of patients have increased rigidity index. The stiffness parameters (PWV and CAVI) correlate with indicators of myocardial remodeling and degree of atherosclerotic lesions of the CCA. Patients with high CAVI demonstrated nonsignificant trend toward reduction of neurogenic and myogenic tone components of precapillary arterioles in the basal skin perfusion and decreased dilatator response to neuropeptides of nociception system.

This study included 151 patients with different variants of glomerulonephritis. The 1-st group consisted of 31 patients with hormone-sensitive nephrotic syndrome, the 2nd - of 95 patients with primary chronic glomerulonephritis and the 3rd - of 25 children with secondary glomerulonephritis in systemic vasculitis. The purpose of the study was to estimate state of hemostasis according to variant of glomerulonephritis. The common blood coagulation tests had been analyzed. Comparison with the results in the control group showed statistically significant signs of hypercoagulability only in patients of group 1 and 3. In patients with hormone-sensitive nephrotic syndrome, a statistically significant increase in coagulability measures was found. Conclusion. The study of hemostasis in patients with different variants of glomerulonephritis showed statistically significant signs of hypercoagulability only in two groups of patients primarily with hormone-sensitive nephrotic syndrome (group 1) and with secondary glomerulonephritis associated with systemic vasculitis (group 3).

The age turns off function of the ovaries and causes a complex set of changes in the neuroendocrine regulation of the human body. The main manifestation of these disorders is the development of postmenopausal syndrome. Reducing the level of sex steroids leads to disruption of neurotransmitter release in the subcortical structures of the brain that coordinates cardiovascular, respiratory, temperature reactions. The modified Cooperman index has been used for assessment of the degree of abnormalities. Along with this, changes in the microvasculature may also develop in the postmenopeusal women. The aim of the study was to evaluate modified menopausal Cooperman index and assess regulation of the peripheral blood flow in women with natural menopause of uncomplicated postmenopausal syndrome and during the treatment of post-menopausal syndrome of low degree. During the study, we examined 25 women with low degree postmenopausal syndrome before treatment and after 1, 2 and 3 months of treatment with phytoestrogen extract of Cimicifuga. As a comparison group, we examined 20 women with uncomplicated physiological postmenopause. We found that treatment resulted in significant decrease of Cooperman index and significant increase in peptidergic sensory regulation of peripheral blood flow.

A technique of wire insertion developed providing electrophysiological investigations of intramedullary tissues. Objective: to confirm that the technique developed provides registration of blood filling changes in tibial condyle subchondral part. The results of studying 22 patients at the age of 55.9±1.2 years with Degree II idiopathic gonarthrosis who underwent tibial condyle tunneling, and infusing autologous blood with bone marrow elements into the tunnels. Bipolar rheography used to register the changes in blood filling, and Dopplerography - to confirm the reliability of the results. As revealed, 3.5-4-fold decrease of inter-electrode distance in intramedullary tissues relative to paraosseous tissues provides study performance. Both, venous outflow disorders and the deficiency of arterial blood inflow in subchondral bone influence the manifestation of pain for gonarthrosis. The direct reaction to bone condyle tunnelization manifests itself as angiospasm in paraosseous tissues and limitation of blood inflow to paraosseous and intramedullary tissues, and that to autologous blood infusion into the wire tunnels - as angiospasm resolution and the increase of blood flow volumetric velocity.

Objective. To study the endothelium-dependent mechanism(s) of microvascular tone regulation using wavelet analysis of skin temperature fluctuations in patients with severe acute pancreatitis (AP). Materials and methods. 22 patients with severe AP were examined. The control group included 12 healthy individuals. Microcirculation was assessed using «Microtest» device (Perm, Russia) during contralateral cold test. The amplitudes of RMS oscillations were calculated in the endothelial frequency range in four time periods: before the cold test, during it, and within 3 and 6 minutes after it. Results. In healthy subjects the amplitudes of skin temperature oscillations significantly decreased during the test, and increased after exposure to cold. In severe AP the initial amplitudes of the skin temperature oscillations were lower than in healthy volunteers. There were no statistically significant changes to cold test and after it. The cluster analysis revealed 3 types of reactions of microcirculation. The first type is characterized by a decrease in the amplitudes of skin temperature oscillations during the cold test and recovery to baseline values within 3 minutes after it. The second type is characterized by a lack of reaction to cold exposure as well as after its completion. In the third type, the increase of oscillation amplitudes was observed in response to cold exposure and 3 minutes after it. Conclusion. Patients with severe AP have abnormally low activity of endothelium-dependent vascular tone regulation accompanied by severe disorders of vasoconstriction and vasodilation. Our study confirms the possibility of using wavelet analysis of low-frequency temperature fluctuations to study the mechanisms of microvascular tone regulation in patients with severe AP.

The aim of this study was to investigate the status and relationships the elements of stromal-vascular tubulointerstisial compartment (TIN) of the kidneys under IgA-nephropathy by analyzing clinical and morphological markers, including factor coefficient obstruction of the arteries. The study included 15 patients with confirmed morphologically diagnosis of IgA-nephropathy (IgAN). All patients were performed laboratory and pathological studies, including immunohistochemistry (α-SMA, CD31, PCNA, TGFβ-1) and quantitative/semi-quantitative assessment of pathohistopathological changes: atrophy of tubules (AT), local sclerosis (LS), perivascular sclerosis, sclerosed glomeruli (SG), the coefficient of obstruction (CO) arteries with a diameter greater than 100 microns. Serum creatinine was inversely negative correlation with CO (r=-0.83, p<0.05). and positive perivascular sclerosis (r=0.64, p<0.05). Correlation analysis of the values of CD 31 «+» and SMA in patients IgAN certified statistically significant positive correlation of morphometric parameters (r=0.53, p<0.05). This is confirmed by the same values and correlation analysis SMA and TGFβ (r=0.71, p<0.05) among themselves, as well as with the AT (r=0.77, p<0.05) and LS (r=0.77, p<0.05). The results indicate that the fibrotic processes in TIN under IgAN may be due not only to immune complex processes, but only to the changes in the structure of arteries, and thus the hemodynamic changes into the renal parenchyma.

Article describes changes in elastic skeleton of the aortic tunica media under modeling of different types of chronic stress. In the experimental study on male Wistar rats, two versions of the model of chronic stress were used: 1) by a two-week intraperitoneal administration of epinephrine (chronic adrenergic stress) and 2) anticholinesterase inhibitor neostigmine (chronic cholinergic stress). The authors have shown that in both cases of chronic stress there was a significant decrease of elastin content in the wall of the abdominal aorta, and the proportion of areas with elastin density ≥ 50 vol % after 2 weeks of administration of neostigmine was significantly less than after 2 weeks of administration of epinephrine, which suggests that elastin degradation is more pronounced in chronic cholinergic stress. Changes in elastic skeleton persist even 1 month after cessation of modeling of both types of stress. It was revealed that two-week introduction of angiotensin inhibitor enalaprilate simultaneously with epinephrine or neostigmine does not prevent changes in elastic skeleton of aorta. In both cases, statistically reliable reduction of elastin content was noted.