The purpose of this review is to increase the awareness of the experts about the multifaceted role of thrombin in the development of complications after percutaneous coronary intervention: restenosis and stent thrombosis. Here we present the analysis of clinical data obtained from 1990 to 2014, dealing with the study of basic mechanisms of thrombin action after angioplasty and coronary stenting, as well as the characteristics of the laboratory evaluation of thrombin generation and new antithrombotic drugs that block its activity. The article presents not only the original data, but also the personal view of the authors on the problem. The above information can be used in the learning process, as well as for the formation of new research directions and practical recommendations for physicians.

Restrictive cardiomyopathy (RCMP) is characterized by the isolated diastolic ventricular dysfunction due to increased myocardial stiffness. Animal models of RCMP include the models of acquired and hereditary RCMP as well as the models in large animals. Acquired RCMP is observed in exogenous iron overload, radiation-induced myocardial fibrosis, eosinophilic myocarditis, systemic sclerosis, and amyloidosis. Genetic models of RCMP mimic clinical scenarios of hereditary hemochromatosis and sarcomeric protein mutations. A new approach to modeling RCMP is genetic modification of fruit flies. There are several critical characteristics of successful animal model of RCMP: 1) severe increase in left ventricular end-diastolic pressure in response to volume load; 2) increased ventricular stiffness in the in vitro settings; 3) biatrial enlargement; 4) lack of left ventricular dilation and advanced myocardial hypertrophy.

Introduction and aim. Hypertension leads to vascular remodeling, due to change its geometry and functional properties. The aim of the study was to investigate of gender specifics of the remodeling of suprarenal and infrarenal parts of the abdominal aorta in hypertension. Materials and Methods. A total of 147 patients (76 men and 71 women aged 35-68 years) with normal blood pressure and hypertension 1-3 degree based in the trial. Using duplex sonography was studied by changing of the diameter and of the wall thickness of the suprarenal and infrarenal aorta. Using tissue Doppler imaging has been evaluated time and velocities values of the front and back walls motion of the aorta. Results and discussion. The values of systolic - diastolic increase of the diameter and the thickness of the wall of the abdominal aorta, Young's incremental elastic modulus, circumferential wall stress, the peak velocities of the front and back walls motion of suprarenal and infrarenal aorta are obtained in the surveyed categories of persons based on sexual differences of the indicators analyzed characteristics. Conclusions. The remodeling of the suprarenal and infrarenal aorta begins in the men at an arterial hypertension of the 2nd degree and is manifested by increased stiffness, circumferential walls stress and reduce velocities values of the front and back walls motion of the aorta. Thickening of the walls of the abdominal aorta in men is an adaptive re-sponse to increase of the wall stress, begins in the men at an arterial hypertension hypertension of the 3rd degree, later than women. Therefore, the risk of the aortic dissection is above in men in the hypertension. The suprarenal aorta is practically not susceptible to pathological remodeling in the women in the increase of the blood pressure Opposite, at an arterial hypertension of the 2nd degree the thickening of the walls of the infrarenal aorta reduces the risk of the aortic dissection in the early stages of hypertension.

Introduction and purpose. The aim of investigation was to evaluate the possibility of using the method of wavelet analysis of skin temperature during the local heating test for the study of the microvascular tone regulation in patients with diabetic foot syndrome (DFS). Materials and methods. The study was performed in 15 healthy subjects and 10 patients with neuro-ischemic form of DFS complicated by trophic ulcers. The temperature of the plantar surface of the hallux was recorded by «Microtest» (Perm, Russia) with temperature resolution 0,002°C. Time-frequency analysis of temperature fluctuations was performed using wavelet analysis. For the reconstruction of the oscillations in endothelial (0.02-0.0095 Hz), neurogenic (0.05-0.02 Hz) and myogenic (0.05-0.14 Hz) frequency ranges we used inverse wavelet transform. Results. In healthy people, indexes of vasodilation (relative changes in the oscillation amplitudes) in the myogenic, neurogenic, and endothelial frequency ranges were 3.04, 4.01 and 2.25 respectively. In patients with DFS the values were significantly lower than in healthy subjects (0.60, 0.67 and 0.51, respectively). Conclusion. In contrast to healthy subjects, the combination of diabetic polyneuropathy with endothelial dysfunction and macroangiopathy in patients with neuro-ischemic form of DFS leads to the progression of mutually aggravating pathological processes and lower limb ischemia. Further implementation of the local heating test at the early stages of diabetic foot is of interest for the prognosis of the disease, evaluating the effectiveness of conservative treatment and endovascular interventions.

In the present article, we discuss the problem of cerebrovascular diseases as one of the most important in social terms. The mechanisms of occurrence and epidemiological parameters characterizing the problem as a whole are presented. The article summarizes the main beam techniques such as angiography, magnetic resonance imaging, ultrasound duplex scanning and X-ray computed tomography with bolus intravenous contrast infusion to allow a timely recognition of the disease. The strengths and weaknesses of different diagnostic tools are considered. The role of CT angiography as a primary diagnostic method is defined. CT angiography offers the advantage of getting comprehensive information about existing circulatory disorders. The case of rare congenital anomaly - hypoplasia of the common carotid artery and internal carotid artery aplasia in conjunction with an aneurysm of the anterior communicating artery, - is described in 58-year-old woman. The characteristics of this disease are discussed. We also present the results of a survey on such vascular anomalies, which is defined on the basis of the type of compensatory intracranial collateral flow. This observation is of particular interest due to the rare occurrence and the existing difficulties in the choice of treatment.

Aim. To investigate the effect of antihypertensive and neurometabolic treatment on the microcirculation in patients with arterial hypertension, coronary heart disease and cognitive impairment. Materials and methods. In total 60 patients with arterial hypertension (AH) of 2-3 stage, coronary heart disease (extertional angina I-II functional class) and mild cognitive impairment were randomized into two groups. In first group, patients were administered antihypertensive medication and course of Actovegin (Actovegin group) while in second group patients received only antihypertensive treatment (control group). Assesment of skin microcirculation by performing of capillaroscopy and laser Doppler flowmetry and assessment of cognitive function (Shulte table) were provided three times: 1 - before antihypertensive treatment correction, 2 - at reaching of target blood pressure (BP), 3 in 4-5 weeks after. Results. Adjustment of therapy led to appropriate blood pressure control in both groups without significant differences between them. Patients in Actovegin group had significant cognitive improvement (p<0.001), significant increase in amount of functioning capillaries (p<0.05), decrease in the degree of hydration of interstitial space (p<0.05) and reduced time of reactive postocclusive hyperemia (p<0.05) at the second and third timepoint. There was no positive changes in skin microcirculation nor cognitive functions in control group. Conclusion. Reaching of target BP did not result in cognitive improvement. Concomitant use of Actovegin and antihypertensive treatment did not influence BP level but led to the reducing of functional rarefication and latent water retention in tissues as well as to cognitive impairment.

Myocardial progenitor cells represent a perspective source for cell therapy of cardiovascular disorders and are intensively studied. However, mainly the cells from adult patients are studied whereas the cells derived from children with congenital heart diseases remained poorly investigated. The aim of the present work was to obtain progenitor cells from intraoperatively obtained cardiac tissue from infants and children undergoing repair of congenital cardiac defects. Following isolation, the cells gave rise to a clonogenic, highly proliferative spindle-shaped cell population. The cells expressed markers of cardiogenic origin and were shown to differentiate towards cardiogenic lineage. This resident myocardial progenitor cells obtained from infant myocardial tissue demonstrate similar characteristics to previously described cells derived from adult myocardial tissue. This study confirms the possibility of obtaining a pool of progenitor cells from tiny tissue fragments and opens a new perspective of using these cells in regenerative medicine and further research of congenital heart disease pathogenesis.

The purpose of the study. The estimation of biostimulating effect of skin flap autografting (SFA) on microcirculation in white rats in the condition of normal and impaired innervation. Materials and methods. The experiments were conducted on 5 groups of white rats: two comprison groups - the animals exposed to sciatic nerve neurorhaphy in the acute and delayed periods, and three experimental - animals with SFA in interscapular region without sciatic nerve damaging and together with acute and delayed neurorhaphy respectively. Skin microcirculation was analyzed by Lazer Doppler flowmetry (LDF). Results. After SFA intact animals show inflammatory changes in skin perfusion in the transplantation area that continue up to the 21st day of the experiment. At the same time there is micro bloodflow increase in the foot dorsum skin in the course of the first two weeks of the experiment. In the presence of sciatic nerve damaging there is decrease in skin perfusion and suppression of skin bloodflow neurogenic modulation in the innervation area detected on the 21st day post-neurorhaphy both in acute and delayed period. SFA conducted together with acute and delayed neurorhaphy normalizes skin perfusion in the innervation area of the damaged nerve. This effect is more frank for acute neurorhaphy. Expressed activation of bloodflow endothelial modulation is the attribute of biostimulating effect in delayed neurorhaphy. Conclusion. SFA has significant biostimulating effect on the microcirculatory bloodstream both in normal and impaired innervation. Biostimulating effect of skin flap on microcirculation in the presence of impaired innervation defines the opportunities of its application in the therapy of peripheral nerve damages.

The purpose of research is to learn the influence of β-endorphin on the functional activity indicators of the isolated heart of rat and to evaluate the role of opioid receptors. Materials and methods. The research was performed on isolated hearts of males nonlinear white rats. Perfusion of the heart was performed on the Langendorff System at constant flow. Register indicators are volume rate of coronary perfusion, perfusion pressure, the pressure in the left ventricle, pulse pressure, heart rate, speed of changing the pressure developed by the left ventricle. Additionally was calculated integral indicator minute performance of the left ventricle corresponding to the area under the curve of change of pressure in the left ventricle per a minute, index of contractile function and the integral indicator of the average performance of the left ventricle per one contraction. Results and discussion. It was identified depressant effect of β-endorphin in slightly declining trend to decrease of myocardial contractility indicators in a concentration range from 6.3x10^-10 to 6.3x10^-18 M. In the presence of a blocker of δ-opioid receptor naltrindole inhibitory effect of β-endorphin identified in isolated use, practically was not manifested. Thus, the peripheral δ-opioid receptors of cardiomyocytes mediate the decrease of myocardial contractility caused by β-endorphin using. Conclusions. β-endorphin in physiological concentrations has a depressing effect on functional parameters of the isolated heart of rat. Stimulation of δ-opioid receptors is one of the mechanisms leading to formation of the negative inotropic effect of β-endorphin as a component of local cardiac activity regulation.

Introduction and purpose. Active lymph flow ensured by the phase contraction of lymphatic vessels and nodes is regulated by humoral mechanisms. The role of atrial natriuretic peptide (ANP) in the modulation of lymph flow has been poorly studied. The goal of the study was to examine the effect of the ANP, which is released into the blood by increasing the volume of circulating blood, on the active transport function of lymphatic vessels and nodes. Materials and methods. The study was performed on isolated segments of bovine mesenteric lymphatic vessels with a diameter of 1.5-2.0 mm (n = 47) and the capsule strip lymph nodes (n = 42). The contractive function of lymphatic vessels and nodes was examined using the equipment for the study of isolated preparations with FORT-10 transducer. The data were processed in program Labmaster. Results and discussion. ANP (1-100 ng/ml) caused a dose-dependent decrease in frequency and amplitude of spontaneous contractions and tone of lymphatic vessels and nodes. The ANP-induced relaxation of lymphatic vessels and nodes was not modified by pretreatment with 5x10^-5 M L-NAME, 3x10^-6 M diclofenac sodium and 1x10^-5 M methylene blue. The relaxation, however, was significantly reduced by pretreatment with 1x10^-5 M glibenclamide. The mechanical removal of endothelial cells in the lymph vessels and nodes caused no significant effect on the ANP-induced relaxation. Conclusions. The results of the study show that ANP inhibits the transport of lymph by reducing the amplitude and frequency of the phase contractions and relaxation of smooth muscle of lymphatic vessels and nodes. The effect of ANP is endothelium-independent and is mediated by activation of plasmalemmal ATP-sensitive K⁺ channels of smooth muscle cells.

One of the most important aims of modern transplantation is the preservation of the morphofunctional state of donor organs for as long as possible time after removing them from the donor prior to implantation into a patient. To solve this problem, heart preservation solutions are used. However, despite the large number of prescriptions of preservation solutions, the time, limited to six hours, after removing donor heart is still a limiting factor in determining the possibility of implanting heart into a patient. In this study, cardioprotective effects of widely used in clinical practice preservation solution HTK and new Krebs-Henseleit buffer-based preservation solution were studied in the rat model of prolonged static cold storage. It was shown that new Krebs-Henseleit buffer-based preservation solution protected the heart significantly even after an eight-hour global ischemia and has the advantage over Custodiol in the infarct-limiting action.