We analyzed the literature data on the role of coronary vessels’ sympathetic innervation in the regulation of the heart muscle blood circulation. We observed different effects of adrenergic influences on coronary circulation in conditions of normal epicardial arteries and in case of dynamic or organic coronary obstruction. We suggested a functional role of sympathetic influences on coronary circulation.

Lower extremity peripheral arterial disease (PAD) is a manifestation of systemic atherosclerosis and is recognized by the ankle-brachial index (ABI). PAD patients’ treatment addresses the relief of chronic leg ischemia and prevention of cardiovascular complications of atherosclerosis. The review describes the PAD patients’ management, and highlights the necessity of intermittent claudication effective treatment with regard to its causes. We discuss the medications used for its treatment and analyze the results of reported clinical trials of propionyl-L-carnitine effect on intermittent claudication signs and evaluated its safety. Since the therapeutic doses of propionyl-L-carnitine are safe and have a positive effect on PAD patients with cardiovascular risks, it should be considered to have high clinical relevance in case of intermittent claudication. The propionyl-L-carnitine is considered to be safe in short-term period but its long-term safety evaluation is waiting for further researches. 

The problem of cellular aging is a key one in determining the mechanisms of organism aging and the development of ageassociated diseases. The study of the cause factors of the endothelial cellular aging program activation is an important aspect of expanding preventive anti-age technologies aimed at slowing down this process and reducing the risk of cardiovascular system diseases. This review highlights current ideas about the factors of endothelial cell aging and the role of endogenous changes in the homeostasis of endothelial cells, their precursors, and the microenvironment. Cell cycle dysregulation, mitochondrial dysfunction, changes in protein homeostasis, depletion of the endothelial progenitor cells pool and changes in the regulation of apoptosis and autophagy programs are considered as mechanisms of endothelium aging.

Introduction. The role of polyclonal free light chains (pFLC) of immunoglobulins in glomerular diseases is still unknown despite the fact that their elevation predicts a poor prognosis in patients with chronic kidney disease (CKD). One of the possible persuasive mechanisms is the formation of low-grade inflammation which could be the reason for endothelial dysfunction and progression of a cardio-renal continuum. The aim was to estimate the possible association between serum FLC and several parameters of cardiac remodeling in the glomerulopathic patients’ cohort. Materials and methods. We examined 97 patients (51 men and 46 women, average age 48±14,6 years) with biopsy-proven glomerulopathies. We used Freelite (Binding Site Ltd, UK) to measure serum pFLC and other clinical and echocardiographic parameters. We calculated the glomerular filtration rate (eGFR) using the 2021 CKD-EPI Creatinine equation. We also performed echocardiography to measure some parameters of cardiac chamber remodeling. Results. Mean eGFR was 46.8 ml/min/1.73 m2 (28.7–80.0), the FLC-kappa level was 27.4 mg/l (16.8–48.4), the FLC-lambda level was 28.2 mg/l (20.8–43.3). The reference levels of FLC in the group were exceeded in 65 % for FLC-kappa and in 54% for FLC-lambda patients. A nonparametric Mann–Whitney U-test was performed to compare the effect of pFLC levels on the parameters of LV and LA geometry. If levels of FLC-kappa were higher than 19,4 mg/l, the left ventricular myocardium mass index (LVMMI) was statistically significantly bigger (99,9±31,2 g/m2  versus 138,3±30,2 g/m2 , р=0,022). If levels of FLC-lambda were higher than 26,3 mg/l, LVMMI was also bigger (104,0±36,6 g/m2  versus 136,2±64,8 g/m2, р=0,023). The left atrium (LA) volume index was also statistically significantly bigger at higher levels of FLC-lambda (33,8±8,0 ml/m2 versus 40,3±11,6 ml/m2, р=0,031). The Spearman analysis has shown statistically significant correlations between FLC levels, LVMMI and LA volume index. Conclusion. The serum pFLC level reflects the grade of local tissue immune inflammation and endothelial dysfunction. The obtained data indicate the involvement of pFLC in cardiac remodeling mechanisms as one of the important stages in the cardiorenal continuum in all types of glomerulopathies. 

Objective. Evaluation of differences in the values of the recorded perfusion parameters of two structurally different LDF devices in a group of healthy people of working age. Materials and methods. The study included 53 relatively healthy volunteers (m/f – 30/23) of working age (43±9 years). The study of microcirculation was carried out in the supine position on the back surface of the left forearm, simultaneously with two LDF devices: a LAKK-02 device with a fiber-optic data transmission and reception probe and a portable LAZMA-PF analyzer. The study included measurement of basal perfusion, respiratory constrictor test (DP), constrictor test with venous occlusion (VO), and dilator test with arterial occlusion (AO). Results. Relative to the stationary variant, the portable device demonstrates statistically significant differences, namely, higher values of the tissue perfusion level – 4.27 [3.82; 5.54] PU and 3.44 [3.03; 4.11] PU, respectively, as well as the amplitude of respiratory fluctuations in blood flow 0.08 [0.06; 0.13] PU and 0.07 [0.06; 0.09] PU, and lower values of the amplitude of pulse oscillations 0.22 [0.19; 0.26] PU and 0.26 [0.2; 0.31] PU and constrictor activity of microvessels in DP – 21.5% [19.2; 29.4] and 40% [29; 51] and VO – 27% [20; 33] and 47% [42; 56] respectively. The statistical significance of differences in values (p<0.05) was confirmed by One-way ANOVA. For a more complete understanding of the results obtained, a numerical simulation of the propagation of optical radiation of two devices in the skin was carried out. The simulation results showed that the probing volume of the skin and the penetration depth of the radiation in a portable device are greater than in a device with a fiber optic probe. The results obtained suggest the predominance of the venular link of the skin microvasculature in the formation of the reflected signal in the portable version of the LDF device compared to the device with a fiber optic probe. Conclusion. The wavelength and design features of LDF devices affect the results of the study due to the different diagnostic volume of the skin, which is recommended to be taken into account in scientific and clinical work.

Introduction. Currently, there is an increase in a variety of dental pathologies in the acute and post-COVID periods. The mechanisms of periodontal disease development are not completely clear. The purpose of this study was to assess the state of the oral cavity and study the microcirculation of periodontal tissues in patients in the acute period of COVID-19 and in chronic generalized periodontitis (CGP) in a comparative aspect. Materials and methods. A clinical study includes patients with an acute course of moderate COVID-19 (n=29) and patients with CGP (n=27) in the acute stage. Methods include a clinical assessment of the state of the oral cavity and periodontal tissues, calculation of clinical indices, laser Doppler flowmetry (LAKK-02, (Lazma, OOO NPP, Russia)) and statistical data analysis. Results. In the acute period of COVID-19, the deterioration of the hygienic state of the oral cavity and the increase in index indicators are similar to the phenomena of the active inflammatory process in periodontal tissues in CGP but have lesser expression. With COVID-19, violations of the perfusion of periodontal tissues occurred with a decrease in the  microcirculation index by 22.2% (p<0.05), σ – by 27.5% (p<0.05) relative to the control values; with CGP, these violations are more significant. Disregulatory phenomena of microcirculatory disorders with COVID-19 are characterized by a decrease in the myogenic component of regulation with an increase in the influence of cardiac and respiratory rhythms. Conclusion. In the acute period of COVID-19, pathological changes in the state of periodontal tissues are associated with impaired microcirculation and are similar to those in CGP, with a difference in disregulatory mechanisms.

Introduction. There are very few modern studies on determination of the fourth ventricle volume using intravital visualization techniques in subjects at a specific age period considering their sex. Objective. To carry out a comparative analysis of IV ventricular volume in men and women of the first and second periods of adulthood, elderly age and old age. Materials and methods. We analyzed the results of magnetic resonance imaging studies of the brain of 196 patients (102 men and 94 women) divided into four groups. The I group consisted of 50 persons of the first period of mature age (21–35 years); the II group included 52 persons of the second period of mature age (36–59 years); in the III group, there were 50 elderly persons (56–74 years) and 44 senile persons (75–88 years) were in the IV group. We used 3D reconstruction mode to determine the volume of the fourth ventricle. Results. The analysis of the results of the study revealed a statistically significant increase in the parameters of ventricular IV volume from the first period of adulthood to old age. Thus, ventricular IV volume increased by 30.3% in men and by 30.5% (p<0,01) in women from the first period of adulthood to the second period of adulthood. From the second period of adulthood to old age, IV ventricular volume measures increased by 35.3% in men and by 35.0% in women (p<0.01). Finally, from old age to senile age, the volume values in men increase by 21.1% and in women by 20.9% (p<0.01). When comparing volume parameters of IV ventricle between samples of both sexes there were no statistically reliable differences. At the same time, we can see a tendency of prevalence of volume parameters in men in every studied age period in comparison with women (p>0.05). Conclusion. Thus, the data obtained can become a certain age «benchmark» in the context of personalized medicine when using various intravital methods of studying brain structures, such as magnetic resonance imaging or computed tomography, serving as a starting point for further research work.

Introduction. Investigation for genetic determinants of cardiovascular diseases takes an important place in the concept of personalized medicine. Objective. To evaluate the effect of Arg72Pro (rs1042522) polymorphism TP53 gene on long-term prognosis in patients with coronary artery disease (CAD) undergoing coronary artery bypass grafting (CABG). Materials and methods. 89 patients with stable CAD and multivessel coronary artery disease (CA) were included in the study. The first sample was 61 people who were carriers of the Arg/Arg and Arg/Pro variants. The second one was 28 people who had the Pro/Pro variant. Patients were evaluated for myocardial remodeling, quality of life, as well as clinical data for the 18-months follow-up period. Results. In carriers of the Arg/Arg and Arg/Pro variants of the TP53 gene, during the follow-up period, we obtained elevation of end-diastolic volume (EDV) and end-systolic volume (ESV) of left ventricle (LV) in the first sample: 104.4 ± 4.2 ml and 45.8±3.5 ml, one year after CABG – 113.3±5.6 ml and 52.4±4.7 ml respectively (p<0.05). Negative dynamics of EDV and LV ESV in patients of group II were not observed. Quality of life by Minnesota scale before CABG in cohort I was 27.3±2.4 points, in 18 months after – 22.6±2.1 (p=0.126). In group II: 32.8±1.9, 1,5 years later – 20.9±2.2 points (p<0.001). Acute decompensation of chronic heart failure (ADHF) in the long-term follow-up period in group I occurred in 19 (32.2 %) patients, while in group II – in 3 persons (10.7 %) (OR 3.96; 95 % CI: 1.06-14.76; p=0.036). Conclusion. Patients with the Arg/Arg and Arg/Pro variants of the TP53 gene demonstrated progression of LV remodeling, as well as a 4-fold increased risk of ADHF within 18 months after CABG. In patients with the Pro allele, quality of life after CABG improved.

Introduction. Type 2 diabetes mellitus (DM2) and chronic obstructive pulmonary disease (COPD) are common and socially significant diseases. Endothelial dysfunction in both diseases plays an important role in the progression of changes in the vascular bed of the lungs and the development of irreversible changes in the parenchyma. Objective. The aim of the study was to determine the features of microcirculation disorders in the lung tissue using a single-photon emission computed tomography in patients with a combination of chronic obstructive pulmonary disease (COPD) and type 2 diabetes mellitus and patients with type 2 diabetes mellitus (DM2). Materials and methods. The work analyzed clinical and laboratory data, indicators of respiratory function, the results of computed tomography, and the single-photon emission computed tomography of the lungs in patients with COPD in combination with type 2 diabetes (39 people) and type 2 diabetes (32 people). Parametric and nonparametric methods of analysis were used for statistical analysis. Result. The features of impaired lung parenchyma perfusion in the described groups of patients were revealed. The discrepancy between the extent of changes detected by radionuclide study and computed tomography of the chest in patients with a combination of COPD and type 2 diabetes is described. The relationship between a decrease in DLCO and the presence of subsegmental perfusion defects was revealed in patients with a combination of COPD and type 2 diabetes. In addition, the number of irregularly shaped defects significantly negatively correlated with FEV1/VC in patients with a combination of COPD and T2DM, which is probably a manifestation of perfusion disorders caused by bronchial obstruction. Conclusion. Microcirculation disorders correspond to different structural changes and are detected at the initial stages of COPD and DM2. When COPD and DM2 are combined, microcirculation disorders have a significantly greater extent than areas of emphysematous altered lung tissue, and they are a reflection of micro- and macroangiopathy.

Introduction. Microcirculatory disorders accompany all stages of inflammatory periodontal diseases and their correction is one of the challenges in periodontitis complex therapy. Considering the significance of antibiotic therapy in the treatment of oral cavity inflammatory diseases, the scientific and practical interest lies in studying the possibilities of using a system for targeted delivery of antibacterial agents, as well as its influence on the periodontal tissues microcirculation.The aim of the study is to investigate the effect of a gel containing alginate microcapsules with silver nanoparticles (AgNP) loaded with metronidazole on the state of the gum’s microcirculation in animals with experimental periodontitis. Materials and methods. The study was conducted on 40 white rats. The experimental design involved dividing all animals into several groups: the control group included rats with intact gums; the comparison group were animals with experimental periodontitis; the placebo group were rats with experimental periodontitis treated with a gel containing microcapsules with AgNP but without active components; the experimental group included animals with periodontitis which received applications of the gel containing AgNP microcapsules loaded with  metronidazole. Periodontitis was modeled by the ligature method by suturing a multifilament non-absorbable thread in the gum area of the lower jaw incisors. The state of periodontal microcirculation in all presented groups was assessed on the 21st day of the experiment after the ligature removal, using laser Doppler flowmetry. Results. In experimental periodontitis in white rats, the pronounced microcirculatory disorders occur on the 3rd week, manifested by an increase in the perfusion index by 37% as well as an increase in amplitudes of endothelial, neurogenic, myogenic, respiratory, and cardiac perfusion fluctuations compared to the intact control. The gel containing only AgNP microcapsules in rats with periodontitis reduces the perfusion index by 23.9%, without influence on the impaired parameters of active and passive modulation of gingival blood flow. Loading metronidazole into microcapsules with AgNP increases the effectiveness of the gel in the correction of the perfusion index by 6.7% of the amplitudes of myogenic and respiratory fluctuations by 26.8% and 19.8% compared to the analogue without active components. Conclusion. The gel containing microcapsules with AgNP and metronidazole is more effective in restoring gingival perfusion, reducing the amplitudes of myogenic and respiratory oscillations, compared to the analog without active components.

The aim is to evaluate the diagnostic and prognostic capabilities of capillary blood flow parameters on an experimental model of acute respiratory distress syndrome (ARDS) with subsequent analysis of hemorheological and hemostasiological parameters as the main factors affecting the effectiveness of microvascular perfusion. Materials and methods. The work was performed on 30 Wistar male rats. The ARDS model of mild severity was reproduced by intratracheal administration of Salmonella enterica lipopolysaccharide at a dose of 20.0 mg/kg. Lipopolysaccharide at a dose of 30.0 mg/kg was used to reproduce severe ARDS. On day 2 after exposure, the rats underwent computer capillaroscopy of the periarticular rollers after which venous blood samples were taken from the animals to determine the level of C-reactive protein and to study hemorheological parameters and parameters of coagulation hemostasis. In order to assess the severity of edema, the mass coefficient of the lungs was calculated. Results. At ARDS, capillaroscopy of the periarticular rollers in rats revealed a decrease in blood flow rate by 34.67 % (p<0.05) in the arterial part of the capillaries, a tendency to spasm of arterioles and expansion of venules, as well as the presence of intravascular aggregates. In addition, all experimental animals showed an increase in blood shear yield stress, and an increase in the content of fibrinogen, soluble fibrin-monomer complexes and C-reactive protein (p<0.05). No significant changes in capillary blood flow indices were observed in ARDS of varying severity. However, the parameters of blood shear yield stress, antithrombin activity and hematocrit had a sufficient level of prognostic ability (AUC>0.8; p<0.05). Conclusion. Indicators of capillary blood flow in combination with hemorheological and hemostasiological parameters can be used in conducting preclinical studies of the effectiveness of drugs aimed at correcting systemic dysfunction of microcirculation including experimental ARDS.