Studying the regularities of organization of hemodynamic conditions in the heart cavities is a complex issue, since this organ has a complex geometric configuration and applying classical theories of hydrodynamics leads to significant contradictions, which are the object of discussion. Currently, researchers tend to vortex (tornado-like) organization of blood flow movement in the heart. A vortex organization is understood as a flow structure with circular or swirling movement of blood around a virtual central axis, which provides it with the ability to accumulate kinetic energy (KE) during swirling. At the same time, the swirling movement of blood should be distinguished from the turbulent one, which is characterized by the chaotic movement of vortices of different magnitudes and the dissipation of KE. The purpose of this review is to summarize the results and conclusions of studies on the anatomical mechanism of forming the conditions for the organization of swirling blood flow in the left ventricle (LV), as well as clinical evaluation and methods of studying swirling flows in patients.

This literature review is devoted to the possibilities of using in clinical practice a new modification of photoplethysmography – its web version. The use of modern innovative techniques in the form of photo/video fixation of the human skin allows for contactless and remote assessment of the main physiological indicators of human health. This approach is of particular importance in conditions of shortage of medical workers, territorial separation of doctors and patients, restrictions in visiting medical institutions in the event of epidemics/pandemics of infectious diseases and it contributes to the development and implementation of telemedicine technologies in the daily work of medical specialists. The article discusses the possibilities of using web photoplethysmography to assess microcirculation (web capillaroscopy), heart rate and other indicators (respiratory rate, pulse rate, saturation, body temperature, etc.). Web photoplethysmography is a sensitive, simple and effective method of registering vital body functions. Its effectiveness as a possible screening method for detecting rhythm disturbances and its prospects in using blood pressure measurement has already been proven. The possibility of using not only video, but also photographic materials, for example, for the detection of cardiovascular diseases, is also described. No less promising is the possibility of using the method in conjunction with thermometry. The importance of studying aspects of web photoplethysmography is seen in the need to activate the processes of import substitution and technological sovereignty, as one of the main paradigms of our country’s development. It is obvious that the development of contactless research methods is one of the priorities in modern healthcare. Given the widespread availability of various devices, it is necessary to further explore the possibilities of using webcams and mobile devices in medical practice. The development and introduction into routine practice of medical devices that allow remote non-invasive early diagnosis of chronic non-communicable diseases is of special interest.

Introduction. The problem of venous thromboembolic complications after planned surgical interventions remains relevant and requires special research and analysis, which was the purpose of this work. Objective. To study and evaluate the possibilities of the thrombodynamics test for predicting, diagnosing, and monitoring the effectiveness of treatment of postoperative venous thromboembolic complications in planned surgical interventions. Materials and methods. In this study, we implemented the thrombodynamics test in parallel with ultrasound examination of the veins of the lower extremities and pelvis before planned surgery and in the postoperative period on 1–3, 7–9, 14–16, and 30 days in 120 patients with common surgical pathology (chronic calculous cholecystitis, external abdominal hernias, and varicose veins of the lower extremities) stratified into risk groups for postoperative venous thromboembolic complications. Results. It was revealed that, in the preoperative period, 16.6 % of patients have hypercoagulation at normal standard blood counts and 65 % of them are patients from a low-risk group of venous thromboembolic complications. In the postoperative period, the number of cases of hypercoagulation increased to 34.2 % due to elderly and senile patients from groups with an estimated moderate and high risk of venous thromboembolic complications. Deep vein thrombosis was detected in 18 (15 %) subjects (6 patients from each risk group) within 2–15 days after surgery and in all cases it developed in the presence of preoperative hypercoagulation. Conclusions. It is shown that the thrombodynamics test is highly informative in predicting, diagnosing and evaluating the effectiveness of venous thromboembolic complications treatment during planned surgical interventions.

Introduction. The functional state of immunocompetent cells (ICC) plays an important role in the regulation of vasoactive mechanisms in patients with arterial hypertension (AH). In turn, an important role in the regulation of ICC metabolism plays an intracellular molecular sensor, adenosine monophosphate-dependent protein kinase (AMPK), which controls numerous intracellular processes as well as the production of biologically active molecules by cells depending on their energy balance. Aim: to assess the relationship between the content of AMPK protein kinase in MNCs and the state of the MAPK/SAPK signaling pathway as well as the level of vasoactive molecules and immunoregulatory factors in patients with hypertension. Materials and methods. We examined 55 patients of both sexes aged 47–67 years with primary hypertension with average and high cardiovascular risk. The control group consisted of 15 practically healthy individuals with normal blood pressure. The study material was venous blood samples taken from patients on the day of hospitalization. Results. The high level of protein kinase AMPK in the MNCs of patients with hypertension compared to the low level was associated with an increase in the production of prostaglandin E2, NO, and IL-4. An increase of eNOS, p38MAPK protein kinase, and HSP90 content was observed in MNCs. Along with this, there was a decrease in the production of proIL-1, IL-18, the soluble form of CD40L, and the content of protein kinase JNK, p70-S6K1, HSP70, and iNOS in MNCs. Conclusions. The high content of AMPK protein kinase in MNCs helps to reduce their pro-inflammatory activation, stimulates the production of NO, limits the activity of p38MAPK and JNK-dependent signaling pathways, promoting the normalization of the intracellular level of eNOS, HSP90 and the production of proinflammatory cytokines.

Introduction. The use of laser Doppler flowmetry (LDF) makes it possible to assess the condition and disorders of blood microcirculation, improving the quality of diagnosis of various cardiovascular diseases. Additional functional tests with laser flowmetric measurements are used to assess the state of the mechanisms that regulate the tissue blood flow. Objective. To identify patterns of blood flow changes in the microcirculatory bed when combining a postural test and a change in air temperature. Materials and methods. The study was conducted on a group of 20 subjects, which included an equal number of girls and boys aged 21–23 years, who were considered healthy and did not have cardiovascular diseases. The experiment was carried out in two stages: first in a room with an air temperature of 201 °C, then at 301 °C. To assess the difference in data between arm positions within the same study phase at the same temperature, the Student’s t-test was used to compare quantitative variables in two dependent samples. The Wilcoxon test was used to assess statistical differences in data for the same hand position but at different air temperatures. Changes were considered statistically significant at p<0.05. The subjects were measured the microcirculation of peripheral blood vessels on the phalanx of the finger in three positions relative to the level of the heart using a portable laser Doppler flowmeter LAZMA PF (Russia). Results. It is shown that an increase in ambient temperature leads to an increase in the difference in microcirculation of peripheral vessels when the arm position changes relative to the level of the heart. When a person is in a room with a temperature of 301 °C, dilation of blood vessels and changes in their tone occur, which explains the increase in microcirculation values in relative perfusion units. Conclusions. The results of the study showed an increase in statistically significant differences according to the Student’s t-test between the different hand positions with increasing room temperature (p<0.0001). In a comparative sample between the first stage (at an air temperature of 20±1 °C) and the second stage of the study (at an air temperature of 30±1 °C), statistically significant results (p<0.001) were obtained according to the Wilcoxon test for the hand position at the heart level and the raised arm.

Backrgound. Magnetic resonance-guided focused ultrasound (MR-FUS) is a new non-invasive technology for the surgical treatment of extrapyramidal movement disorders for such pathologies as essential tremor, Parkinson’s disease, etc. In these cases, the brain is injured and a zone of ischemia is formed. Arterial hypertension (AH) is one of the most common pathologies, which is often accompanied by neurological diseases. Objective. To investigate the effect of the remote ischemic preconditioning (RIPC) on blood pressure (BP) during MR-FUS surgery. Design – blinded, randomized, controlled, 2-group study with sham preconditioning. Materials and Methods. Patients were randomized into the RIPC group (cuff systolic BP (SBP) >50 mmHg, n=42) and the group with sham RIPC (cuff diastolic BP (DBP), n=39) before surgery in regime 3 cycles each 5 min with 5 min rest between cycles. Results. While there was a decrease in SBP and DBP before and after the operation in the RIPC group, there was an increase (p<0.001) in the sham RIPC group. Using the Difference-in-Difference equation for SBP, SBP was 8.9 (5.9–11.9) mm Hg higher in the sham RIPC group than in the RIPC group (p<0.01). Conclusion. As a result, MR-FUS operations showed a significant decrease in BP during RIPC compared to the imitation, which confirms the angioprotective effect of preconditioning.

The statistics of acute cerebrovascular accident (ACC) has been disappointing for decades. It is especially interesting to study the oxygen transport properties of blood under stroke as a probable mechanism for progression of acute hypoxia of the nervous tissue. The aim of this research was to study changes in the structure and oxygen transport capacity of hemoglobin in patients with varying degrees of ischemic stroke severity using RAMAN spectroscopy. Materials and methods. There was a clinical cross-sectional observational study of patients (n=60) with stroke of ischemic origin. We did standard diagnostic procedures, RAMAN spectroscopy of blood smears (inVia™ Basis spectrometer (Renishaw, UK, laser wavelength 532 nm, power 1.5 mW), statistical analysis of the data. Results. The conformational structure of hemoporphyrin in erythrocytes of patients with stroke has significant differences from the results of relatively healthy donors, corresponding to the severity of the pathology. The content of oxyhemoglobin decreases by 7.1–16.1 % (p<0.05) relative to the control. The ability of hemoglobin to bind and release ligands increases by an average of 34.7–47.2 % (p<0.05) and 9.9–23.9 % (p<0.05), respectively. Ligand affinity increases by 30.1 %, 29.0 % and 47.3 % (p<0.05) under mild, moderate and severe forms of the disease. Conclusion. In the erythrocytes of patients with stroke of ischemic origin, the conformation of hemoglobin changes, its affinity for oxygen increases, and its oxygen transport function is modified. The revealed changes correlate with the severity of the stroke.

Objective. To study the dynamics of microcirculatory blood flow in the skin during a course of use of the electrical stimulator AVR-051 in men of low and moderate cardiovascular risk with newly diagnosed arterial hypertension. Materials and methods. The single-center placebo-controlled study included 44 men of working age (30–60 years) with low and moderate cardiovascular risk with newly diagnosed hypertension, who were randomly divided into 2 groups. The control group (CG) included 30 men who underwent electrical stimulation with a commercial device. The placebo group (PG) included 14 men who used the AVR-051 device, with the electrostimulation function disabled. The study design included 3 visits. After visit 1 and randomization, the subjects underwent electrical stimulation/sham at home 2 times a day for 14 days. Visit 2 was carried out immediately after the end of the physiotherapy course, visit 3 was 14 days after visit 2. At each visit, a one-stage comprehensive study of microcirculation (video capillaroscopy, laser Doppler flowmetry and photoplethysmography) and 24-hour blood pressure monitoring on the left upper limb were performed. Results. In the CG, while blood pressure decreased at visits 2 and 3 by 5.5/3.5 and 7.5/3.5 mm Hg relative to the initial values, statistically significant changes at the level of the microvascular bed were recorded only at visit 3: an increase in the functional density of the capillary network by 10 cap/mm2, an increase in the amplitude of pulse oscillations of blood flow from 0.68 to 1.06 PU and the perfusion contribution of pulse oscillations from 3.89 to 8.22 %, a decrease in the augmentation index from 6.25 to 3.2 %, a decrease in the stiffness index from 7.45 to 7 cm/s and the reflection index from 37.4 to 30.2 %, respectively. In the GP, no reliable dynamics was recorded for any of the analyzed parameters. Conclusion. Positive dynamics at the level of the microvascular bed of the skin is a consequence of a decrease in blood pressure level against the background of systemic normalization of sympathetic tone. After the course of electrical stimulation, a hypotensive effect is observed in 86.7 % of men at early stages of the hypertension development, and in 20 % of them, a complete normalization of blood pressure level is observed.

Aim of the study was to establish the possibility of synergism between the TP receptor for TxA2 and purinergic P2 receptors during COX inhibition, and the effect of the resulting remodeling of signaling pathways on aggregometry parameters in patients with nephrolithiasis (NLT). Materials and Methods. The study was prospective and included 30 patients with imaging evidence of urinary tract calculi who were treated with high doses of non-selective NSAIDs for analgesia. The severity of hematuria was assessed at the time of hospitalization and during 7 days of lithokinetic therapy (LKT). Analysis of functional activity of TR-receptors, purine P2X1and P2Yreceptors of platelets (Tc) was performed by turbidimetric method on ChronoLog analyzer (USA). Agonists (ATP, ADP and Arachidonic acid) were used at concentrations of EC50 and EC10. Statistical analysis was performed using MedCalc package. Results. Two waves of COX activity decrease were revealed 24h and 72h after the beginning of NSAID administration. On the 5th day of LKT, the compensatory reaction of Tc was switched on, which was reproduced at restoration of normoreactivity of TR-receptor. Purine P2X1 – and P2Y-receptor synergism had a more pronounced inducing effect on aggregation parameters compared with the interaction between P2Y-receptor and TR-receptor or TR-receptor and P2X -receptor. On the 7th day, the residual level of COX activity was reached and hyporeactivity of TR-receptor was registered; at the same time the preserved level of TxA2 synthesis did not provide limitation of hematuria. Conclusion. Upon COX inhibition, potentiation of Tc proaggregant activity is reproduced by purine P2-receptor and TR-receptor interaction due to an increase in the rate of intracellular signalling (Slope) and the number of aggregates formed (AUC).

Introduction. The influenza A virus (IAV) can infect vascular endothelial cells and cause activation and/or dysfunction of the endothelium. Previously, we have shown that the influenza A(H1N1)pdm09 virus leads to alteration in functional activity of blood vessels in different vascular beds, and also causes various histopathological changes in pulmonary blood vessels of Wistar rats in the acute period of infection. Aim – to study the duration of systemic alteration in vasomotor function of microvascular endothelium caused by the influenza A(H1N1)pdm09 virus. Materials and methods. The Wistar rats were intranasally infected with the influenza A/St. Petersburg/48/16 (H1N1)pdm09 virus and at 1, 4, 7, 14, 21, 30, 60 and 90 days post infection (dpi) they were anesthetized and necropsied. The expression level of endothelial nitric oxide synthase (eNOS) was determined in mesenteric vascular endothelium by immunohistochemistry. The vasomotor activity of the mesenteric arteries was studied using wire myography. Results. The influenza A(H1N1)pdm09 virus causes a decrease in eNOS expression by 13–39 % within 60 dpi (p<0.05). In addition, the influenza virus also reduces the maximal response of mesenteric arteries to the vasodilator by 74–108 % within 21 days (p<0.0001) and reduces the response by 16–26 % within 30 and 60 dpi (p<0.0001), respectively, and also increases the maximum response of the arteries to the vasoconstrictor by 26–57 % within 30 dpi (p<0.05). It should be noted that such long-term changes are observed while virus is eliminated by the 7th dpi. Conclusion. The influenza A(H1N1) pdm09 virus causes long-term endothelial dysfunction in the Wistar rats which is characterized by the reduced expression of eNOS in mesenteric microvascular endothelium within 60 dpi, decrease of the maximal response of mesenteric microvessels to vasodilator within 60 dpi and increase of the maximal response to vasoconstrictor within 30 dpi. Alterations of systemic functional activity of mesenteric microvessels in rats infected with influenza A(H1N1)pdm09 virus are registered in absence of the reproduction of virus in mesenteric blood vessels while virus is eliminated from pulmonary tissues by the 7th dpi.

We present a case of a successful surgical treatment of posttraumatic false aneurysm of the left ulnar artery in a young patient with hypothenar hammer syndrome (HHS). Patient I., 22 years old, was admitted to the Clinic of Vascular Surgery with complaints of a throbbing painful mass on the palmar surface of the left hand. The patient was known to have a posttraumatic thrombophlebitis of the trunk and tributaries of the great saphenous vein of the right shin with incomplete recanalization of the lumen of unknown age and also he suffers from varicose veins of both lower limbs. The diagnoses were confirmed by ultrasound examination. The patient was examined and the results revealed an aneurysmal dilatation of the left ulnar artery in the wrist with a maximal diameter of 6.5 mm, the indication for surgical treatment were determined. On February 09, 2023, a surgical intervention was performed: aneurysm resection followed by ulnar artery replacement with a reversed аutologous vein. The clinical interest of the observation lies in the rare occurrence of this syndrome among patients, technical complexity of the operation due to anatomical features of the aneurysm location, as well as the use of microsurgical techniques during surgical treatment. The use of angiographic control made it possible to timely eliminate the pronounced vasospasm that developed immediately after starting the blood flow through the reconstructed section of the arterial bed. The result of the intervention was a complete relief of pain and pulsation in the left hand in the early postoperative period.