The Journal of V. N. Karazin Kharkiv National University. Series «Medicine»

11-21

Authors: S. A. S. Belal, N. A. Vodyanitska, M. I. Yabluchansky

Changes of systolic blood pressure (SBP) in biofeedback (BFB) sessions with closed loop of paced breathing (PB) and heart rate variability (HRV) during standard drug therapy of arterial hypertension (AH) was studied. 275 patients with 1-3 degree of AH (143 men and 132 women, mean age 58,55 ± 7,99 years) was divided into two comparable groups: 1 - BFB (139 patients) in investigated PB loop, 2 - control group (136 patients) with BFB without PB. In both groups was performed 10 sessions of BFB. Changes of SBP depending on the stage and degree of AH, gender and age was assessed. BP was measured by the method of Korotkov’s with monometer Microlife BP AG1-20 in same conditions. Data were processed by parametric and nonparametric statistics. It is proved that the use of biofeedback in the loop of PB and HRV significantly (p < 0.01) exceeds in efficiency an isolated drug therapy in control of SBP at any stage and degree of AH in patients of both sexes in all age groups. Extent of the effect increases with the stage and degree of the disease and not related to the sex and age of the patient. Findings allow to recommend this technique in clinical practice.

27-34

Authors: S. O. Dubyna

The norm of morphometric indicators of bone structures of an orbit for population of 96 people at the age of 48,6 ± 3,2 years without pathology of craniofacial area is established by method of a computer tomography. Means, confidence intervals (р = 0,05), correlation and reliability of distinctions in morphometric indicators of a skull and an orbit by groups on types of cranium are defined. In frequency distribution of the studied population by types of cranium brachiocephalic people are 63 %, dolichocephalic – 27% and mesocephalic – 10 %. In groups by types of cranium among linear indicators of an orbit length of a medial wall statistically reliable decreases from dolichocephals to brachiocephals, length of lateral wall, orbital floor and roof and also orbital breadth – from mesocephals to brachiocephals. Orbital height between groups’ types of cranium reliable does not differ. An angle between medial and lateral walls of orbit statistically reliable increases from dolichocephalic persons to brachiocephalic. The interrelation of changes of an angle of orbital entrance inclination and types of cranium is not observed. The number of statistically significant correlations between morphometric indicators of an orbit increases from dolichocephals to brachiocephals at the absence of a reliable difference between them. Average degree correlation is noted only between orbital breadth and lengths of medial wall and orbital floor; orbital depth and lengths of the orbital floor and roof; between lengths of the orbital floor and roof – at brachiocephals, and also between lengths of the orbital floor and roof – at dolichocephals and mesocephals. The conclusion is drawn that when planning reconstructive operations at bone structures of an orbit it is necessary to consider the available distinctions in length of lateral wall, orbital roof and floor, height and breadth and value of an angle between medial and lateral walls by types of cranium.

39-44

Authors: M. S. Maltseva

97 patients (55 men and 42 women) with implanted pacemakers (PM) in DDD/DDDR, VVI/VVIR and CRT modes were investigated. Pacing mode, location of the right ventricular (RV) and left ventricular (LV) electrode, percentage of the right atrium (RA), RV and LV stimulation, percentage of atrial flutter (AFl) and atrial fibrillation (AF), percentage of ventricular tachycardia (VT), base frequency of stimulation, RV and LV electrode impedance, RV and LV electrode stimulus amplitude and duration, RV electrode sensitivity, R-waves sensing, stimulated and detected AV-delay, interventricular delay, the minimum refractory period were evaluated in acute postoperative period (3-5 days) and six months after pacemaker implantation. Patients were divided into classes 1 (normal QTc (320-440 ms)) - 41 (42 %) of the patients) and class 2 (long QTc (> 440 ms)) - 56 (58 %) patients) of QTc interval duration. For data processing were used standard statistical procedures by Microsoft Excel. QTc interval prolongation is most often observed in patients with VVI/VVIR stimulation, normal QTc interval duration – in patients with CRT. The same part of normal and extended QTc interval duration is observed in patients with DDD/DDDR stimulation. Prolonged QTc interval duration is associated with more frequent RV electrode implantation in heart apex, higher percentage of AFl and AF, LV electrode impedance, RV and LV electrodes stimulus amplitude, detected and stimulated AV-delays, minimum refractory period in first six months after PM implantation. Patients with increased QTc interval duration after PM implantation require more intensive monitoring of stimulation parameters and enhancing medication.

49-52

Authors: I. V. Shanina, D. E. Volkov

100 patients (46 – women, 54 − men) 69 ± 7 years old with implanted pacemaker in three QRS complex duration classes (under 120, 120-149, 150 and more ms) were investigated in the early postoperative period, six months and a year of permanent pacing. Basic pacing rate, atrioventricular (AV) delay (stimulated and detected), ventricular threshold, ventricular lead impedance, percentage of ventricular pacing, percentage of atrial fibrillation/flutter time were measured. Basic pacing rate, stimulated and detected AV-delay, as well as the percentage of ventricular pacing were not associated with QRS complex duration classes and had not been changed in observation stages. Ventricular threshold, ventricular lead impedance and the percentage of atrial fibrillation/atrial flutter time in the annual monitoring stage were defined to QRS complex duration class. Ventricular threshold in the first six months of observation was not changed in any QRS complex duration classes and grew at an annual stage in class 3. The impedance of the ventricular lead in the first six months decreased in all classes, it was stabled at the year in classes 2 and 3 and was continued to decline in the class 1. Percentage of atrial fibrillation/flutter time was initially higher in class 3, and was decreased in six month observation stage, however, without reaching the values in classes 1 and 2.

59-62

Authors: E. E. Tomina, E. P. Kamenskaya, P. V. Lebedynets, V. V. Tomakh

The article concerns a clinical case management of patients with polycythemia vera. The data are given from the laboratory and instrumental diagnostic methods, clinical diagnosis, selection of the optimized treatment and modification of the habit of life.

71-80

Authors: O. V. Petrenko

Review devoted to chronotherapy of hypertension. The questions of chronomedicine and chronobiology, biological rhythms, especially circadian regulation of blood pressure, types of daily blood pressure profile violations, the role of de-synchronization of biological rhythms in the development and course hypertension, opportunities to optimize antihypertensive therapy with the method of chronotherapy using alpha- and beta-blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, diuretics, calcium channel blockers and melatonin are contemplated.