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

7-10

Authors: Kravchun P. G., Kadykova O. I., Zalyubovs'ka O. I., Shumova N. V.

The article assesses the contribution of leptin gene polymorphism (Arg223Gln) in the development and progression of obesity in patients with coronary heart disease. 222 patients with coronary heart disease and obesity were surveyed. The study of leptin gene polymorphic locus Arg223Gln was performed by polymerase chain reaction of all examined patients. G allele and G/G genotype of the leptin gene polymorphism (Arg223Gln) are more common among the patients with coronary heart disease and obesity and the frequency of their detection increases with the growth of the degree of obesity.

19-26

Authors: Petrenko O. V., Yabluchansky M. I.

Blood pressure (BP) circadian rhythm violation, manifested as an insufficient degree of its sleep-time relative decline, is an independent cardiovascular risk factor. The main method of the correction is chronotherapeutic approach, when at least one antihypertensive drug is taken at bedtime. However, most researchers focus on normalizing the daily profile of systolic blood pressure (SBP) and do not pay enough attention to changes in the daily profile of diastolic blood pressure (DBP) and blood pressure in general. The aim of the study was to evaluate the influence of the chronotherapeutic approach on the SBP and DBP levels and the DBP daily profile in hypertensive patients with an insufficient degree of sleep-time relative SBP decline. The study included 12 patients with arterial hypertension (AH) with an insufficient degree of sleep-time relative SBP decline. Participants were divided into two groups: group 1 included patients who take at least one antihypertensive drug at bedtime, group 2 – patients who take all antihypertensive drugs in the morning. All patients underwent 24-hour blood pressure monitoring using the computer system «Cardiosens» (KhAI Medica, Ukraine, with the oscillometric method of BP measuring) when enrolling in the study and after 3 months. The type of SBP and DBP diurnal profile, the mean values of SBP, DBP and hyperbaric indices were determined and compared between groups 1 and 2 at each visit, as well as within groups between visits. The results showed that the SBP daily profile normalization in patients with insufficient degree of sleep-time relative SBP decline from group 2 was achieved only in 11 % of cases, and in group 1 SBP and DBP daily profile normalized in 1/3 patients. In some patients from group 2 SBP and DBP daily profile converted into the overdipper type, while in group 1 overdippers did not appear at the end of the study. It was concluded that conversion of daily DBP profile to overdipper as a consequence of bedtime drug administration requires a review of the accepted treatment strategy.

36-40

Authors: Pochinska M. V., Shevchuk M. I.

Dose factor of the main groups of cardiac medications in five pulse pressure (PP) classes was studied in 220 patients (110 men and 110 women) at the annual stage after pacing, the average age 70 ± 9 years. Patients with the IV and V class of PP require the administration of higher doses of antiarrhythmics, diuretics, calcium channel blockers and ACE inhibitors.

47-50

Authors: Tymoshenko O. S., Yabluchansky M. I., Martynenko O. V.

Parameters of heart rate variability (HRV) were studied in 112 patients with arterial hypertension (AH) aged 58.5 ± 9 years (60 patients with difficult-to-control arterial hypertension (DTCAH) and 52 patients with controlled arterial hypertension (CAH)). The control group was consisted of 20 conditionally healthy persons of the same sex and age. It has been established that patients with AH were characterized by decrease in the level of total power of the HRV spectrum, the power of the high-frequency (HF) and low-frequency (LF) domains of the spectrum, and increase in the level of the very low-frequency spectrum (VLF) and value LF/HF that reflect sympathovagal balance. It has been established that there were more significant disorders in neurohumoral regulation in patients with DTCAH in comparison with patients with CAH, which consist of the predominant adrenergic activation, primarily due to the sympathetic link of the autonomic nervous system. HRV can be used as an effective non-invasive method for the diagnosis and control of DTCAH.

57-62

Authors: Bogun L. V., Lawal Wuraola F., Ivleva O. O., Okhryamkina O. O.

The article emphasizes the necessity of meticulous physical examination of the patient in the modern clinical practice. Two clinical examples of diagonal earlobe crease, also known as Frank’s sign, are given. Both cases describe patients with ischemic heart disease, but age of patients and severity of Frank’s sign differ. The literature data about its frequency in different groups of population as well as the clinical significance and possible underlying pathophysiological mechanisms of Frank’s are shown.

68-70

Authors: Ovda A., Nazarko I. V., Lysenko N. V., Lebedinets V. V.

The patient with the severe course of dermatopolymiositis served as an example for diagnostics, clinical syndromes establishment, and treatment tactics. The importance of the syndrome but not of the nosological diagnosis was marked.