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

8-12

Authors: J. Akermi, Y. A. Andreeva

The article presents the results of investigation of gastric mucosal microcirculation with the help of laser-Doppler flowmetry in acute phase of duodenal ulcer during 7 and 14-day eradication therapy. The study enabled to obtain some data on effectiveness of the two therapeutic eradication regimens as well as their im-pact on gastric mucosal microcirculation in the process of ulcer defects healing.

17-21

Authors: P. А. Garkaviy

Age and gender difference of SBP orthostatic reaction types and HR in healthy subjects and AH patients were found. Rate of SBP hyper- and hypotensive reaction types decrease with age. Frequency of hypertensive type in AH is increased. HR increases in orthostasis disregarding SBP reaction type, the extent of growth increases from hyper- to hypotensive reaction. HR reactivity is higher in males.

29-36

Authors: M. S. Maltseva, D. E. Volkov, D. A. Lopin, I. V. Soldatenko

Implantation of the pacemaker (ECS) in the various classes of corrected QTc interval duration of stimulated complexes were investigated. Evaluation was made by sex and age of the patients, chronic forms of ischemic heart disease (CIHD): postinfarction cardiosclerosis, stable angina (I-IV functional classes (FC)); stable angi-na (I-IV FC), arterial hypertension (AH) – 1-3 degrees and stages (1-4), type of diabetes mellitus (DM), atrial fibrillation (AF) (paroxysmal and persistent, permanent), chronic heart failure (CHF) – stages I-III, I-IV FC; functional indicators before pacemaker implantation and in the acute postoperative period (3-5 days after surgery): QTc interval duration, heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP); ejection fraction (EF) of the left ventricle (LV), anterior-posterior size of the left atrium (LA), end-systolic volume (ESV) and end-diastolic volume (EDV), the thickness of the back wall of the left ventricle (AP LV), the thickness of the interventricular septum (IVS), left ventricular mass (LVM). The patients were divided into 3 classes: class 1 – normal QTc (320-440 ms) – 27 (22 %) patients, class 2 – elongated QTс (> 440 ms) – 97 (78 %) patients. Standard statistical procedures using Microsoft Excel were applied for data processing. The results showed that QTc interval duration of stimulated complexes in the acute postoperative period after pacemaker implantation can be established in a physiological range in 22 % of patients, and in 78 % – it remains longer or even elongated. Elongation associated with a higher incidence and the increase of FC and stages of heart failure, high values of ESV and EDV, mostly in the pacing mode VVI/VVIR and DDD/DDDR. Patients with a pacemaker require more careful monitoring the stimulation parameters as well as ongoing drug therapy.

42-46

Authors: I. V. Shanina, D. E. Volkov, D. A. Lopin, N. I. Yabluchansky

125 patients (57 – women, 68 – males) with permanent pacing were examined. Among the indications for pacemaker installation there were atrio-ventricular block (AV-block) – 77 people (62 ± 4 %), sick sinus node syndrome (SSNS) – 32 patients (26 ± 4 %), bradysystolic AF – 8 patients (6 ± 2 %). 8 patients with cardioresynchronization therapy (6 ± 2 %) were also included. Average age was 69 ± 7 years. The patients were divided into two groups: first – patients with QRS complex duration under 120 mc, second – QRS duration complex with more than 120 mc. It was found that QRS complex duration with more than 120 mc is associated with males and patients with postinfarction cardiosclerosis, heavier functional class of heart failure and atrial fibrillation. Given the trend towards more clinically significant cardiovascular disease in patients with a QRS complex duration with more than 120 mc, this group of patients needs optimal therapeutic management. The results show the feasibility of and prospects for further study of this group of patients.

54-63

Authors: V. P. Starenkiy

The possibilities of use of modern multimodal imaging technologies during the distant radiation therapy treatment planning are analyzed. The conditions for carrying out of different modality tomography research for needs of treatment planning are determined. The issues of informativity of the hybrid images for target volume finding are considered.

72-76

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

The case of cardiac biventricular resynchronization without destruction of the atrio-ventricular node in patients with chronic heart failure (CHF) and permanent atrial fibrillation (AF) is described. The observation period was 14 months. The case demonstrates that biventricular resynchronization for severe heart failure with atrial fibrillation and significant atria size with theoretical and practical impossibility of its’ transforming into the long-term persistent atrial fibrillation is a reasonable alternative of atrio-ventricular pacing. Though the destruction of the atrio-ventricular node can be delayed for a significant period of time, it should be done at the earliest opportunity. Pacemaker implantation does not cancel medical therapy, with the necessity for the latter to be according to the conducted biventricular pacing.