The proposed method of quantitative estimation of regulatory and adaptive status (RAS) of human organism is based on complex responses of two major vegetative functions - breath and heart rates under organism exposure to a number of factors and diseases. It has been evidenced that during the follicular menstruation stage and during optimum readiness of female organism for childbirth RAS increases, however, stress impact can also cause RAS set off to decrease. Likewise, the possibility of quantitative organism stress resistance estimation is also presented. Under some pathological conditions (myocardial infarction, hypo-and hyperthyroidism, diabetes type 2), RAS goes down, and the degree of its restoration depends on the attained therapy effect. It is shown that RAS dynamics provides an innovative methodological approach to medication efficiency estimation based on its influence not only on the body organ or target function, but also on adaptive abilities of the organism.

Atherosclerosis ranks first among cardiovascular system diseases. It is the “disease of the century”, and more than 50% of people with circulatory pathology die of it. The clinical manifestation of atherosclerosis is observed at the middle and older ages, but it is known that the pathological process develops much earlier. There has been a clear trend in theoretical and practical cardiology in recent years to study the earliest atherogenic markers. Epidemiological, clinical, and morphological studies have proved the presence in children and adolescents of sexual, endogenous, exogenous, primary, and potentiating risk factors contributing to an early formation of a pathogenic foundation for atherosclerotic cardiovascular diseases. Disorders of lipid metabolism – dyslipidemias are attributed to the most significant risk factor for atherosclerotic cardiovascular diseases. The DLP prevalence in the pediatric population is extremely high. According to the results of conducted global studies, lipid metabolism disorders occur in more than 70% of children and adolescents. It causes the need for timely diagnostic, therapeutic and preventive measures. The need to extrapolate the risk factor concept to childhood age is justified by several reasons, the main of which include the broadest spread of atherosclerosis that has become a global pandemic, genetic determinism, and low variability of the lipid spectrum of blood serum: the levels of lipids and lipoproteins discovered in childhood are stable throughout life and have an independent prognostic value. That is why the most practical significance is inherent to the study of lipid and lipoprotein metabolism, starting in the early periods of lipid and lipoprotein ontogenesis. Since risk factors can be identified at the preclinical stage of the atherosclerotic process, dyslipidemia phenotyping will facilitate identifying children and adolescents at risk of developing cardiovascular pathologies in the future. The study objective is to examine the pathophysiological aspects of lipid and lipoprotein metabolism and examine DLP epidemiology – as the leading atherosclerotic cardiovascular disease risk factor in children and adolescents, DLP classification, modern approaches to DLP diagnosis and management.

This study describes methods of volitional management of heart rhythms and proves that it is possible by means of management of its operations, subject to arbitrary control, which also has a strong functional connection to the center of the heart rhythm formation in the brain. Experiments demonstrate that it is possible for arbitrary changes in the heart rhythm to be made through conscious control of the breathing rhythm, and even a short-term cardiac arrest by means of contracting abdominal muscles. We postulate that the management of human heart rhythm is indirectly regulated through arbitrary controlled operations. The present article describes and analyzes ways that enable a human to consciously and purposefully manage the frequency of heart contractions. Common principles of arbitrary management of the heart rhythm in humans are uncovered through analysis.

Objective To evaluate myocardial injury and tissue hemodynamics in elderly patients with permanent atrial fibrillation (AF) based on the achieved range of ventricular contraction rate (VCR).Materials and Methods This prospective, randomized, blind study included 75 patients aged ≥60 with permanent AF. All patients were prescribed bisoprolol as a VCR-reducing therapy. Patients were randomized to two groups according to the permuted-block design based on the range of resting VCR goal: group 1, 60–79 bpm (n=38) and group 2, 80–100 bpm (n=37). All patients also received perindopril and apixaban. Troponin I concentration was measured using the high-sensitivity assay (hsTn); parameters of tissue hemodynamics, including the mean blood flow velocity (Vm) and pulsatility index (PI), were measured using high-frequency ultrasound doppler flowmetry; echocardiographic indexes of left heart remodeling were recorded at baseline and after 6 month of VCR monitoring.Results Mean age of patients was 74±7 years. Medians [25th percentile; 75th percentile] of baseline hsTn concentrations were 10.2 [5.25; 21.2] ng / l in group 1 and 10.3 [5.4; 20.4] ng / ml in group 2 (p=0.91). 89.5 % of patients in group 1 and 100 % of patients in group 2 achieved the VCR range goal. At 6 month, resting VCRs were 70±4 bpm in group 1 (n=34) and 88±5 bpm in group 2 (n=37) (p1, p2<0.001). According to echocardiographic data significant progression of myocardial remodeling was not observed. Concentrations of hsTn significantly decreased in both groups but the decrease was more pronounced in group 1, to 8.0 [4.13; 17.23; p1<0.001] ng / l vs. 9.2 [4.8, 17.5] ng / l in group 2 (р1, p2<0.001). A weak direct correlation was found between the VCR decrease and hsTn concentration (rs=0.44; p=0.009 in group 1, and rs=0.41; p=0.01 in group 2); regression coefficient was 0.78 at 95 % confidence interval (CI), from 0.21 to 1.3 (p=0.009) in group 1, and 0.14 at 95 % CI, from 0.04 to 0.24 (p=0.007) in group 2. Vm values were increased to 2.93±0.10 (p<0.001) and 3.21±0.09 cm / sec (p<0.001) and PIs were decreased to 1.42±0.03 conv. units (p<0.01) and to 1.34±0.02 conv. units (p<0.001) in groups 1 and 2, respectively.Conclusion The treatment aimed at VCR control in patients older than 60 with permanent AF was associated with a positive dynamics of myocardial injury (hsTn) and tissue hemodynamics indexes (Vm и РI). This indicates a possibility for using these indexes for further improvement of managing such patients.

Purpose. To analyze the possibility of using high-sensitivity cardiac troponin I (hsTnI), N-terminal pro-B type natriuretic peptide (NT-proBNP), tissue hemodynamics parameters, echocardiographic data and the quality of life for selection of the individual regimen for ventricular rate (VR) control drug therapy in patients with permanent atrial fibrillation (AF). Methods. The study included 120 patients aged >60 years old with the diagnosis of permanent AF, who gave the informed consent. Patients were randomized into 2 groups according to the target range of VR at rest: 60-79 bpm (first group, n=60) and 80-100 bpm (second group, n=60). Patients in both groups were prescribed a selective beta1 -adrenoceptors blocker bisoprolol for VR control. The following parameters were determined before randomization and after 6 months of VR control in the target ranges: atrial and ventricular remodeling with transthoracic echocardiography; biochemical markers hsTnI and NT-proBNP; the tissue hemodynamics by the mean flow velocity (Vm) and the value of the pulsatility index (PI) using high-frequency ultrasound Doppler flowmetry; the patients’ quality of life with the “Atrial Fibrillation Effect on QualiTy-of-life (AFEQT) Questionnaire” and the “EQ-5D-5L” system with a scale EQ-VAS.Results. VR at rest after 6 months was 70±3 and 88±4 bpm (p1, p2˂0.001) in the first and second groups, respectively (p1 - comparing the initial and achieved values, p2 - values of the first and second groups). The level of hsTnI significantly decreased in both groups, but it was more pronounced in the 60-79 bpm range group (p˂0.001). Spearman’s correlation coefficients between the degree of decrease in VR and decrease in the level of hsTnI were 0.45 (p˂0.001) and 0.44 (p˂0.001) in the first and second groups, respectively. AFEQT and EQ VAS scores of quality of life improved after 6 months in both groups: the increase in the total AFEQT score in the first group -56.2±17.0% (M±SD), in the second - 42.6±15.3% (p˂0.001); EQ VAS values also increased, but differences between groups were not significant (p=0.078). In both the first and second groups, a strong positive correlation was found between the degree of decrease in VR and increase in the total score of the AFEQT questionnaire. The tendency toward an increase in Vm and a decrease in PI observed in both groups was more pronounced in the group with VR of 80-100 bpm, where Vm increased by more than 10% (p1, p2˂0.001). Changes in NT-proBNP under the influence of therapy for the reported observation period did not reach statistical significance in both groups (p1 =0.092, p2 =0.063). There was no significant dynamics of echocardiographic parameters of myocardial remodeling.Conclusion. The degree of chronic myocardial damage caused by arrhythmia (estimated by hsTnI), as well as the tissue hemodynamic parameters Vm and PI, can be the basis for individualized selection of the target VR range. This approach will allow to find a balance between cardioprotection and improvement of tissue blood flow. In creating the algorithm of selecting the target VR for patients older than 60 years with permanent AF, it is advisable to use such parameter as the degree of the initial VR change and quality of life data from the “AFEQT Questionnaire”.