Objective. Assesment of chronic heart failure (CHF) prevalence and differential treatment in Rostov Region based on retrospective and prospective evaluation. Materials and methods. Retrospective analysis of 3059 casehistories of CHF patients hospitalized in cardiology departments of Rostov Region in 2008. 745 patients prospective followup. Results. Inpatients demonstrate a 52% CHF prevalence with a mortality rate of 3%. Major CHF development factors (in 82% cases) were determined to be ischaemic heart disease and arterial hypertension. Optimal medical treatment with basic pharmacological groups of drugs was conducted in 82% of inpatients the number decreasing to 53% during a year after discharge.

1Êëèíè÷åñêàÿ áîëüíèöà ¹ 1 ÔÃÓ «Þaeíûé îêðóaeíîé ìåäèöèíñêèé öåíòð ÔÌÁÀ Ðîññèè», 2 Ðîñòîâñêèé ãîñóäàðñòâåííûé ìåäèöèíñêèé óíèâåðñèòåò, Ðîñòîâ-íà-Äîíó Цель работы: определение нейрогуморальных и генетических детерминант развития и прогрес сирования хронической сердечной недостаточности (ХСН) у больных ишемической болезнью сердца (ИБС). Материал и методы: у 100 человек выполнено определение концентрации нейрогор монов (ангиотензина II, альдостерона, эндотелина 1, мозгового натрийуретического пропептида (N проМНП), фактора некроза опухоли α (ФНО α) и генотипирование (ген ангиотензин превра щающего фермента, ангиотензиногена и рецепторов 1 типа ангиотензина II). Полученные резуль таты: для ранних стадий ХСН характерна активация эндотелина и N проМНП, при развитии де компенсации -альдостерона и ФНО α. Структурный полиморфизм генов ренин ангиотензиновой системы (РАС) не является значимым в развитии и прогрессировании ХСН у больных ИБС.Ключевые слова: нейрогормоны, полиморфизм генов, ренин ангиотензиновая система, сердечная недостаточность. CLINICAL AND PATHOGENETIC ASPECTS OF ISCHAEMIC HEART DISEASECOMPLICATED BY CHTONIC HEART FAILURE Dorofeeva N.P., Pleskachev S.A., Shlyk S.V., Tchigaeva E.V., Ther Ananyanz E.A., Mashtalova O.G.,. Koulikova I.E, Pleskachev A.S., Todorov S.S.Objectives: To investigate genetic and neurohumoral determinants of chronic heart failure (CHF) development and progression in ischaemic heart disease (IHD) patients.Methods: Serum neurohormone level analysis (angiotensin II, aldosterone, endotheline 1, NT proBNP, TNF α) and genotyping (genes encoding ACE, angiotensinogen, and type 1 angiotensin II receptors ) were implemented in 100 patients Results: Activation of endotheline and NT proBNP is characteristic of early CHF stages while decom pensation of chronic heart failure shows elevation in aldosterone and TNF α . Structural polymorphism of renine angiotensine system genes is not significant in CHF development and progression in IHD patients.

The aim of the investigation was to study the morphological condition of blood cells in the basins of the ischemic limbs and their dynamics as a result of various types of surgical treatment. Implementation of combined surgical treatment has a more normalizing effect in comparison with isolated reconstructive surgical treatment. The use of lumbar sympathectomy in patients with occlusive lesions of arteries of lower limbs and varying degrees of ischemia reduces endothelial dysfunction and normalizes a number of parameters describing the morphology and functioning of red blood cells and platelets. There was detected the deformation of red blood cells indicating that the restoration of the plasticity of red blood cell membranes significally reduced the degree of agglutination of red blood cells. According to obtained data the influence of sympathectomy depends on the severity of the disease in general the highest efficiency is observed at the II and III degree of ischemia.