The aim: To optimize the treatment of children with Essential Arterial Hypertension (EAH) in assotiation with Endotelial Dysfunction (ED) by studying the clinical and morphofunctional characteristics of the cardiovascular system disorders and correction of endothelial dysfunction with the using of essential phospholipids. Materials and methods: The study group consisted of 80 children and 30 – a control group. The next stage included the division of 80 children into 2 subgroups. Patients in the first subgroup received basic treatment (angiotensin-converting enzyme inhibitor of the third generation), the second – optimized treatment (basic treatment was with addition of certified drug lecithin). Doses were determined according to the instructions and age for 2 months. In the study were used: ECG, Echocardiography, Ultrasonography, Morphofunctional studies of the endothelium. Results: There is a dynamic decreasing in the level of left ventricular myocardial mass index (LV MMI), reduction of end-diastolic volume (EDV) and increase in the absolute values of shock volume (SV), ejection fraction( EF) under the influence of optimized treatment due to the inclusion of lecithin in the treatment of children with EAH with ED. The Ve/Va ratio had a tendency to increase. Vasoconstriction of vessels after the reactive hyperemia test was significantly reduced, but the degree of vasodilation varied depending on the method of therapy. The intima-media thickness (IMT) decreased in 1.12 times in the cases of children with an optimized treatment, accompanied by a decreasing of DEC by 2-times. Levels of the aortic stiffness index had a tendency of decreasing (from 0.88 ± 0.02 to 0.71 ± 0.01 and to 0.63 ± 0.01, respectively, by groups and in comparison with the control group – 0.55 ± 0 , 01), which reflects the improvement of hemodynamic parameters. The dynamic parameters obtained in the cases of patients with EAH in association with ED, taking into account the impact of the optimized treatment had positive correction on the total risk of cardiovascular complications, changes in the profile of LV diastolic filling, dysfunction of arterial endothelium. Conclusions: The inclusion of essential phospholipids in the treatment of children with EAH and ED helps to optimize the profile of LV diastolic filling and exclude vascular endothelial dysfunction and indicate a positive effect of optimized treatment on the overall risk of cardiovascular complications.

The aim: To investigate discrete laboratory and morphometric features of atherosclerotic lesions in patients with chronic ischemia of the lower extremities (CILE). Materials and methods:The examined contingent consisted of 47 patients (age 56.32 ± 1.09 years) diagnosed with obliterating atherosclerosis of the lower extremities. The study included determination of levels of Homocysteine, Folic acid, C protein, quantitative determination of circulating Endothelial cells (DEC) in blood plasma, and morphometric study of DEC. Results: Protein C levels are within the reference values (0.97 ± 0.12 mg / l. In 37 (78.7%) patients Hypoacidofoliemia (<3.0 mmol / l) was observed. Homocysteine levels were clearly elevated in all patients. In the vast majority Hyperhomocysteinemia mild form (91.5%) was observed. The number of DEC in patients was -3.22 ± 0.39x105/l and after compression –6.12 ± 0.21x105/l Conclusions: Protein C levels were within the reference values (0.97 ± 0.12 mg / l); Folic acid levels in the vast majority (37 patients, 78.7%) were <3.0 mmol /l. Blood plasma Homocysteine levels were clearly elevated in all patients. The mild form of Hyperhomocysteinemia (91.5%). was observed in the vast majority The number of DEC in patients was -3.22 ± 0.39x105 and after compression –6.12 ± 0.21x105/l, which confirmed the presence of the endothelial dysfunction.