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Introduction: Management of acute myocardial infarction (MI) mandates careful optimization of volemia, which can be challenging due to the inherent risk of congestion. Increased myocardial compliance in response to stretching, known as stretch-induced compliance (SIC), has been recently characterized and partly ascribed to cGMP/cGMP-dependent protein kinase (PKG)-related pathways. We hypothesized that SIC would be impaired in MI but restored by activation of PKG, thereby enabling a better response to volume loading in MI.Methods: We conducted experiments in ex vivo rabbit right ventricular papillary muscles under ischemic and non-ischemic conditions as well as pressure–volume hemodynamic evaluations in experimental in vivo MI induced by left anterior descending artery ligation in rats.Results: Acutely stretching muscles ex vivo yielded increased compliance over the next 15 min, but not under ischemic conditions. PKG agonists, but not PKC agonists, were able to partially restore SIC in ischemic muscles. A similar effect was observed with phosphodiesterase-5 inhibitor (PDE5i) sildenafil, which was amplified by joint B-type natriuretic peptide or nitric oxide donor administration. In vivo translation revealed that volume loading after MI only increased cardiac output in rats infused with PDE5i. Contrarily to vehicle, sildenafil-treated rats showed a clear increase in myocardial compliance upon volume loading.Discussion: Our results suggest that ischemia impairs the adaptive myocardial response to acute stretching and that this may be partly prevented by pharmacological manipulation of the cGMP/PKG pathway, namely, with PDE5i. Further studies are warranted to further elucidate the potential of this intervention in the clinical setting of acute myocardial ischemia.

Abstract Background Swift and adequate fluid loading is a cornerstone of septic shock therapy. Yet, careful assessment of volume responsiveness and volume amount during the resuscitation process is a prerequisite. Both overzealous initial fluid administration and late fluid overload are harmful and may be associated with increased mortality. Main body Static (i.e., central venous or pulmonary artery occlusion) pressure readings are erroneous for monitoring fluid resuscitation and should be abandoned. Dynamic measurements (i.e., stroke volume and pulse pressure variation) better predict fluid responsiveness than static filling pressures but the conditions necessary for these parameters to correctly evaluate preload dependency are frequently not met. The passive leg raising maneuver as a means to alter biventricular preload in combination with real-time measurement of cardiac output changes is an easy-to-use, fast, relatively unbiased, and accurate bedside test to guide fluid management and to avoid fluid overload during early septic shock treatment. Moreover, PLR may also be particularly useful to assist various treatments that trigger fluid removal during the “de-resuscitation” phase of septic shock. Conclusions The passive leg raising maneuver in combination with real-time measurement of cardiac output changes is an easy-to-use, fast, relatively unbiased, and accurate bedside test to guide fluid management during septic shock.

Purpose: to justify ratio means general physical training and special physical trainingin the annual cycle of training university students who train in sports sections swimming. Material and Methods: the study involved students G. S. Skovoroda HNPU aged 16–17 years, who were involved in the sport of swimming section. In the paper we used the following methods: analysis of scientific and methodological literature, teaching observations, educational testing, pedagogical experiment; methods of mathematical statistics. Results: by volume of training loads and improved ratio means general physical training and special physical training at different stages of the annual cycle of training university students who train in sports sections swimming. Conclusions: rational relationship means general and special physical training allows you to find the most effective ways of improving the process of preparing students fins and helps to improve the absolute athletic performance.

Purpose : to study the dynamics of the special performance and volume of training load during annual training swimmers. Material / Methods : The study involved 14 teams of students of Kharkiv universities. All swimmers are of high qualification. Motor tests of special performance swimmers, functional tests were used to confirm the effectiveness of the training process. Results : The dynamics of special performance indicators and volume of training load of highly qualified swimmers in the annual cycle of training. Determined part of aerobic (58.3 %), aerobic- anaerobic special (34.5%), anaerobic- glycolytic (5.5%), anaerobic- alactate (1.7%) loadings in the direction of total training load for the academic year. Conclusions : In preparing swimmers stayer is the most appropriate single-cycle construction of the annual cycle, and for swimmers, sprinters should be based on two-cycle version of the load distribution.