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Aim: To identify and determine the mechanisms of an association between arterial hypertension (AH) and proatherogenic systemic metabolic disturbances in hypertensive disease (HD), as well as the possibility of eliminating these disturbances by antihypertensivetherapy., Subjects and Methods: Fifty-four patients with HD and 64 persons randomly selected from an unorganized urban population were examined. Systolic and diastolic blood pressure (BP), insulin sensitivity, the most important metabolic parameters of lipids, lipoproteins, and glucose, the degree of systemic inflammation and oxidative stress, and the rate of lipoprotein proatherogenic and immunogenic modification were determined., Results: All the patients with HD were found to have a regular concurrence of AH with systemic inflammation and activated free-radical reactions, metabolic abnormalities, such as atherogenic dyslipidemia, insulin resistance, atherogenic and immunogenic modified lipoproteins. Antihypertensive treatment failed to eliminate metabolic disturbances even when BP control was fully restored., Conclusion: AH and systemic metabolic disturbances in HD have a common pathogenetic basis and the treatment of hypertensive patients should provide the normalization of not only BP, but also inflammatory and oxidative status and systemic metabolism.

A significant correlation exists between clinical types of chronic glomerulonephritis (CGN) in a new clinical classification and morphological CGN types according to classification of WHO experts. Rapid progression is significantly correlated with clinicomorphological variants of CGN represented by unfavorable clinical types and unfavorable morphological types. No rapid progression occurred in combination of clinically favourable types and morphologically favourable and unfavorable types. The above classification is recommended for practice.

Compared to healthy controls, patients with transplanted heart have higher baseline heart rate (HR), delayed initial HR reaction, slower changes of HR both during exercise and after it, diminished chronotropic and inotropic reserves. The data obtained contribute to better understanding of physiology of transplanted denervated heart and objective assessment of patients after heart transplantation.

An analysis was made of the work carried out by the Department of Coronary Surgery and Heart Transplantation as regards heart transplantations during 1988. As many as 119 patients, hypothetical heart recipients, received medical advice. The Department refused hospitalization to 42 patients because of the nonconformity to the indications and contraindications to heart transplantation. 77 patients were admitted to the Department. During examinations and treatment, 53 persons were discharged from hospital. 8 patients died before donor's hearts were received. Donor's hearts were transplanted to 10 patients. 3 persons died from severe infectious complications on days 12, 15 and 43 after the operation. Following the operation 7 patients have been surviving from 4 to 17 months. The patients' status remains satisfactory. The functional parameters of the donor's heart are within normal. Taking into consideration the lack of the treatment methods for patients with terminal heart lesions, it is necessary that the number of operations be increased. A great importance in this case is attached to the joint efforts of internists and cardiologists, aimed at the screening and examination of potential heart recipients.

A total of 168 patients admitted to the intensive care department with the diagnosis of unstable angina pectoris (UA), were investigated. Proceeding from the clinical criteria, the patients were divided into 2 groups: with primary (the 1st group) and progressive (the 2nd group) angina. The diagnosis was confirmed by the transesophageal pacing test (TEPT) performed in parallel with two-dimensional echocardiography. Positive TEPT was noted in 84% of the patients in the 2nd group and in 39% of the patients in the 1st group. The volume and expression of ischemia at the height of stimulation (ECTG findings) did not differ in both groups. Some patients with negative TEPT (in both groups) demonstrated an unfavorable time course of volumetric indices: an increase in end systolic and end diastolic volumes, a decrease in the ejection fraction. However, the diagnosis of CHD could not be excluded. Patients need further examination.

Altogether 75 patients (males aged 31 to 67 years) with unstable angina pectoris were subjected to transcutaneous pacing to measure the coronary reserve level before and after administration of obsidan (propranolol) in a dose of 40 mg. The area and depth of ischemia were found to be noticeably decreased, which was appraised according to 35 precordial leads on the ECG regardless of the unchanged "double product". It is concluded that not only the reduction of the heart rate and afterload but also their effect on the functional factors of angina pectoris are implicated in the mechanism of the anti-ischemic action of the beta-blockers.