[Involutive and hypertensive fibrosive transformation of the heart in formation of myocardial dysfunction and chronic heart failure.]

To assess the conjugation of involutive and hypertensive fibrotic transformation of the heart formation with myocardial dysfunction and chronic heart failure (CHF), 30 normotensive individuals and 60 elderly patients with arterial hypertension (AH) (mean age - 66±0,7 years) were examined by echo and dopplercardiography, estimation of the volume fraction of interstitial collagen (VFIC) in the myocardium, serum concentrations of markers of systemic collagenogenesis, using a six-minute walk test. A higher intensity of LV myocardial fibrosis was revealed with a significant increase in the VFIC content in elderly patients with AH compared with normotensive patients, which indicates the predominance of interstitial collagenogenesis over collagenolysis. The increased content of fibrous tissue in myocardial interstitium caused the development of unfavorable types of cardiac remodeling and the progression of diastolic dysfunction, negatively affecting the functional reserve of the circulatory system, as evidenced by negative correlations between the level of the VFIC and the results of a 6-minute walk test: weak in patients with I FC CHF, moderate strength in patients with AH with II FC CHF.

[The state of geriatric care in the Kursk region: problems of formation and development prospects.]

The article presents the main promising directions for the development of geriatric care for the elderly population implemented in the Kursk region thanks to the efforts of the Polyclinic Therapy and General Practice Department of the Kursk State Medical University, the Kursk Branch of the Gerontological Society of the Russian Academy of Sciences, and the team of the Kursk Local Center of the Global Aging Network for the International Association Gerontology and geriatrics, consisting in the professional retraining of specialists for working with the elderly population, providing quality advisory services to specialists of outpatient medical institutions, organizing scientific and practical conferences devoted to the discussion of urgent problems of gerontology and geriatrics, effective cooperation with the service of social protection of the population. The important role of training qualified medical staff, conducting modern scientific research, introducing their results into healthcare practice, the need to organize additional education for the elderly, involving them in performing volunteer activities to maintain a functional socially-demanded activity, and quality of life are emphasized.

Impact of industrial contamination on the populations of small forest rodents

Investigations performed for monitoring the impact of industrial contamination from the Kostomuksha ore mining and processing enterprise (northern Karelia) on the populations of forest mouse-like rodents revealed increased embryonic mortality (three to four times higher compared to the control) in breeding females from the areas contaminated by nitrogen and sulfur oxides within the territory studied. The toxicants also influence other parameters of the population: abundance dynamics, ecological and spatial structure of the population, and reproduction rates. The results demonstrate that the population reactions of species may turn out to be more accurate and demonstrative when estimating the consequences of industrial contamination than the direct concentrations of a particular toxicant in the animal body.

[Significance of insulin resistance in the pathogenesis of sarcopenia and chronic heart failure in elderly hypertensive patients]

To determine the pathogenic role of insulin resistance in the formation of involutive sarcopenia and chronic heart failure (CHF) were examined 88 elderly patients with arterial hypertension (AH) and 32 elderly patients without cardiovascular disease by methods of carbohydrate metabolism and the level of brain natriuretic peptide precursor evaluation, muscle mass and strength measuring, echocardiography, 6 minute walking test. It was found that in the group of hypertensive patients with low mass and muscle strength significantly increased indices of insulin resistance and more expressed signs of the left ventricle myocardial dysfunction and functional class of heart failure, probably as a result of disorders of energy homeostasis, resulting from the deterioration of glucose into the muscle cells of the heart and skeletal muscles.

[Significance age-related predictors of chronic heart failure in determining the risk of death in elderly patients with hypertension]

In order to establish the prognostic value of age-related pathogenesis and the development of heart failure related to lipid peroxidation, endogenous subclinical inflammation, apoptosis, sarcopenia, interstitial myocardial fibrosis in the risk of mortality and survival rates, for the first time the results of echocardiography, enzyme immunoassay, bioimpedansmetry with the scale of the Seattle model of heart failure performed in 84 elderly patients with arterial hypertension stage II (middle age 68,3 +/- 1,8 years) were compared. We found that the increased activity of markers of chronic heart failure progression was associated with an increased risk of death in patients. We identified the most important indicators in assessing the risk of death and prognosis of heart failure in elderly patients; their timely correction will imply an increase in life expectancy of older patients with chronic heart failure.

[Pathogenetic significance of interstitial fibrosis in development myocardial dysfunction and chronic heart failure in elderly patients with arterial hypertension]

To estimate the pathogenetic significance of interstitial fibrosis in development myocardial dysfunction in elderly patients with arterial hypertension the complex investigation of 84 patients (76 women and 8 men), suffering from arterial hypertension (AH) II stage and practically healthy 22 persons of advanced age was spent. It is established, that expressiveness of myocardial fibrosis in the elderly patients with AH, confirmed by an increase of volume fraction of interstitial collagen was accompanied by authentic change of serous level markers of its exchange: decrease in concentration of the matrix metalloproteinasum-1 predecessor and increase its inhibitor. Progressing of myocardial dysfunction from diastolic variant to sistolo-diastolic one is interfaced to maintenance increase of extracellular matrix and its negative changes of serous markers, decrease of index collagen degradation, tolerance to physical activity, development forecasting adverse variants of heart remodelling

[Apoptosis and interstitial fibrosis in development of myocardial remodelling in elderly patients with arterial hypertension]

To determine the apoptosis and interstitial myocardial fibrosis pathogenetic role in development of myocardium dysfunction we surveyed 84 patients of elderly age suffering from an arterial hypertension (AH) II stage by methods of echo- and dopplercardiometry, enzyme multiplied immunoassay of Nt-proBNP level, serumal markers of collagen exchange, apoptosis activity. The patients with normal geometrical model of heart due to AH demonstrated a low level of apoptosis and fibrosis activity. Structural reorganization of a myocardium from concentric to eccentric hypertrophy and concentric remodelling of left ventricle was characterized by strengthening of cellular apoptosis and interstitial myocardial fibrosis in extracellular matrix expressiveness, prevalence of collagen synthesis over collagen degradation, progressing of myocardium dysfunction.

[Age-related sarcopenia as the risk factor of development of myocardial dysfunction and chronic heart failure in elderly patients with arterial hypertension]

To estimate the expressiveness of involutive sarcopenia and its influences on the development of myocardial dysfunctions 88 patients of 60+ years with arterial hypertension (AH) II stage (middle age 66.9 +/- 0.7 years, 76 women and 12 men) and 32 persons who do not have cardiovascular diseases were surveyed. It is revealed that expressiveness of involutive sarcopenia is non-uniform at senior patients; structural and functional changes of heart in elderly patients with AH clinically shown by myocardial dysfunction, decreased tolerance to physical activity, are more pronounced in the group of patients with a low index of muscular weight. High values of the indicators of oxidative modification of lipids in the blood serum and the insufficiency of mechanisms of antioxidant protection in elderly patients with AH who have low index of muscle mass point to the negative role of oxidative stress in the pathogenesis of involutive sarcopenia.

[Interrelation of endothelial and myocardial dysfunction in persons of elderly age with arterial hypertension]

For the purpose of estimation of peculiarities of interrelation between endothelial dysfunction (ED) and myocardial dysfunction (MD) in elderly persons due to arterial hypertension (AH) 66 patients of elderly age with AH of II stage and 26 persons of similar age without cardiovascular diseases were examined. It is established, that development AH is accompanied by formation of a concentric hypertrophy and concentric remodelling of myocardium, diastolic and systolodiastolic myocardial dysfunction, its expressiveness is interfaced to severity of endothelial dysfunction. Progressing of ED is accompanied by infringements of lipids' metabolism, increasing of their peroxidation activity and decreasing in efficiency of anti-oxidation protection.

[Prognostic value of target organ's impairments risk factors caused by arterial hypertension in elderly patients]

With the purpose of an establishment of the importance of disturbances of a lipid exchange and oxidizing updating of lipids in definition of heart impairment at arterial hypertension (left ventricle myocardium hypertrophy, LVMH) at elderly people parameters of echocardiography and lipid's profile are analysed: the general cholesterol, triglycerides (TG), lipoproteins high (HDL) and low density (LDL); parameters of antioxidative system are estimated at 103 patients. It is established, that LVMH it is accompanied with lipid's disorders, caused by the high maintenance of triglycerides and LDL, depression of their resistance to the oxidation. Parameters of left ventricle final diastolic size, thickness of interventricular septum, level of general cholesterol, LDL, antioxygenic properties of serum etc. have high prognostic significance, they are necessary for supervising during treatment-and-prophylactic actions.

[Forecasting of severity of functional disorders in patients of advanced age with a cardiovascular pathology]

The cardiovascular system of a person functions in close interrelation with all structures of an organism, providing their metabolic requirements, homeostatic mechanisms. In majority of elderly patients with cardiovascular diseases the accelerated ageing can be observed. The highest biological age, a functional class of a circulatory insufficiency is registered in patients with a cardiologic pathology complex. The analysis of correlation interrelations of functional parameters with an estimation of total, force and an orientation of connections enablesto understand mechanisms of indemnification, fastness and intensity of functioning of a system of circulation. The established limits of homeostatic fluctuations of parameters of a circulatory system of growing old patients integrated to it with cardiovascular diseases serve as a reference point for forecasting risk of advance of their functional heart failure, restrictions of vital activity.

[Thermoregulatory activity of the motor units of skeletal muscles in the pigeon]

The firing rate of single motor units was 5-12/sec during cold tremor in anesthetized pigeons. Some differences of the firing rate characteristics were found between pigeons captured in winter and in summer.