State Of Hemodynamics Research Articles

The state of hemodynamics in middle-aged and elderly people

The article presents the results of a study of hemodynamic parameters in conditionally healthy middle-aged and elderly people in comparison with those of people with hypertension of middle and elderly age. Anthropometric data and hemodynamic parameters were determined and recorded in men and women, statistical processing of the obtained data was carried out using the analytical software IBM SPSS Statistics, 22.0. In the course of the study, a more significant inclusion of compensatory mechanisms for normalization of stroke volume, minute volume and peripheral vascular resistance was found in the group of conditionally healthy elderly people in comparison with a similar age group with arterial hypertension.

Cardiac Development and Related Clinical Considerations

The anatomy, physiology, and hemodynamics of the premature heart vary along the range of gestational ages cared for in neonatal intensive care units, from 22 weeks to term gestation. Clinical management of the preterm neonate should account for this heterogenous development. This requires an understanding of the impact of ex utero stressors on immature and disorganized cardiac tissue, the different state of hemodynamics across intracardiac shunts impacting the natural transition from fetal to neonatal life, and the effects of intensive pharmacologic and non-pharmacologic interventions that have systemic consequences influencing cardiac function. This article provides a review of the increasing but still limited body of literature on the anatomy, hemodynamics, and electrophysiology of the preterm heart with relevant clinical considerations.

#1073 Changes in endothelial function in patients with impaired central and renal hemodynamics respiratory pathology

Abstract Background and Aims To determine the degree of influence of endothelial dysfunction on the hemodynamics of renal and central vessels in respiratory pathology, as well as to determine the effectiveness of complex therapy regimens with carvedilol. Method Studies were conducted in 26 patients with chronic obstructive pulmonary disease (COPD) of II- III severity (group 1, in whom the level of glomerular filtration rate of the kidneys eGFR CKD-EPI ≥6 ml/min/1.73 m2 was determined) and 32 patients with COPD of IV severity (group 2, they were determined e GFR CKD-EPI ≥60 ml/min/1.73 m2). Patients received one course of ten-day standard therapy (GOLD, 2020) in combination with a beta–blocker drug, T. carvedilol 5 mg (Vertex). Doppler echocardiographic examination of peripheral vessels, heart and renal vessels of patients was performed. Stable metabolites of nitric oxide (Cm NO) in blood plasma, ventilation and perfusion state of the lungs were determined. Results A significant decrease in the functional state of the respiratory system was parallel with a decrease in Cm NO synthesis, which was clearly reflected in the second group (by 11%) compared with the first group (by 7%). Pronounced structural changes with remodeling of the right parts of the heart, as well as a pronounced degree of pancreatic hypertrophy in the second group were accompanied by a sharp change in renal filtration function (eGFR ≤60 ml/min/1.73 m2). When measuring the state of diastolic dysfunction of the right parts of the heart, a decrease in E/As well as an increase in the circulatory vascular resistance index and mean blood pressure were significantly higher in the first group of patients (where еGFR ≥6 ml/min/1.73 m2). After a course of treatment with t. carvedilol, based on basic treatment, normalization of endothelial function was determined, reflected in an increase in the concentration of stable metabolites of nitric oxide by 1.05 and 1.5 times (p<0.05) in the biological fluid, respectively, in the first and second groups. In the dynamics of the course of therapy in groups of patients with 75% and 35% decrease in lung ventilation capacity, mean pulmonary arterial pressure decreased by 18.1 and 14.3%, respectively, and the hemodynamic resistance index decreased by 7.9% and 5.7% in parallel (p<0.05). Conclusion When monitoring the functional state of central and renal hemodynamics and ventilation-perfusion function of the bronchopulmonary system after complex treatment with carvedilol, a long-term hypotensive effect, a decrease in endothelial dysfunction, respectively, and an improvement in central and renal hemodynamics were determined.

#1972 Changes in vegetative hemodynamic relationship in the comorbid state of patients with respiratory pathology

Abstract Background and Aims The parameters of the vegetative nervous system (VNS) and its relationship with the function of the central and renal vessels in patients with bronchial asthma (BA) in comorbidity with glomerular filtration dysfunction of the kidneys were studied and the above-mentioned indicators of complex treatment regimens were determined. Since the tension of neuropsychiatric predictors negatively affects the state of hemodynamics and internal organs directly of the VNS. The constant hyperactivity of this system due to chronic inflammatory processes is the starting point of vegetative imbalance. Method 68 patients with comorbidity with glomerular filtration dysfunction of the kidneys and 30 healthy individuals were examined. Studies were conducted in 36 patients with BA grade II-III (group 1, in which the level of glomerular filtration rate of the kidneys was determined by eGFRCKD-EPI ≥6 ml/min/1.73 m2) and 32 patients with BA grade IV (group 2, they were determined by eGFRCKD-EPI ≥60 ml/min/1,73m2). The functional state of the peripheral VNS was studied by cardiointervalography (CIG) using methods of mathematical analysis of indicators: Mode (Mo, sec.) and mode amplitude (AMo, %); Vasodilation of dependent endothelium (VDE) was determined by hyperreactive brachial artery Dopplerography test: maximum systolic velocity (Vmax) and vascular resistance index (IR). Results On the first day of admission to the hospital, patients were examined by the VNS meth, where eitonia and vagotonia were detected in practically healthy people, and hypersympathicotonia was determined in patients with BA with disorders of central and renal hemodynamics. A significant decrease in Mo parameters and an increase in AMo levels were analyzed when compared with the reference parameters of healthy individuals. This reflects the tension of the sympathetic department, and parasympathicotonia, on the contrary, decreased. There is a decrease in the ability of PA vessels to actively vasodilate due to an imbalance in the tone of the VNS. In the results of the hyperemic test, it was analyzed that in patients with BA in comorbidity with glomerular filtration dysfunction of the kidneys, the Vmax of blood flow decreases, and IR increases in parallel with the severity of the disease. All patients underwent complex therapy with halotherapy for 20 minutes daily and resonance therapy for the area of both kidneys for 5 minutes of exposure, once a day, for 10 days. After the course of treatment, there was a positive dynamics in the functional parameters of the state of the VNS. The indicators of CIG were analyzed, where hypaticotonia decreased by 6.7%, and the parameters of the parasympathetic system improved to 5.3%. Conclusion At the heart of the elevation of maladaptive processes of chronic respiratory inflammation, hypoxia of brain structures and dysfunctions of glomerular filtration of the kidneys, vegetovisceral imbalance develops. The regimens of complex therapy have a positive effect, both anti-inflammatory at the visceral level and a calming effect on the VNS.

Features of Hemodynamics of Retinal Vessels in Hypermetropic and Myopic Defoci during Treatment with Orthokeratological Lenses

Conduct a study of the hemodynamics of retinal vessels in eyes with myopia with hypermetropic and myopic defocuses: 60 eyes (30 patients) with mild myopia and 100 eyes (50 patients) with moderate myopia were examined. The average age of the patients was 12.0±0.38 years. The average degree of myopia was — (−) 2.2±0.25 D with a mild degree; (−) 4.7±0.22 D at average; The control group consisted of 40 eyes (20 patients) with emmetropia, average age -13.0±0.27 years. Along with generally accepted research methods, the following were carried out: autorefractometry, ophthalmometry, biometry, keratotopography, binocular ophthalmoscopy, OST of the optic disc and macula, OST-A with calimetry, ultrasound of the vessels of the central nervous system and central veins. All patients were fitted with orthokeratological lenses of reverse geometry Moonlens from Sky Optix, with repeated examinations after 1-3-6-12-24 months. With a weak degree of myopia, a narrowing of the caliber of the vessels of the central nervous system was revealed to 71.0±0.60 µm in 14.8% with hypermetropic defocus, with the absence of narrowing of these vessels with myopic defocus. With an average degree of myopia, narrowing of the vessels of the central nervous system to 66.1±0.60 μm was detected in 55% (55 eyes) with hypermetropic defocus, versus 35.8% (36 eyes) with the caliber of the vessels of the central nervous system — 68.6±0.57 μm (P <0.05). Along with this, in patients with an average degree of myopia, a narrowing of the vessels of the central vein with hypermetropic defocus was found to 93.1±0.59 μm in 72.7% (73 eyes), versus 56.4% (56 eyes) with myopic defocus. In both groups, normalization of LBF in the central vascular system to 5.8±0.59 cm/sec and 5.3±0.63 cm/sec with myopic defocus was revealed, and LBF in the central vein to 15.3±0.64 cm/sec. sec with average degree of myopia (P <0.05). In both groups, an increase in the resistivity coefficient (RI) was found to 0.85±0.54 (P <0.01). Conducted studies of OCT-A with calimetry of the vessels of the central nervous system and central nervous system in moderate myopia revealed a significant decrease in the frequency of vasoconstriction in myopic defocus. When examining vessels using ultrasound, a significant normalization of LBF in the central nervous system and central veins was revealed, with myopic defocus with mild and moderate myopia during treatment with orthokeratological lenses. Accordingly, the state of eye hemodynamics may be one of the factors in the effectiveness of treating myopia with orthokeratological lenses.

Features of the state of extraembryonic structures in miscarriage early terms of pregnancy

Background. Despite the modern achievements of medicine, miscarriage remains the main problem of obstetrics and gynecology science and practice. Purpose – to assess the features of the state of extraembryonic structures in case of miscarriage in the early stages of gestation. Materials and Methods. Under observation were 32 patients (main group) with a verified threat of pregnancy termination with bleeding in the embryonic period of gestation (up to 10 weeks) and 20 women (control group) with a physiological course of early pregnancy. The exclusion criteria from the study were patients with induced pregnancy, multiple pregnancies, anomalies of the development of female genital organs. All patients underwent a standard clinical and laboratory examination. During the ultrasound examination, both the state of the embryo and the state of extraembryonic structures were evaluated: the volume of the fertilized egg (V f/e), the average internal diameter of the yolk sac, the nature of vascularization of the corpus luteum, the state of hemodynamics in the myometrium. During transvaginal ultrasound, the chorionic volume (Vc) was calculated and its vascularization index (VI) was evaluated using a special three-dimensional VOCAL program. Results. Analysis of embryo biometrics in the studied groups did not reveal any significant difference. When assessing the state of extra-embryonic structures, we found that the volume of the fertilized egg and the average internal diameter of the yolk sac in women with miscarriage in the embryonic period of gestation was significantly lower. The volume of the corpus luteum of the ovary in the main group was equal to 3.0±0.3 cm3 in the control group – 5.3±0.61 cm3 , (p < 0.05). Vascularization of the corpus luteum in patients with bleeding in early pregnancy was also reduced. In patients with threatened termination of pregnancy with bleeding, Vc was 32.5±2.08 cm3 in control 71.6±2.4 cm3 . The vascularization index of the chorion in pregnant women of the main group was equal to 9.5±1.2, while in women with a physiological course of gestation it was 19.1±1.7 (p<0.05). When evaluating the hemodynamics in the myometrium, it was also established that the resistance index in the uterine and spiral arteries in the patients of the main group was significantly higher compared to the pregnant women of the control group. Conclusions. When there is a threat of pregnancy termination with bleeding in the embryonic period of intrauterine development of the child, significant changes occur in extraembryonic structures. A decrease in the volume of the fertilized egg, the average internal diameter of the yolk sac, blood flow disorders in the corpus luteum and myometrium, a decrease in vascularization of the chorion and its hypoplasia create a high risk of developing placental dysfunction and worsen the prognosis of pregnancy.

The state of central and peripheral hemodynamics in patients with out-of-hospital pneumonia associated with subclinical hypothyroidism

Objective: to investigate the state of сеntral and peripheral hemodynamics in patients with out-of–hospital pneumonia (OHP) combined with subclinical hypothyroidism (SH). Materials and methods: the study was conducted in 132 patients with OHP of clinical groups II-III, including 64 with OHP combined with SН — the main group, and 68 with OHP without SН (comparison group). The average age of the patients was 37.4±3.3 years, including 74 women among the studied, 58 men. The state of microcirculation in patients was studied by biomicroscopy of the bulbar conjunctiva using a slit lamp with the calculation of conjunctival indices, intravascular aggregation of shaped blood elements was observed in the presence of a sludge phenomenon according to N. Knisely (1965), and central cardiohemodynamics parameters were determined. Results: in patients with OHP, along with small clinical signs of hypertension, laboratory data were revealed: TSH — (6,4±0,6) мIU/ml, free T4 — (13,2±1,1) pmol/L, the level of ATP — 53,7±2,3 IU/ml — microcirculatory disorders with changes in the microvascular wall, sludge in them, perivascular changes, as well as dysfunction of the right and left ventricles of the heart. Conclusions: the combination of OHP and SH in patients is accompanied by significant microvascular shifts, which are associated with disorders of central cardiohemodynamics in the form of dysfunction of the right and left ventricles of the heart. The found correlations between the parameters of cardiohemodynamics and microcirculation in patients with OHP combined with SH and TSH levels confirm the negative effect of subclinical hypothyroidism on the state of central and peripheral hemodynamics in patients.

The state of cerebral venous hemodynamics in patients with various types of headache

The state of cerebral venous hemodynamics in patients with various types of headache

Assessment of the treatment effectiveness of men with mild and medium degree of erectile dysfunction.

. Aim: To assess the effectiveness of monotherapy and complex treatment of patients with erectile dysfunction depending on its severity. Materials and Methods: Men with moderate and mild erectile dysfunction took part in the study, who, in turn, were divided into groups, depending on the treatment, with the evaluation of the results of the International Index of Erectile Function (MIEF-15), the state of cavernous hemodynamics and the function of the vascular endothelium before and after treatment. Results: In patients with an average degree of severity, who received complex treatment including a course of low-energy shock wave therapy, against the background of taking sildenafil and L-arginine, the best results were obtained in the quality of erection and increased cavernous blood flow, which positively affected satisfaction with sexual intercourse and overall satisfaction. It has also been proven that the function of the endothelium was improved in patients receiving L-arginine, due to which there was a probable decrease in endothelin-1. A probable improvement of erectile function was obtained in the group of patients with a mild degree who received L-arginine, and there was no statistical difference from the indicators in the group who received sildenafil, which was confirmed by the data of dopplerography. Conclusions: Patients with an average degree of erectile dysfunction require comprehensive treatment. The use of L-arginine can be an alternative to phosphodiesterase type 5 inhibitors in the treatment of mild erectile dysfunction.

Study Ocular Hemodynamics in Pregnant Women with Disorders of Carbohydrate Metabolism

Purpose. To study state of ocular hemodynamics in pregnant women with disorders of carbohydrate metabolism using color Doppler imaging. Patients and methods. 147 pregnant women were examined: 40 of them had type 1 diabetes mellitus (DM), 87 had gestational diabetes (GD); in 20 — pregnancy proceeded physiologically. Examination of pregnant women with DM was carried out in each trimester and 3 months after delivery, pregnant women with GD and control groups — once in the third trimester. The parameters of hemodynamics in the central retinal artery (CRA) and in the short posterior ciliary arteries (SPCAs) were studied using color Doppler imaging. Results. It was found that the peak systolic velocity (PSV) in the CRA was significantly lower in the GD and DM groups, while PSV in the SPCAs and end-diastolic velocity (EDV) in the CRA were higher in the control group compared to the GD. In SPCAs, the resistive index (RI) was the highest in the DM group, and the lowest in the GD group. Conclusion. In patients with GD in the third trimester of pregnancy, there is a statistically significant decrease in PSV and EDV in the CRA and SPCAs, combined with a decrease in RI in SPCAs, compared with patients with a physiological course of pregnancy. In patients with diabetic retinopathy (DR) in the third trimester of pregnancy, PSV and EDV in the CRA and SPCAs were significantly lower, and the pulsatility index (PI) and RI were significantly higher compared to pregnant women with DM without DR. In pregnant women with DR during gestation, there was a decrease in PSV and EDV against the background of an increase in RI and PI in the CRA and in the SPCAs. In pregnant women with DM and absence of DR during gestation, there was an increase in PSV, EDV and PI in the CRA and SPCAs from the first to the third trimesters. The revealed features of the state of hemodynamics in the CRA and SPCAs in pregnant women with DM with presence or absence of DR can become the basis for creating criteria for manifestation and progression of DR.

STUDY OF RISK FACTORS FOR CARDIOVASCULAR DISEASES AND CENTRAL HEMODYNAMICS IN SENIOR STUDENTS

HighlightsThe article examines the prevalence of risk factors for cardiovascular diseases (CVD) and the state of central hemodynamics (CHD) in senior students. Aim. To study the risk factors for CHD and CVD in senior students with the aim of early detection of arterial hypertension (AH) and the implementation of therapeutic and prophylactic measures.Methods. The study involved 223 senior students of medical universities in Moscow aged 20-27 years (the mean age was 22.8±0.17 years). The following cardiovascular risk factors were assessed for each student: age, gender, smoking, physical activity, genetic predispositions; body mass index. The indicators of CHD were studied by volumetric compression oscillometry using a portable automated software-hardware complex for non-invasive research of central hemodynamics (“SHCNIR CHD vco-“Globus” device).Results. The presence of CVD risk factors in senior students was revealed in 52.5% of cases; more than two risk factors were found in 19.3% of cases; 1st degree arterial hypertension (AH) in 11.2% of cases; “white coat hypertension” in 10.8% of cases; genetic predisposition to CVD in 30.0% of cases; overweight in 17.0% of cases; obesity in 5.4% of cases; low physical activity in 23.8% of cases; smoking in 16.1% of cases. An altered CHD profile was found in 62.1% of students. An increase in total peripheral vascular resistance at normal blood pressure levels was noted in 31.8% of cases. Indicators of total peripheral vascular resistance, mean blood pressure, systolic and diastolic blood pressure were significantly higher in the group of students with CHD risk factors.Conclusion. Outpatient follow-up groups should include students with established risk factors for cardiovascular diseases, diagnosed AH, and with altered indicators of CHD. Preventive examinations should include a simple method for studying hemodynamics – compression oscillometry.

The State of Hemodynamics of Retinal Vessels in Primary Open-angle Glaucoma in Patients With Type 2 Diabetes Mellitus

Objective: to study the features of linear blood flow rate with central artery and retinal vein calibration in patients with POGC and type 2 diabetes. Examined 220 eyes (110 patients) with type 2 diabetes and 40 eyes (20 patients) with PAH without diabetes. The average age — 58 years old — 0,35. In addition to the common methods of research were: ophthalmoscopy with Goldman lens, binocular ophthalmoscope (Schepevsa), and lens Volk-90,0D (USA), gonioscopy with lenses (Krasnova, Goldman), tonometry by Maccov, NIidek (Japan) pneumototometry NT-2000, simplified tonography for Nesterov, OCT optical nerve disc and yellow spot Carl Zeiss Cirrus, HD OCT Model 4000/5000 Germany), OCT retinal vessels with calibre meter (Cirrus HD-Octiss Ultrasonic), Carl Ultrasonic (ISS) Central artery vessels and retinal veins (UZ — expert class system Sono Scapesq), ultrasound of the eyes. The data are processed statistically. In patients with PSA with SD 2 type of LSC reduction in the CAC at the initial and advanced stages up to 12.5 0.66 cm/s and 11 0.46 cm/s, with blood flow slowing in the CNS-LCC vessels 8.0.5 cm/s and 9.0 0.52 cm/s. In addition, the vascular calibre of the CAC increased to 91.5 0.67 μm and 93.5 0.65 μm at the initial and advanced stages of glaucoma, and the vascular size of the CAC was reduced to -97.6 0.19 μm at 75% and 93.5 0.9 μm at 50%, respectively, and expanded to 141.5 0.7%,7%. Revealed microcirculatory disorders in retinal vessels at POGC with type 2 diabetes allow recommending patients to conduct adequate therapy.

Neurogenic Regulation of Cerebral Blood Flow

The brain has a well-developed vascular network, which allows it to consume up to 15% of the cardiac output with a low mass relative to the whole-body weight. Normally, the metabolic demands of the brain depend considerably on the intensity of functioning of its different departments, which requires constant regulation of the local blood flow level. On the other hand, the state of systemic hemodynamics can have a significant impact on the organ blood flow. Complex and multilevel mechanisms of the regulation of organ cerebral blood flow are aimed at minimizing the possible adverse effects of systemic hemodynamics impairment. The importance of precise and prompt regulation of cerebral blood flow is reinforced by the absence of energy reserves or substrates for its autonomous production in the nervous tissue. The main mechanisms of cerebral blood flow regulation include: myogenic regulation, influence of local humoral influences and vasoactive substances (hormones, metabolites) of systemic blood flow, changes in blood gas composition (increase or decrease in blood oxygen or carbon dioxide tension). In addition, endothelium-dependent mechanisms of regulation are distinguished. Finally, one more level of cerebral arterial tone regulation is represented by the effect of neurotransmitters released from vasomotor fibers terminals of sympathetic and parasympathetic sections of autonomic nervous system, as well as from subcortical neurons and cortical interneurons terminals. In the present review, the principles of neurogenic regulation of cerebral blood flow are considered. The neurogenic regulation of vascular tone is the most complex regulatory circuit. The autonomic innervation of cerebral vessels has significant features that distinguish it from that in most other organs of the great circulatory circle. In addition to the autonomic innervation proper, the vessels of the brain receive sensory innervation, and the small intracerebral arterioles are also innervated -directly by subcortical neurons and cortical interneurons. In this connection, a deeper understanding of the molecular mechanisms of the neurogenic regulation of cerebral blood flow may serve as a basis for the development of new methods of treatment of severe brain diseases based on neuromodulation in the long term.

Donor heart preconditioning during orthotopic transplantation

Background. To date, there are about 500 patients in the heart transplant waiting list in Ukraine. The study included 20 donors for orthotopic heart transplantation. Their average age was 32.3 years. The study evaluated the preparation of the donor heart in terms of its protection against ischemia-reperfusion injury during transplantation and the effect of donor heart preconditioning in a recipient after orthotopic heart transplantation. Тhe purpose was to evaluate the effectiveness of donor heart preconditioning for increasing myocardial resistance to ischemia-reperfusion injury and its preparation for orthotopic transplantation. Materials and methods. The work is based on the results of 20 donors who were diagnosed with brain death and authorized for the use of transplantation of human anatomical materials. Then changes in the main biochemical parameters (lactate, troponin, acid-base balance, creatinine clearance, blood glucose) and the functional state of systemic hemodynamics (blood pressure, heart rate, central venous pressure, ejection fraction, cardiac index) were analyzed at the time of donor heart explantation. Results. It was found that in 100 % of donors, norepinephrine was used for inotropic support, in 40 % — dobutamine and in 25 % — dopamine. Lactate levels were higher than normal in 75 % of cases and troponin levels were increased in all donors, indicating a possible microcirculatory dysfunction that led to a deterioration in donor preconditioning and enhanced ischemia-reperfusion injury to the transplant. According to the correlation coefficient between time and cardiac index, there was a tendency to the deterioration in the donor’s condition depending on the time of making a decision about heart transplantation before heart explantation. Conclusions. The study showed that in 100 % of donors, norepinephrine was used for inotropic support — more often than dobutamine or dopamine. Lactate levels were higher than normal in 75 % of donors and troponin levels were increased in all donors, indicating a possible microcirculatory dysfunction that led to a deterioration in donor preconditioning and increased ischemia-reperfusion injury to the transplant. According to the correlation coefficient between time indicators and cardiac index, it is noted that the longer the time of authorization for orthotopic heart transplantation, the greater the deterioration in the donor’s condition, which is expressed in a decreased myocardial contractility. Based on the correlation coefficient between time indicators and troponin, it was concluded that the growth of troponin complexes was observed with an increase in the time of making a decision for obtaining permission to transplant human anatomical materials, which indicated the onset of ischemic changes in the myocardium.

Autoregulation of cerebral blood flow in normal and pathological conditions

The metabolic needs of the brain largely depend on the intensity of the functioning of its various departments, which requires constant regulation of the level of local blood flow. The importance of accurate and timely regulation of cerebral blood flow is enhanced by the lack of substrate stores for autonomous energy production in nervous tissue. In this case, the state of systemic hemodynamics can have a significant effect on organ blood flow. At the same time, given the significant importance of the central nervous system in providing all physiological processes, the regulation of organ cerebral blood flow is aimed at minimizing the possible adverse consequences of the influence of disorders of systemic hemodynamics. In this regard, the regulation of cerebral blood flow is based on multiple and complex physiological mechanisms at various levels. The basic level of regulation of cerebral blood flow is myogenic response, which provides the phenomenon of autoregulation of blood flow in the brain. The review focuses on the physiological mechanisms underlying myogenic regulation as well as the change in this regulation in various diseases.

Reproductive system status in men after coronavirus infection and vaccination

Introduction The COVID-19 pandemic is a serious problem for the health care system in Russia and worldwide, as the pathogenic influence of the pathogen can cause a systematic range of complications in the body, especially in the reproductive system.The aim of the work was to determine the state of the reproductive system in men after coronavirus infection and vaccination based on the analysis of literature data.Materials and methods The search for papers on the state of the reproductive system in men after coronavirus infection and vaccination was conducted in PubMed, Medline, EMBASE and eLibrary.ru databases.Results The reproductive capacity of male patients who have undergone COVID-19 is affected by numerous factors: general health status, activity of the renin-angiotensin-aldosterone system, development of systemic inflammatory response, activation of lipoperoxidation processes, etc. This changes cause inflammatory response in the tissues of the reproductive system, secretion of pro-inflammatory cytokines, imbalance of the antioxidant system, formation of oxidative stress, damage to Leydig and Sertoli cells, formation of reproductive insufficiency and infertility.Discussion The pathogenetic role of SARS-CoV-2 in the development of reproductive depression in men with coronavirus infection, which has a prolonged, negative and persistent effect on the state of testicular hemodynamics, the level of total testosterone in blood and ejaculate parameters, was confirmed.Conclusion The results of the study suggest a deterioration of the reproductive system in men following coronavirus infection.

Myocardial contractility in vibration disease

The article describes the features of the state of central hemodynamics and myocardial contractility in patients with vibration disease of various forms and severity using an echocardio graphic study based at the Department of Occupational Pathology, the regional center of occupa tional pathology Samara City Hospital No. 5. It has been established that patients with vibration disease are characterized by the formation of a phase syndrome of myocardial hyperdynamia and a hyperkinetic variant of central hemodynamics, while hemodynamic changes depend on the form of vibration disease, its severity, and the length of work with exposure to vibration.

Peculiarities of Systemic Hemodynamics and Autonomic Status in Medical Personnel of PCR-Laboratories with Different Emotional Intelligence

INTRODUCTION: The ongoing pandemic of a new coronavirus infection COVID-19 (COronaVIrus Disease 2019) places high demands on the activity of PCR-laboratories (laboratories performing polymerase chain reaction). The medical personnel experience overloads due to stay in the red zone wearing the individual protection means, and also in association with a high personal responsibility for the result of their work. One of the criteria that is proposed for professional selection with the aim of increasing the effectiveness of the work of personnel of PCR-laboratories, is the emotional quotient (EQ).
 AIM: To analyze the state of systemic hemodynamics and heart rate variability in medical workers of PCR-laboratories with different emotional intelligence working in condition of COVID-19 pandemic using means of individual protection against the biological factor.
 MATERIALS AND METHODS: The extent of health risk and tension of adaptation mechanisms during the work were evaluated by parameters of systemic hemodynamics (tonometry, pulse oximetry) and heart rate variability (cardiorhythmography). Thirty three individuals with the working period in a PCR-laboratory from 1 to 33 months were examined. The average age of the participants at the time of inclusion in the study was 32.4 1.44 years. In 33.7%, EQ corresponded to the medium level (81120 points), and in 66.7% to the high level (121168 points).
 RESULTS: Before the start of the work shift, increased blood supply to tissues in personnel with high EQ was achieved by increased heart activity: cardiac output (CO) 3938.9 ml/min, interquartile range (IQR) = 3404.24230.2 ml/min with the underlying reduction of vessel tone: total peripheral vascular resistance (TPVR) 1922.8 dyn s/cm5, IQR = 1636.52085.8 dyn s/cm5. After the end of the shift, to these compensatory mechanisms (CO 4284.7 ml/min, IQR = 3935.44688.8 ml/min; TPVR 1692.4 dyn s/cm5, IQR = 1584.61903.1 dyn s/cm5), increased myocardial oxygen consumption (MOC; 7917.5 RU, IQR = 7430.28811.0 RU) added as a reaction to the muscular component of labor activity. In individuals with average EQ, these mechanisms were less pronounced in considerable mental stress: before the shift CO 3722.0 ml/min, IQR = 3163.13739.0 ml/min, p = 0.013; TPVR 2303.1 dyn s/cm5, IQR = 2058.12402.1 dyn s/cm5, p = 0.016; after the shift CO 3375.0 ml/min, IQR = 3372.04402.0 ml/min, p = 0.010; TPVR 2010.5 dyn s/cm5, IQR = 1972.62351.9 dyn s/cm5, p = 0.017; MOC 7450.0 RU, IQR = 6653.37867.3 RU, p = 0.023.
 CONCLUSION: The extent of tension of mechanisms of self-regulation of systemic circulation, apart from characteristics of used technical means and the working regime, significantly depends on the level of emotional intelligence. With this, personnel with high emotional intellect are preferable for the work in the red zone because of lower tension of regulatory mechanisms.

INFLUENCE OF EXPLANTATION ON THE HEMOCIRCULATION OF THE TESTICLE IN MEN OF FERTILITY AGE: LONG-TERM RESULTS, PRELIMINARY FINDINGS

Abstract. The introduction of explantation techniques into clinical practice allowed to reduce the percentage of recurrence of inguinal hernias to the level of less than 1%. But there are data indicating a negative effect on the reproductive function of men. On the other hand, a number of researchers deny the negative consequences of explantation.
 The purpose of this study is to evaluate the effect of a polypropylene prosthesis on testicular hemocirculation in men of childbearing age.
 Materials and methods. The peak systolic velocity, end-diastolic velocity and resistive index (RI) in the testicular, capsular, and intratesticular arteries were studied using the Doppler ultrasound method in 30 men aged 20-45 who underwent surgical intervention — herniotomy, Lichtenstein hernioplasty for a unilateral inguinal hernia. The obtained results were compared according to the data of the contralateral side. The study was conducted 6 and 12 months after surgery.
 Results and discussion. None of the applied parameters of testicular hemocirculation in the arteries that were studied during the observation period was statistically significantly different from the control.
 Conclusions. Within 6-12 months after hernioplasty, the synthetic explant does not have a negative effect on the state of testicular hemodynamics.

Аcute renal failure in patients with implanted LVAD in the early postoperative period

AKI is one of the major complications in the cardiac surgery group of patients in the world. In patients with LVAD in the short postoperative period, the situation with such a complication as AKI is associated with the state of hemodynamics and fluctuations in the parameters of the hemostasis system.
 The purpose of this scientific work is to analyze the state of the blood coagulation system and its response to therapy and complications in the early postoperative period in fifty patients with implanted devices for mechanical support of the left ventricle, left ventricle assist device, LVAD, in the Silesian Heart Disease, Poland. Patients were divided into two groups, a control group receiving classical anticoagulation targeted therapy (ATT), which included the most controlled monotherapy with heparin, after reaching the target values of APTT, the addition and transition to monotherapy with warfarin until reaching the target INR and ASA, and the main, research group, who received an alternative ATT consisting of the previous one with the addition of P2Y12-receptor blockers and Xa-factors.
 The results showed that the control group of patients with classical anticoagulant targeted therapy had greater mortality associated with AKI than the patients of the study group, and it was also demonstrated that the initially longer duration of surgery and intraoperative polyuria gave a greater percentage of AKI in the postoperative period.
 The work was carried out within the framework of a bilateral agreement on scientific cooperation between the Department of Anesthesiology & Intensive Care at the National Medical Academy of Post-Graduate Education Named After P.L. Shupyk and the Silesian Center for Heart Diseases (Poland). This article is part of the analysis of the work on the analysis of the blood coagulation system in patients after implantation of the left ventricular mechanical circulatory support system with the analysis of such postoperative complication as acute kidney failure.