Remote ischemic preconditioning (RIPC) is the set of ischemia episodes that protects against subsequent periods of prolonged ischemia through the cascade of adaptive responses; however, the mechanisms of RIPC are not entirely clear. Here, we aimed to study the impact of RIPC in patients with stable angina pectoris and compare it with healthy individuals with respect to arterial stiffness and heart rate variability. In the randomized, sham-controlled, crossover blind design study, a group of 30 coronary heart disease (CHD) patients (63.9 ± 1.6 years) with stable angina pectoris NYHA II-III and a control group of 20 healthy individuals (58.2 ± 2.49) were both randomly allocated for remote RIPC or sham RIPC. Arterial stiffness, pulse wave velocity (Spygmacor, Australia), and heart rate variability (HRV) were recorded before and after the procedure followed by the crossover examination. In the group of healthy individuals, RIPC showed virtually no impact on the cardiovascular parameters, while, in the CHD group, the systolic and central systolic blood pressure, central pulse pressure, and augmentation decreased, and total power of HRV improved. We conclude that ischemic preconditioning reduces not only systolic blood pressure, but also reduces central systolic blood pressure and improves arterial compliance and heart rate modulation reserve, which may be associated with the antianginal effect of preconditioning.
Arterial blood pressure measured by Korotkov’s method is a non-valid predictor for possible cardiovascular events, which requires introduction of new methods of arterial hypertension diagnostics. Recently, the effect on arterial stiffness has become a very important characteristic of antihypertensive drugs overall efficacy. Evaluation of arterial stiffness (central aortic pressure, augmentation index and pulse wave velocity) contributes to more precise cardiovascular risk stratification and reflects target organ damage and the effectiveness of antihypertensive treatment. In particular, pulse wave velocity exceeding 12 m/s is a significant risk factor of cardiovascular events. Arterial compliance can be determined by applanation tonometry, pulse wave shift at the carotid and femoral arteries, finger photoplethysmography, volume pulsoxymetry, echo-tracking, suprasystolic pulse waves recording method and cardio-ankle vascular index. Different effects of antihypertensive drugs on arterial stiffness at the same blood pressure reduction have been repeatedly shown. The article discusses the impact of the most commonly used antihypertensive drugs, including contemporary antihypertensive drugs combinations, on arterial stiffness. Effect of beta-blockers greatly varies depending on the characteristics of the drug, diuretics have neutral effect, calcium antagonists (especially amlodipine) decrease the pulse wave speed and arterial wall stiffness. Both angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers (more data for enalapril, perindopril and valsartan) were effective in decreasing arterial wall stiffness. A significant reduction in arterial wall stiffness was mainly found if antihypertensive drugs combinations were used, especially the combination of calcium antagonists and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers.
The article tries to trace the Japan influence on the Russian Art Culture in the end of XTX - beginning of XX centuries. Tt is found that the beginning of Japanese culture reception in Russia was connected with decorative and applicable art and painting and then with the theatre, literature and music. Tn some cases reception took place indirectly through oriental genres of European Art.
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