We studied the effect of a single session of hyperbaric oxygenation on the size of risk, ischemic, and necrotic zones in rat myocardium after irreversible occlusion of the coronary artery and excessive oxygen pressure of 0.02 and 0.1 MPa. Myocardium infarction was reproduced by ligation of the left coronary artery. The size of the risk, ischemic, and necrotic zones was planimetrically evaluated. Hyperbaric oxygenation (60-min session) was performed 3 h after artery occlusion at excessive oxygen pressure of 0.02 and 0.1 MPa. In rats not exposed to hyperbaric oxygenation, the risk zone median was 31.7% of the left ventricle weight, while after the session it did not exceed 25%. In spontaneous course of myocardium infarction, the ischemia to necrosis zone ratio was 1.7:1, while under conditions of hyperbaric oxygenation at oxygen pressure of 0.1 and 0.02 MPa, the these values were 0.6:1 and 2:1, respectively. Excessive oxygen pressure of 0.02 mPa is better than traditionally used 0.1 MPa, because it promotes redistribution of the ischemic and necrotic areas in the risk zone: the area of necrotic zone decreased at the expense of the ischemic zone. Hyperbaric oxygenation produces a positive effect on the myocardium under conditions of total occlusion of the coronary artery.
(1) Background: This study was planned to assess the concentration of antihypertensive drugs (AHD) in the blood serum in patients with controlled and uncontrolled arterial hypertension (AH). (2) Methods: We assessed 46 patients with AH. Based on the results of 24 h blood pressure monitoring (ABPM), the patients were randomized into two groups. The first group consisted of the patients with controlled AH; the second group consisted of the patients with uncontrolled AH. Venous blood was taken in both groups of patients in the morning before and 2 h after taking drugs to assess the concentration of lisinopril, amlodipine, valsartan, and indapamide. (3) Results. The first group included 27 patients, and the second group 19 patients. In patients with uncontrolled AH, the median concentrations of lisinopril, indapamide, amlodipine, and valsartan before and after taking the drugs did not differ from patients who reached the target BP values. (p > 0.05). In some patients with uncontrolled and controlled (shown for the first time) AH the concentration of AHD was below the limit of quantitative determination. (4) Conclusions. The obtained results indicate that the pharmacokinetics of AHD, apparently, does not play a significant role in the development of ineffectiveness of the ongoing therapy for AH. Therapeutic drug monitoring can be used to test adherence to the treatment.
Surgical treatments of acute myocardial infarction (MI) possess a high clinical effectiveness, but there are fixed limitations, related to the patient's state, which are limited by medical resources and organizational problems. The development of new medical technologies provides a better and effective non-surgical treatment of acute MI and increases long-term prognosis in this category of patients. The study aims to investigate the influence of hyperbaric oxygenation treatment on clinical outcomes (survival rate and recurrent myocardial infarction (rMI)) during the five-year period of monitoring. The study involved 697 patients who suffered from acute MI, having undergone the standard treatment. The patients were randomly divided into two groups: Group 1 (reference, n = 363); Group 2 (test, n = 334). Patients of Group 2 were given the traditional treatment, accompanied with HBOT (isopression for forty minutes at a working pressure of 0.03 MPa). HBOT was applied first through the fifth day following MI. The treatment course included six cycles, once per day. The clinical assessment was focused on clinical outcome: rMI and mortality related to cardiovascular events. HBOT application that accompanied the acute MI with traditional pharmacotherapy has been proved to reduce rMI within five years following inpatient discharge (rMI rate was 14% in the reference group and 5.4% in the test group, χ 2 = 13.3, р < 0.05). The combination of HBOT with traditional methods in treating acute MI makes it possible to raise the five-year survival rate from 84.4% up to 95.9%.
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