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MOSCOW INTERNATIONAL FORUM OF CARDIOLOGY

2628 2013 , . 26-28 March 2013, Moscow

ACCEPTED ABSTRACTS

, 2013; 12 ()CARDIOVASCULAR THERAPY AND PREVENTION 2013; 12 (March), special edition

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, 2013; 12 () 3

001-005

001 HAWTHORNE IN INCREASING CARDIO STRENGTH

Gabinskiy V., von Peters W., Kushnir I., Gabinskaya L., Gabinskaya I., Gabinskiy R., Gorinshteyn B.

First National University, Idaho, Russian-American University, Atlanta, USA

The herb Hawthorne (Crataegus oxycantha) has been used as a heart tonic for centuries. Hawthorne is a spiny shrub that has been traditionally used as a heart tonic in European herbal medicine. The herb is a rich source of bioflavonoids and anthocyanidins. The herbal medicine is made from an extract of the leaves or berries blossoms of two primary species (Crataegus oxycantha and Crataegus monogyna).

In this study 17 males age 4768 who satisfied entry criteria of confirmed Cardio-Vascular Disease (CVD) disease with at least 60% blockage as determined by Echocardiogram were placed on the protocol for 120 days.

Therapeutic dosages for the Hawthorne was 250 mg. per day in capsules divided into two doses. Hawthorne group achieved a mean increase of 22% in coronary blood flow plus improvement.

Participants also reported increased stamina, better wind, and the ability to participate in everyday activities without breathlessness.

Our conclusion is that hawthorne berry should be considered as an adjunct to standard cardiotherapy.

002 GREEN COFFEE EXTRACT IN IMPROVING HUMAN VASOREACTIVITY

Gabinskiy V., von Peters W., Kushnir I., Gabinskaya L., Gabinskaya I., Gabinskiy R., Gorinshteyn B.

First National University, Idaho, Russian-American University, Atlanta, USA

Green coffee bean extract is made from the green beans of the coffee Arabica plant. There are two types of coffee plants, arabica and robusta the arabica is higher in quality and higher in chlorogenic and coffee acids, two primary compounds responsible for anti-oxidant activity.

The extract has strong anti-oxidant properties similar to other natural anti-oxidants like green tea and grape seed extract. These beans have polyphenols which act to help reduce free oxygen radicals in the body (in other words acting as good antioxidants). Green coffee bean extract is standardized to 30 to 50% chlorogenic acid, a compound present in coffee which has long been known for its beneficial properties.

It has been found that the extract contains significant amounts of chlorogenic acid, ferulic acid that acts on nitric oxide derived from the vascular endothelium.

The study involved 15 generally healthy males between the ages of 37 and 64, who were diagnosed with reduced vasodilatation responses, as measured by strain gauge plethysmograms (SPG) to ischemic reactive hyperemia. The SPG was taken before and after the 90 day ingestion period.

The reactive hyperemia ratio (RHR) increased 12% in the final SPG. In addition, there was a significant decrease in the plasma total homocysteine level compared with the pre-ingestion level. Further, without changing dietary or exercise habits the study participants lost an average of 10.5% of their overall body weight and 16% of their overall body fat.

It should be noted that roasted coffee beans do not contain the chlorogenic acid, and thus drinking coffee does not have the benefit of green coffee bean extract.

Conclusion: Green coffee bean extract can be a valuable adjunct both in increasing vasoreactivity and in helping reduce cardiac risk factors such as obesity.

003 STAPHISAGRIA AND POST-SURGICAL COMPLICATIONS

Gabinskiy V., von Peters W., Kushnir I., Gabinskaya L., Gabinskaya I., Gabinskiy R., Gorinshteyn B.

First National University, Idaho, Russian-American University, Atlanta, USA

Staphisagria is an herb that is traditionally used as a vermifuge, emetic, cathartic, and narcotic. However, it is when prepared in homeopathic potency that its usage in surgery, both pre- and post-surgical, gains its efficacy.

Homeopathic Staphisagria is regarded as the best remedy in the homeopathic armamentarium for use with incised wounds, i. e., where there is a clean cut, such as after surgery. Used here the remedy helps prevent post-operative pain, and promotes an intensified healing.

In our study 13 people were given Staphisagria in the 30C potency post cardiac bypass surgery. The Staphisagria was taken 6 pellets prior to surgery, and then every 4 hours post surgery for the first two days following the surgery, and thereafter 3 times daily for 2 weeks. Staphisagria 30C was used along with standard medical treatment for pain and post surgery.

The results were that the participants reported, on average, less pain and a faster healing of the incision site, and less problems with sutures was noted. The surgical site overall had less swelling and complications. Healing time, on average was about 30% faster than normally found without usage of Staphisagria 30C.

Staphisagria has been a part of the homeopathic armamentarium for well over 100 years. In potency, such as this study, it is a safe and valuable adjunct to standard medical post-operative care.

004 EFFECT OF NARCOTIC TREATMENT ON OUTCOMES OF ACUTE CORONARY SYNDROMES

Iakobishvili Z., Porter A., Battler A., Behar S., Roth A., Atar Sh., Boyko V., Mager A., Hasdai D.

Rabin Medical Center, Petah Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Background: Current guidelines have recommended intravenous narcotics (IVNs) for patients with ST-segment-elevation acute coronary syndromes (STEACS) and patients with non-STEACS (NSTEACS), although the safety of IVNs has been challenged.

Methods and results: We performed a retrospective analysis of the 30-day outcomes stratified by IVN use among patients enrolled in a national survey, using logistic regression and propensity score analysis. Of the 765 patients with STEACS and 993 patients with NSTEACS, 261 (34.1%) and 97 (9.8%) had received IVNs, respectively. The patients with STEACS who received IVNs were more likely to undergo reperfusion (79.7% vs 55.2%, p

, 2013; 12 ()4

006-007

Rabin Medical Center, Petah Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Background: We aimed to determine the optimal renal function formulas for risk stratification in acute decompensated heart failure (ADHF) and chronic heart failure (CHF).

Methods: We compared 5 formulas of estimated glomerular filtration rate (eGFR) for prediction of 30-day, 1-year, and 4-year mortality in a nation-wide heart-failure survey: chronic kidney disease epidemiology collaboration (CKD- EPI), modification of diet in renal disease (MDRD), Mayo quadratic (Mayo), inulin clearance based (IB), and Cockcroft-Gault (CG (.

Results: Of the enrolled patients, 1604 ADHF and 1100 CHF patients had 1 measurement of serum creatinine. Renal insufficiency (RI), defined as eGFR

, 2013; 12 () 5

008-010

52% of the surveyed persons, i. e. variant presence 677 (genotypes / or /) were observed in 6272% of cases. Almost similar results have been received in our research (77, 7%) that allows to carry us in group of the European samples of the population with polymorphism on a mutation 677 gene MTHFR.

Thus, carrying out of genetic identification of Ala222Val of gene MTHFR for the purpose of revealing of group of individual RF will allow optimizing in due time primary and secondary preventive maintenance of an atherosclerosis and atherothrombosis at the population that substantially will lower SAE case rate.

008 ROLE AND INFLUENCE OF THE COAGULATIVE FACTOR OF POLYMORPHISM OF GENES ON THE CURRENT OF THE ISCHEMIC HEART DISEASE AT PERSONS OF UZBEK NATIONALITY

Nurillayeva N. M.Tashkent Medical Academy, Tashkent, Uzbekistan

Considering multifactorial character of an ischemic heart disease (IHD) pathogenesis, i. e. presence of set of the risk factors leading to development and advance of disease, analysis carrying out on presence of associations of polymorphism Ala222Val of a methylene tetra hydro folate reductase gene (MTHFR) with the clinical-anamnesis data of ischemic heart disease patients in investigated groups became a research objective. 2 groups of the patients suffering an ischemic heart disease became the material of the research, in I group 68 patients werent trained at the health School, the second comparable 67 patients, were trained in the conditions of School of health of a primary link of public health services.

The burdened anamnesis on disease in I group (i. e. presence of an ischemic heart disease at parents and close relatives) at 45 (66,2%) the patients, not burdened at 18 (26,5%) is taped, at 5 (7,3%) patients predisposition to an ischemic heart disease at parents didnt become perceptible. According to the anamnesis data of patients of II group hereditary burdeness is defined at 43 (64,2%) ischemic heart disease patients, 24 (35,8%) the patient of predisposition to disease havent noted the others. Frequency of occurrence of heterozygotic genotype Ala222Val of gene MTHFR has appeared above almost on 42% in group of ischemic heart disease patients concerning group of healthy faces. For today it is already known that the risk of development of a serious stenocardia is directly proportional to quantity of the found out genetic deviations. The given hypothesis is confirmed with presence at our patients of a clinical debut of an ischemic heart disease, i. e. positive correlation communication r=0,20 is found out. Besides it, at ischemic heart disease patients of persons with heterozygotic genotype MTHFR notes presence of high occurrence of controlled risk factors: a disturbing-depressive syndrome in 59,8%; obesity in 56,3%; hypercholesterolemia in 36,2% of cases, and also directly proportional dependence of genetic deviations with high frequency of hospitalization (1,6 times a year) and higher functional class of a stenocardia (III and IV) in 61,3% of cases. Considering high frequency of occurrence of a mutation of gene MTHFR among coagulative factors and its communication with modified risk factors of an ischemic heart disease, carrying out of the further genetic researches for active primary and secondary preventive maintenance of stable angina of exertion as diagnostic criterion of an early manifestation and ischemic heart disease advance is necessary. Studying of association of polymorphisms of the specified genes with development and a current of the above-stated pathology in the presence of certain modified RF, also will allow to estimate risk of development of conditions menacing to life, and also correctly to define ways of their treatment, preventive maintenance and possibility of application of those or other medicinal preparations.

009 PHYSICAL ACTIVITY IN MEDICAL STUDENTS WITH PREHYPERTENSION: HOW DOES IT WORK?

Venevtseva Y., Liashenko K., Gomova T., Melnikov A., Borisova O.

Tula State University, Tula, Russia

Purpose. Mental overload in the medical school may lead to maladaptation and casual blood pressure (BP) rise. It seems to be due of insufficient physiological reserve. Modern environment does not need any physical exertion in the day life, but optimal physical activity may have beneficial effect on health and performance.

The aim of the study was to evaluate the influence of 12-week program of aerobic fitness (45 min. twice weekly, treadmill, mean heart rate (HR) in the steady state phase 130 beats/min, with 10-min. relaxation) on the functional status in 28 university students (6 male, 22 female) aged 1920 yrs with low habitual physical activity level and high normal BP.

Methods. HR and BP at the rest and during exercise were measured before, after 6 week (w) and in the end of intervention. The autonomic tone and regulation has been evaluated with 5-min. ECG recording in supine and standing position. Heart rate variability (HRV) was calculated in the time (SDNN, RMSSD) and frequency domains (total spectral power, TP, power in VLF, LF and HF band). The battery of psychometric tests was used to access executive (active attention, working visual memory) and sensorimotor function (simple reaction time, choice reaction time, flicker fusion rate, finger tapping test and motor coordination).

Results. After 12-w training HR (87.1 vs 80.0 beats/min), systolic BP (M+/-SD) before 132.54.2 mm Hg, 119.09.1 mm Hg after 6 w and 115.95.8 mm Hg in the end, P

, 2013; 12 ()6

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, -, 9 I (13,5%), 3 II (5,76%) 3 III (13%). , - 22 I (33%), 14 II (26,9%), 3 III (13%).

I 4 (6%), II 10 (19,2%), III 6 (26%). , 2 (

, 2013; 12 ()24

055-056

, ; ; ; ; ; ; ; ; -; ; ; ; ; ; ; ; ; ; ; ; ( ). - t- , 2 ( - ).

. -, (=5,85; =0,013) - . : ( =8,67; = 0,0084).

. , - : (=0,035), (=0,036), III (=0,0001), (=0,02), - (=0,006). , (=0,014) , .

- - (=7,57; =0,005). , - (=13,4; =0,0002). - . 18,79,7% . - (48,16,8%). - -: =4,34 ( 0,033) (0,05).

, , , (=0,0051).

. - : , , - , , , , , , , . : , , .

055

. ., . ., . . ,

,

. - () (), - () ().

. 90 - . -.

. 3 . (n=34) , 15 . (n=30) - (+). 8 . (n=30) . 5 /. - HAQ DAS28. Sharp G. C. - .

. () 1- . () . - - (=0,52,

, 2013; 12 () 25

057-058

(). 25,5% - : - (20,0%) (5,5%) . () 89,7% -, (+) 37,9% . - 97,2% , 64,2%. . 2,1% - (- - , - ). , - , - , ST (OR=0,30, 95% CI [0,140,63], p=0,004). 75150 (84,0%), 10,2% - 50 , 5,8% >150 . 100% - 75 .

: , . - (+) .

057 - , :

. ., . . ,

,

: , (), - - () .

: 20102012 . 3 (, , ) ( ). ( ) , 6 .

: 1068 . 63,610,2 , 61,2% . ST ( ST) 53,2%, ST ( ST) 41,1%, 5,7% (). - () 89,7% , (+) - 37,9% . - (-) 87,8% . - (70,1%), (22,5%) (7,4%). - () 70,8% -. (36,9%), (33,3%), (15,1%), (10,3%), (2,2%) (2,1%). 70,3% . - (49,7%) (47,8%), 2,5% - . - (47,8%) (-, , ) 42,0%. - :

II (12,5%), (25,5%), - (21,7%), (2,1%). , ( ST), - (=0,44, 95% [0,230,86], p=0,008), II (=0,49, 95% [0,270,92], p=0,02).

: , , . - , - -, : (, ), -, , .

058

. ., . ., . ., . . -

, , - , , ,

() () - - , .

: - 1 600 ( ) 0,4 2 .

: 45 45 65 . . 710 , 2 . 8 (), . - (). 10% - 30% .

, 2013; 12 ()26

059-061

. - - , -. - , .

. - . , .

059 3 ,

. ., . ., . ., . . -

, , , ,

: ( 3- ) - , .

. 35 , 1 3 . 35 , 59,5 . - 10%, 35%, , . - , - . - ( 85% ), (45% , 30% ), - (35% 28% ), - () 18%. 20 , , . - 1,0 46 .

. - . 12% -, 21%. - ( 14%, 27%). - ( -). - - - - . - . 8% -, - . . - , - - .

. , , - -, .

060

. . 1, . . 21 -

, , ; 2 , ,

, - -, - . , , , -.

: - - -.

: 30 - 50 75 - . (46,1%) 5 , 4- . , - () - () ; - () - , () . () - . .

86% . 0,550,03 0,70,04 (

, 2013; 12 () 27

062-064

: - .

: ; - ; ; 6- ; (--).

. 40 , IIIII II , 23 - , -- - . I (20 ) --01, , -; II (20 ) - , . -. , - , , , - , -, , , . - . I , - , - - - - II , , . -, .

, , - , .

062

. ., . . -

, ,

. - () () - . - - 24 56,7%. () . , , , , .

- .

. 295 , - (, , , - , , ). 95 . , . -

, - ( (), ( - ()). Statistika 6.0.

. 42,3% , 30,3% (=0,048). ( 20 ) 64,18%, 36,4% (=0,036). 11 20 - , - (=0,03), (46,9% 14,3% , =0,03). - (=0,0050,007), 10 20 - QTc (=0,011) -, . 11 20 - 1,2 (=0,015). (=0,01).

. - , . , -, . - , - (, ).

063

. ., . . , ,

: () .

: - 2 (, ) 2059 . 519 , 222, 297. -- , -.

: (),

,1999). STATISTICA 8.0. - () 5%.

. 5,7% ( 7,2%, -3,7%, p=0,58) , , .

. , - , , .

064

. ., . ., . ., . ., . ., . .

, ,

, 2013; 12 ()28

065-066

: - .

: - (n=32) . 43,43,1 , 18,641,9 . 30 - (), - . 65,42,1 , 40% . - - , - .

. , - - () 90,7% , 75% SCORE, 15,7%. , (), , : , -, , . - () 93,8% , 34,4% . - 59,4% , 21,9% . - 53,1% ; 57% - . - , , 16,7%. , 56,7%, 13,3%, 26,7%, 66,7%, 1023,1 , 912,7 . - 96,7% -. 36,7% , - . - 43,3% , 13,3%. , , . - 13,3% , 6,6% .

: - , . - , - , , - , , .

065 - : ( 7 )

. ., . ., . ., . ., . .

, , ,

: - () - () , . , 7 .

: - 29 - . 29 (15 14 ) , ( 57,72,2 ). . . (2008 .) - -.

: ( 68%), 69% ; 31%. , II . II , 13,8% . : (51,7%) - (38%). . 10% . . 10% - . 7 , (58,6%) - , . - , 76,7% - , - 10% .

. , 38%, - 44,8% 17,2% .

: -, - , , - .

066 ,

. ., . ., . ., . ., . .

- - , ,

- () - , , , , . () - .

: - () , (), .

. 28 , 4668 IIIII . - (), , 50 100 , 1 . 2 , 1 . 70 .

, 2013; 12 () 29

067-068

. HOMA2-IR, ISI0,120.

. 1 . (p=0,025), 2 , (=0,049). - (, 1999 ) - 4 8 (p=0,006). , 10 . 2 , (=0,045). HOMA2-IR , ISI0,120 , (=0,036). - ISI0,120 - , .

. 1 . . , .

067

. ., . ., . .

. . . , ,

: , - - - (), - S, .

: 80 -: 55 ( 38 84 ) 25 ( 58 95 ) , . , -, - -.

: ( 58+11,9 , - 69+10,7,

, 2013; 12 ()30

069-071

. - - 2 - .

069 : .

. ., . ., . ., . ., . ., . .

-, ,

- .

. 11 (9 2 ) 41 59 - . - ( , , ). 2 - , - . - , -, , . .. , . - . 1- (- ) , 4- - , 6 . , . . , , , , , , , , - , , .

. - 3 5 . - , 2 (18,2%) , 9 (81,8%) 6 (54,5%) - , 4 (36,4%) - . - 7 (63,6%) ( 4 -, 3 , 6 (54,5%) . -. . - 40%, . 5 (45,4%) - , 4 (36,4%) . 6 (54,5%) . 6 (54,5%) -, 3 (27,3%) .

070

. ., . ., . . . . .

, ,

Na+ .

: Na+ - ().

: 49 , 26 23 . 58,459,2 , - 10,499,8 . 11 2 38 3 . : 2 , 9 38 - . 13 - ( 58,337,8 , 6 7 ). (>0,05). - . . - Na+ 24- .

- .

. Na+ 201,58112,22 /. 190,61103,05 /. - (=0,25). (r=0,37, p

, 2013; 12 () 31

072-073

138,00 /, 25- 104,00 /, 75- 226,00 /) (=0,34).

- . , - 100 300 / - : (p=0,03), (p=0,04) (p=0,03), ( 103/71 . . 127/82 . .). - - : (r=0,45,

, 2013; 12 ()32

074-075

51,94)), 7 (117 (70,8162) / 94,3 (62113) /)), - - (7,17% (2,67519,225) 2,68% (1,7453,125)). - (40% (3745) 48% (4250)). -,

, 2013; 12 () 33

076-078

076

. ., . .

, ,

. () () () .

. - 60 - : IIII , ( IIIII ) (65,90,5 ). 60 (64,70,6 ).

. , 57,8% - - , , . 1/3 -: (61%), (21%), (12%) (6%). 32,4% . - (11%). - , .

( , , ) (25,4% ) - (9,2% ).

, : III (46,7 28,3% ), (46,7 38,3% ), (35, 0 23,3% ).

III () 55,0% -, , (20,0%). II (41,7 23,4% ) II (18,3 0% ).

- . III III (76,9%) IV (100%). , (3 ) 66,7% IV , , II (7,5%) III (23,1%).

. - , , III , II III , - -. .

077 ? ( ACS-Registry )

. ., . ., . ., . ., . .

. . . , . . . . , ,

- () - W. B. Kannel 50 . -, , . , - - 4060% , - , , - . , , . . 100% !

: - , - () . , - , .

. - (ACS-Registry). - , . . , . . -. 305 , 4 . , 13 -. (.) 155 ., (.) 150. - ., . . 99 . 1, 51 . 1.

. . - , - () , - . -. , -, %: 7 ./28% 5 ./18% =0,6818 N: 7+5=12. 23 , . . 161 115 . -: =0,0500. , 3612 ., 8 . . . , -: () 1%, 5%, . . 15% (

, 2013; 12 ()34

079-080

- , - .

. 4- - 34 (30 , 4 ) - , 51,43,2 . 2 : 1- (n=16) (, - , ) -, , , , 2030 ., 1012 . (n=18) . - - . -: 6- (6), () (2, 2).

. - - : ( , 2,320,10 1,790,11 ;

, 2013; 12 () 35

081-082

- (=0,691 0,716, ). , , , . 23 ( 0,032 /) 2 : 11 , (2 -, 1 9 ), 12 - . (=0,022), - - ( - 0,477, =0,018). - 2 (95% 0,19 20,55).

: 0,032 / (=0,022) - (, , ). - (95% 0,19 20,55) .

081

. ., . ., . ., . ., . .

. . . , , . , ,

: - -- , - - , .

: 82 -, 7 2011 2012 . 11 (13,4%) , 4 (4,9%) , 40 (48,8%) 27 (32,9%) -- . - - . - 7 -. 30 . , , 30 .

: - : 1,09 (0,29) /; 1,12 (0,28) /. - (=0,33). 2 : 1 31 ( 7 , 4 - 22 ); 2 51 -. - (=0,841 0,244

) (=0,593 0,663 ) . - : , , , , (- , , - , , - ). - .

: - . . - - - .

082

. ., . . *, . ., . .

- . . . . , ; * , ,

: () (), -- .

. 101 - , 57 -. 22 . : , : -- () -, - - , - , -.

. - - - (389,06191,02 /), 7 - ( 50 /). - - - (14,811,77 /) (17,9613,78 /) (>0,05). - , (4,411,98 / 5,722,65 /, ; =0,037). (2,760,22 /). - - : () ( r=0,6281, =0,004; r=0,5424, =0,0164), - () () (r=0,6963, =0,0009; r=0,5504, =0,0335), (r=0,5101, =0,0256; r=0,5114, =0,0252).

. 1. - , .

2. - - .

, 2013; 12 ()36

083-085

083

. ., . . *, . . -

. . . . , ; * , ,

: - () , .

: 89 II , 45 (53,3%) 44 (46,7%), 55,511,65 . 33 . - : , : -1 (-1), -6 (-6), -4 (-4), --17 (-17), - , - - .

: , , - - - : -1 (R= 0,40, p=0,007), -6 (R=0,34, p=0,02 R=0,43, p=0,002 ). -6 (R=0,23, p=0,04, R=0,29, p=0,01). - (R=0,31, p=0,04, R=0,47, p=0,02), -6 - (R=0,35, p=0,049). - -17 , (R=0,34, p=0,04 ). - - : (Beta=0,264, p=0,00), - (Beta=0,282, p=0,00). - , ( Beta=0,297, p=0,00, - Beta=0,291, =0,00), - . , , , - .

. 1. - , .

2. - (Beta=0,264, p=0,00) - (Beta=0,282, p=0,00).

084

. ., . . *, . . -

. . . . , ; * , ,

: () (), - , .

: 70 , 51

, - . 19 . : , : -1 (-1), --6 (-6), -4 (-4), -17 (-17), - , - .

: - -6 (3,772,72 1,911,95 , =0,00001 3,653,16 2,043,07, =0,0012 -). - - , , . , , -17 . - () - (=0,00001 =0,0056 ). - - - (=0,037). ( 12 =0,25; 13 =0,006; 23=0,14 ; 12=0,05; 13 =0,001; 23=0,29 ). - ( 12 =0,31; 13 =0,03; 23=0,02). , .

- - .

. 1. - , -, -1, -6, -17, - .

2. - - .

085

. ., . .*, . ., . .

- . . . . , ; * , ,

: - () , - .

: 72 , 40 - (). 33 - . - . : , : -1 (-1), -6 (-6), -4 (-4), -17 (-17), - .

: : - (R=0,83, p=0,00), -1

, 2013; 12 () 37

086-087

(R=0,41, p=0,01), -6 (R=0,57, p=0,0004), -17 (R=0,89, p=0,02), - -1 (R=0,61, p=0,00005), - -6 (R=0,70, p=0,000005), -1 -6 (R=0,55, p=0,0009). - : (Beta=0,569, p=0,04), - (Beta=0,506, p=0,00), -1 (Beta=0,268, p=0,00), -6 (Beta=0,370, =0,0008). (Beta=0,323, p=0,048). - 2,6 /, (=0,001). : 2,6 5,7 / - 3,5 . -. - 2,1 / (=0,02), - 2,14,1 / 5 . -1 1,1 / (=0,0001). -1 0,9 1,3 / - 3 . -6 3,0 / (=0,003). -6, - 2,1 2,3 3,1 3,4 /.

. 1. (, -, -1, -6, -17) , .

2. 3,5 2,6 5,7 /, 3 -1 0,9, 5 - 2,14,1 /.

086

. ., . ., . ., . ., . .

-,

- , -, () .

. .

. (), (), , - , 284 -. , : , - , .

. 65% - 45 (122 ), . , - - (

, 2013; 12 ()38

088-090

, , - - 40% 20%, 20% 50%.

. , 30- - -3 , : -, , -. , - .

088

. ., . ., . ., . . , ,

. - - .

: 6 - .

. 50 52 73 , . . (-, , - , , ). - 23 6 . : - (); (.); (). 2 - (30 20 ). - ( ; ; ).

: 6 - . -, ; (0,660,69); (0,630,65). ( ) . ( 0,650,65 0,630,63). , - . (0,640,60); - (0,650,65). (- 102135,2 115,5118,5). - , ( 54%51% 65,5%60%), ( 54,12%48% 54%51%).

. 6 - , ( , ). , - -.

089

. ., . ., . . ,

. . . , ,

. (-, , ) ().

. 50 , 55,59 , - (), 41 (82%) . 39 ST (ST) 11 ST (ST). , , . : -, - , , -.

: 8 (16%), 1 (2%), 25 (50%), () 4 (8%). (74%), (68%), (67,3%). 20 (48%), 12 (24%). - 4 (8%) . : 48 (96%), 1- (2%) 1- (2%) . Md 147,5 (78,8; 262,5) . 47 (94%) 12 . I Killip 34 (68%) , II 14 (28%), III 1- (2%) IV 1- (2%). (>60 //1,73 2) 10 - (20%). () 41 (82%) . 11 ST 30 ST, - 76,9% (39 ). 1- - () 17 (41,5%), 23 . 39 ST 33 (84,6%). () 13 (33,3%) 12 (30,8%). - - 7 (17,9%) , - , 1- (2,5%) , . 11 ST - . 0,40 3 (6%) . ( 2=25,045; p=0,015). 4 -, , 2 . 14%. - 2 10 . - .

. (-, , ) , - , 14%, .

090

. ., . ., . ., . ., . .

, ,

: .

: I - (), 20 - -

, 2013; 12 () 39

091-092

50 /; II (), 20 20 /. 2 , 6 , 24 , - . , -, . . (1990) 45 () , (.%) , . - - (TGF-1), (FGF-2), I --1 - Autostainer 360. , - , - . 9 () () () 1 2 ( ).

. .

, -, , , .

, .

, . , .

- , . , FGF-2 3 .

- GF-1 6 , .

, GF-1, - 3,5 5,5 , - , , , .

I , . -1 - .

091 - 2

.., ., . .

, ,

: - - 2 .

: 81 2 . - 2 : 1 - 43 2 (0,05). 1 - , , - (>0,05), (0,05) 2 . - - , (>0,05). - 1 - 2 (>0,05). - (r= 0,392; p=0,015 r= 0,463; p=0,003 --). (r = 0,340; p=0,026). (r=0,448; p=0,006) HOMA-IR (r=0,350; p=0,036) . - - , (r = 0,495; p=0,002; r = 0,538; p=0,000) - (r = 0,465; p=0,003); - (r=0,415; p=0,010).

: 2 , -, , , - .

092 :

. ., . ., . ., . ., . ., . .

, ,

. , - - ( -) () () - .

. 60 - 1111 , , - . 16 5/16010/ 160 /. () -04 Meditech, . - -, ().

, 2013; 12 ()40

093-094

12 (). (YI).

. ( ) 1 . 100% , 2 . 83,3% , 3 . 63, 64%, - .

- ( 1- 3- ); 3 (13,88 0,48 /) (0,01,

0,05) - (12 .). 1 . , (3 .: 13,880,48 / 12,410,28 /, 0,01). (YI) ( 6,4 0,15 1. 7,630,23 3 . , 0,05). - CAYI 2 . (0,05), - 3 .

. - . ( ) , , - .

093

. ., . ., . ., . ., . ., . .

, ; - , , ,

: - ,

: 488 3059 : 294 2 1,2 130 - , , 64 2 ., 1,2 . (. ). 48,66,1 , 17,56,8 , 12,54,7 . , , . - (20082010) . -- () Bruce. -: (), - , (), (ME). - . - STATISTICA, 6,0 ().

. . , - (p

, 2013; 12 () 41

095-096

100% . , II . 100% I ; II 50% .

: - - , -, , . -.

095 -06

. ., . .

1 . . . , ,

, - - (). . - , - . , , -.

. --06: 1) ( ) -, , ; 2) , - .

. - 60 ( 40,11,6 ), 40 . - . - (), - . , - (). ( Statistica 6.0).

. - , , , , - , -.

, , , . , -, , - , - , . , . - .

. ,

, - , .

, , - .

096

. .

1 . . . , ,

. - (), - .

. 80 - , . , , () .

. - , . - () , : 1) ; 2) - , , ; 3) ; 4) ; 5) .

, (), - .

() . -: , , , . - , , -. , , -, . , , .

: 1) -, - ; 2) QT - QT (QT); 3) .

, , .

-, , ,

. : I (): 1) -; 2) . II$5 (): 1) ; 2) ; 3) ( ); 4) (, , ); 5) , - QT, -.

, - -

, 2013; 12 ()42

097-099

. .

097

. ., . ., . . ,

,

. - - .

. 85 () 40 84 , 68,7% , 31,3% . 21 . () 180 - 90 2 /. - ( (), --, -, ). - , - , , , .

. 85 7 (8,2%). 6 (7,1%), 1 (1,2%). -- PLATO 1 (1,2%), ( PLATO 11,6%). (, , , ) 5 (5,9%). 1 (1,2%) -, - , ( PLATO - 0,9%). - ( 50 ) 6 (7,2%). 2- (2,4%) - ( I 1,2%, II , I 1,2%). - , -, -. . - 1 (1,2%) , - 64 ST. - 325 , . 5 , .

: 1. - . 2. 1,2% . - 5,9% , , - PLATO. 3. -. 4. 1,2% . 5. .

, - - .

098

. ., . ., . .

, ,

() - - -- () - (). - - (), , - . .

: .

. 70 . 64,510,2 . - () II 39%; III 49%, I 3% IV 9%, 6- . I/D . .

. 24% , 45% - , 2535% . 3 : 1- DD (25,8%), 2- ID (25,8%), 3- II (48,4%).

1- III IV (65% 16%). , 6 , 251,799,5; () 32,314,0 / 2. - (37,5%). 50% - , 25% .

2- IV (4%). , 1- 305,097,0 (

, 2013; 12 () 43

100-101

() - - . - - () . .

.

. 100 - , - . 2010 . ( ASAS, 2009) ( K/DOQI, 2007), () MDRD. - . SPSS Excel2007.

. 77 (77%) - : 4210,98 . (2066 ), 14,998,6 . - 39% [ 31; 47] ( , p

, 2013; 12 ()44

102-103

. 18 , - 34 TIMI III - 11 (61%) , 5 (27%) - TIMI I 2 (11%) . , -- 56 5 (45%), 6 (55%) ST.

, , - . - - .

102

. ., . ., . .

, ,

- , - . - .

. () - - . .

. 100 - () ( ), -, 2155 ( 48,20,7), - . 2 : , 50 ( 38%, - 62%), 50 (36% 64% ). - , . 2 94%; 2 92%, 3 - 8%, 3 ; 2 - 60% 3 40%. II ( ) ( ).

. non dipper 65,6% 53,1%, . - , - () , . - 88%, - 76%, - 70% --14% (p=0,009). , , , - : dipper 25,9% 40,7% , non dipper

33,3% 25,9%; night peaker 29,6% 18,5%, over- dipper 11,1% 14,8%. - , - (94%) - , 78%- - , () 94% (p=0,0001), -2% (p=0,002).

. , non dipper, - , - . - -- , - . over- dipper - --. .

103

. ., . ., . .

, ,

. - -: , - .

. 130 -. : 40 (- 1 ); 30 ( 10 ) - ( 2); 30 1 ( 3); 30 - 1 , (4 ). 222 . - - (a. carotis) (a. radialis) . : - , , , . - Statistica 6.0.

, 2013; 12 () 45

104-105

. - . , - , , - . - .

104 C

. ., . ., . ., . ., . .

. . , ,

: () () - (), , , - .

: 66 49 72 , 36 (4964 ) 30 (6372 ). 10 20 . 180/100 . 240/120 .. - ( 80% 2 , 20% , ).

66 (1 16%, 2 84%). - , . . .

: , 1 140\90 . , 2 3 : 1) - , - 23% 2) , , , , 37% 3) ( , , , -) , , 40%. - 3 - 1 , (, -), 17 , , 9 23 -.

: - , . . , -.

3 . . .

105

. ., . ., . ., . .

, ,

: - () .

. 305 - 13 - () 3598 . 140 - . 3 , , . ESN/ ES (2007 ). ( .,1986), . : , - , , - .

. - , , , . 3040 , , , . - 3 5 , 12 . ( 30 ) 40% , 50% . , . - 38% .

50% - , 7% . - 3% ( ) 15% ( ). -, 25% - , -.

. - - . - , , - .

, 2013; 12 ()46

106-108

106

. ., . . -

, ,

, . , - - .

2012 - 84 40 , 5 (6%). : , 3 (2 ) 2 (1 ). - - > 30 /2.

2012 (). -, .

, - () 2,0 /, () 1,1 1,3 /. L- 70 .

. 29 24 , - 200/100 .. , - . . : 66 /, 180/80 . 4,1 /, 2,06 /, 0,74 /, () 0,42 /. () . - , .

39 , -. - 3. 5 - 240/120 .. - . 3- , - , -. , , 180200/110120 ..

: 80 /, 210/110 .. : 5,2 /, 3,4 /, 0,85 /, 2,2 /. , . .

, 40 , , .

107 III

., . . . . . , ,

: - () - () III .

: 35 (-20, -15; 56,798,2 ) III . - () Mini-Mental State Examination (MMSE), (), 5 7 12 .. 5 . - SF-36.

: 12 74,28% (26 ). - - 141,611,9 128,625,43 86,241,02 77,211,42 .., 52,411,27 38,274,23%, 36,732,82 29,483,15% (

, 2013; 12 () 47

109-110

- (), - , . (VM) , - . . (2007). (Pet) (Einc), () Moens-Korteweg. - (LQ; UQ), , LQ UQ .

. 1- 0,9 (0,7; 1,2) , 2- 1,0 (0,8; 1,2), 3- 1,0 (0,9; 1,3), p>0,05; >0,9 42,3% 1- 64,3% , =0,032. 1- 23,8 (19,6; 30,2) 2, 2- 28,7 (22,9; 37,4), p=0,048, 3- 28,7 (23,8; 32,2), p=0,038; VM 0,209 (0,154; 0,260) /, 0,253 (0,207; 0,284), p=0,039 0,234 (0,198; 0,333), p=0,064. 17 (65,4%) 1- , 17 (56,7%) 2- 15 (57,7%) 3-; - () 4 (15,4%), 4 (13,3%) 2 (7,7%); () 4 (15,4%), 6 (20,0%) 7 (26,9%, =0,035 ); - () 1 (3,8%), 3 (10,0%) 2 (7,7%). , - 1- , =0,035. Pet, Einc (), p>0,05. - Pet Einc -- V- - 3 - =0,086. 1- 55,5 (50,5; 61,5) , 2- 58,5 (53,0; 62,0), 3- 63,0 (59,0; 66,0), =0,002; 86,6 (73,5; 97,5) , 91,7 (80,0; 100,9) 98,3 (79,0; 108,8), p=0,059; 31,0 (28,8; 35,2) / 2, 31,3 (28,1; 37,3) 32,1 (28,9; 35,8), p>0,05; - () 106,5 (99,5;112,5) , 112,5 (100,3; 117,5) 115,5 (103,0; 119,5), p=0,071; / 0,94 (0,91; 1,01), 0,96 (0,91; 0,98) 0,97 (0,94; 1,04), p=0,048, - 139 (130; 148) .., 145 (136; 152), =0,053 144 (130; 157), p=0,059, 50 (44; 57) .., 56 (54; 65), p=0,003 60 (50; 70), p=0,002.

: VM , - ; 23 . . Pet Einc - , , /, ; , .

109

. ., . ., . . ,

,

, - - - - , , . - ().

: - .

. - , (n=114), ( 3 -

) (n=34) - 3555 . . .: () (). SPSS 13.0. - MSD.

. : 13716 .. vs. 13011 . (

, 2013; 12 ()48

111-113

, - . . , - SF-36, -.

. -. . 6- 198,032,8 378,515,6 (p

, 2013; 12 () 49

114-115

: I - (), 20 - - 50 /; II (), 20 20 /. 2 -, - . - , -, . . (1990) 45 () () , - (.%) (), ().

, 2 c 6,830,30 .% 8,61,39 .% (p>0,05), 6,830,30 .% 8,720,06 .% (

, 2013; 12 ()50

116-117

7,6%, 34,3%. - III IV , 62,4% 27,1% -; 10,5% II . I II , 79,3% . . . - I II 71,8%.

: 1. - .

2. - - .

3. . - .

116

. ., . ., . ., . .

. . . , , 81, ,

, , - , , - , , . .

. - () - - .

: 95 - . 87 8 50 84 ( 67,6 7,1 .). 2 : I 52 , - ( ) . II 43 , - , . 1012 . , , , , - , , (>0,05). - . I 25 (48,1%) II III 8 (15,4%); 6 (11,5%). () 18 (34,6%) . II 37 (71,2%) III 2 (3,9%) . 21 (45,7%) . II II III 16 (37,2%) 7 (16,3%) ; - 3 (7%), 13 (30,2%). II 22 (51,2%) III 2 (4,7%) . - 19 (46,3%) . -

- (>0,05).

: - -, , - . I 10 13,76,6 / 67,95,7 / (

, 2013; 12 () 51

118-119

, -, 19, - 6 . - , . CAR Aperio Scan Scope CS (Aperio Technologies Inc, ).

. 1 2 (294.9 vs 3711.3%, =0,3), ( 240127 vs 22082.6 , =0,1) - IIV (NYHA). - 4 1 , 3 2 . - - 2 1 . 5 3 -. 1 (4114%), 2 (2217%, 0,05). SF-36, , SGRQ (p0,05). 1846G CYP 2D6 .

. - CYP2D6.

119

. ., . ., . . , ,

( ) - - , - . . -, - . - : 60.3% (5574 ), 37.7% (7589 ) 2% .

- .

, (86%), . , , (52%) (38%).

- . - , - . 34 . - . - , - . , - , -, , , , , - . ,

, 2013; 12 ()52

120-122

, - .

, , ( , 72.3% , 98.2% 100% ) - , - . , , , , - . 460 2 - , - .

120

. ., ., . ., . ., . ., . .

-, 1, ,

.

: 20 ( 69,4 ) () II , 10 . 15 5 , 12 , 8 II III , 3 ( ). - 10 2 ( 8 20 ). , 8 (- 20 1 2 ). - , - , , - --, . -, , , - . - . -

, 2013; 12 () 53

123-124

4 . . . -. 62,91,1 . 17,50,9 . - - - . . (. --). , - -, -, - ( . -). - Friedewald W. T. et al. (1972).

. -262 - (2 (p=0,01), (p=0,015), (p=0,001), (p=0,03), (118,610,5 vs 97,03,4 mmol/l, p=0,05), LDL- (4,00,2 vs 3,30,13 mmol/l, p=0,001). . - , , , , - (p=0,002). (16% 1,6% p=0,005).

, 2,5 - (24% vs 9,4% p=0,04 39,5% vs 19,3% p=0,03, ). - , NYHA>2 - , (18,4% vs 5,3% p=0,01).

. , , , LDL-- , , - .

124

.., . ., . ., . . , ,

, - () - () , . - .

: , .

. 114 , 64,10,9 , 56% 44% , 8,60,8 . , - , -, , , ( 2,5 ). - - .

. 30,90,4 kg/m 2, - 105,40,7 cm, 27% , 82,5% , 16,7% , 10% 48% -. 41% , 26,7% , 12,3% 22% .

Q 70% , -

, 2013; 12 ()54

125-127

71% . - 13,80,8 /, 25,7% . - 15,8%, - 27,3%. : - (F=14,2, p=0,0003), (F=11,5, p=0,001), (F=13,9, p=0,0003), - (F=9,8, p=0,003), (F=9,6, p=0,003).

. : , , -, , .

125

. ., . ., . .

, ,

. () () () .

. 42 - (/, 24/9) - 37,56,3 , III (27, 63%) IV (6, 37%) . (-). , - . (1995). - 2 : - . - , : , -, , , -, .

. 3 ( 66,221,2 28,919,7 ; p

, 2013; 12 () 55

128-129

. ., . ., . ., . ., . ., . ., . .

, ,

: () 2 - .

: 20102012 - 65 ( ) 60,39,8 ( 75%) - 2 : 1 () 2 (n=28) 11,65,7 2 2 (n=37).

, -, -, , . . Judkins (1967 ). : (), - (), , (, ), -I, ( -I, ), ( ()) (Cobas Integra 400 plus); : - - (hs-CRP) (Clima MC-15), -1 (-1), 6 (-6), 8 (-8), (-) (IMMULITE 1000), CD40 (sCD40 L) (Bender MedSystems), CD40 --9 (MMP-9) (Bender MedSystems and Bioscience company), -1 (TIMP-1) (Personal Lab); -1 (Dynatech) (Humalyzer 2000 Human).

: 1 2 - hs-CRP, -, MMP-9; (), , -1 TIMP-1. 1 - : , , , , / -I; : -1 . 1 (

, 2013; 12 ()56

130-131

. () - - - () .

. 64 - 17 , - 58,0 , -, - . 5 7, , -.

. - - , . - , ( 7 -). ( > 0,1). - MANOVA . (=0,008) 7 (=0,83). (=0,05). 7. - (=0,84). -. . - , - .

. - , , - . . - - .

130

., . . , ,

. - (-) - () ().

. 36 (, 58,1 ). - (-04--3, , ).

-: QRS (FQRSd), 40 (LAS40) 40 QRS 25 (RMS40). (InVisor, Philips, ) - .

. FQRSd (rs = 0,68, p

, 2013; 12 () 57

132-134

. - -. - - 7 (63,6%), - 3 (27,3%). S.viridians, S.bovis, S.aureus, , .

. , - . . - .

132

. ., . ., . ., . ., . ., . ., . .

, ,

- .

. - - .

. 2010 2012 69 30 50 (41,84,2) . - , , - , - () .

. 48 , 59,33,24% . - - 50 (76,9%), - 46 (70,7%), 7 (10,7%), 1 9 (13,8%) , 7 (10,1%). 17 (24,6%), 13 16 (23,2%). ( II, III 3,03,5 ) 24 (43%) , ( -) 44 (63,8%). 13 (20%) S T 2 III, aVF, V5-V6. -

, 2013; 12 ()58

135-136

; 2- 36 , , - (). 15 . , , 6-- , , - .

. - - - - . 6 ( 2 . 3 ), 40 / 2 .

, 15- - , , 35 (79,5%) , . - 50,0%, - 68,2%.

( 57,1%) - ( 62,7%) .

, , , -, - -.

135 - .

. ., . ., . . , ,

() , , , - , - - , () .

. - - III () - / .

. 38 - III - () II 4567 , 26 12 . - , -, . - 4 : , - .

. 20 . 15 (44,1%) - (), 19 (55,8%) () 14 (41,1%) . 5 (27,7%), 8 (44,4%), 5 (27,7%). ( ), ( ). (, 1,170,03 &1,030,02 (

, 2013; 12 () 59

137-139

137 -

. ., . ., . ., . ., . .

- , ,

: - - - (), - , 1 GARFIELD.

: 133 ( ) , - . . 6535 , 1 GARFIELD.

: 65 33,8% , GARFIELD 73,8% (

, 2013; 12 ()60

140-142

15 . 7 . (, Servier) 20 3 100 3 . 14 .

. 5 3 (

, 2013; 12 () 61

143-143

- , , Q Q

. 3 - 1 (n=134). 1 - 35 (19 16 ) Q ( 56,20,8 ); 2 32 (15 17 ) Q (56,11,0 ); 3 33 (18 15 -) IIII (53,50,8 ); 4 34 (23 11 ) , (46,90,9 ). , - , , - () (). 25 / 2 , 30 / 2 ; . - 12 , , , , (). - , , , , (), (). - - (Hb%) . - STATISTICA 6,0.

. , , - (=0,05), , 25,60,6. 1 30,30,8 / 2, 7 10 . 2 29,90,7 / 2, 2 ST 7 , 12 . -, , 32,00,8 / 2, 3 , 3 22 11 - 96,11,5 .

1, 2 3 , - ( 0,05) - (5,40,2; 5,60,2; 6,50,5, 4,90,1 -) Hb 1, 2, 3 (6,50,1; 6,20,2; 6,80,2; 5,60,1 ). 1 26,7% , 2 13,3% -. , 3 2 , ( 23,3% ) 2 (46,7% ).

1, 2, 3 , - , (=0,001), (3,10,1; 3,00,1; 3,20,1; 2,890,1 ); (1,00,04; 0,90,03; 1,10,1; 0,590,04); (2,20,2; 2,00,1; 1,90,2; 1,480,1); 1 2 , , - (=0,001, =0,005), (1,00,04; 0,960,04; 1,30,1; 1,360,07); 1 2 (=0,005, =0,001), (4,20,3; 4,50,3; 3,40,2; 3,00,3 ).

. , - Q , Q , -

IIII -, 2 , . - .

143

. ., . ., . ., . ., . .

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() , - , . , - () , . - .

: - , - () .

. 119 5276 , - . 9 . 23 -- -4 -8. - ( ), (- ), - () - () . - .

. - - ( ) - ( ). , - , .

- (, ), -. .

, , . -.

. - , , -, . - - . - , , - , .

, 2013; 12 ()62

144-146

144

. ., . ., . ., . ., . ., . .

, --,

: - () () - () - - .

. 75 - ( 567,8) II , 2 , . 1- . -- (), . - (CAVI), - (), (). 5,0 1,25 ( -, Servie, ). 3 . - - STATISTICA 7.0 (StatSoft Inc., ).

. - 3 . - () . CAVI (9 /); . 3 . CAVI 13% 11% (

, 2013; 12 () 63

147-148

(n=22) If- ().

. () 17,0 (3,0; 875,0) 208,0 (4,75; 396,0) , 0 (0,0; 0,5) 0 (0,0; 0,5) . - (), .

- () 36,0 (24,0;48,0) 26,0 (6,0; 39,0) . 0 (0,0;2,0) . () - 0 (0,0;1,5) . , >0,05. (25;75).

27,5 (0,75; 506,0), 70,0 (2,5; 240,0), 0 (0,0; 0,25) 0 (0,0; 1,0) . . 26,0 (9,5; 171,0) 22,5 (17,0; 141,0) . 0,0 (0,0; 3,0) 0,0 (0,0; 1,75), 0,0 (0,0; 1,0) 0,0 (0,0; 1,0), 0,0 (0,0; 1,0) . , >0,05. (25;75).

QT : QT (F) 407,14 18,07 401,5 14,92 , >0,05. QT - QT (F) 404,0 42,56 385,58 19,21 , =0,01. ( ).

. , , - , - -.

147 ,

. ., . . . . .

, ,

. , , - (44 ) (4559 ) .

: 159 - 29 (40,33,2 .) ( 1) 130 (53,43,5 .) ( 2) (), 2010 . : , , , : . , , , , , , , - , , , , , - (), : -, , . 2012 . - .

. -: (93,1% 1 , 85,4% 2 ), (55,1% 31,5% - (p

, 2013; 12 ()64

149-150

(Me) . - .

: sE- (sE) + (

, 2013; 12 () 65

151-153

, - TGF-1, .

151 -

. ., . ., . ., . ., . ., . ., . .

- . , ,

: - .

: MMSE, , , , , - .

: 43 - - , - - . . . 599 (-27, -16). 5., - 3., - 34., - 1. 30 . 8 -. - 35 . 22 -. 36 (83%). - 13. (30%), - 5. (11%), - 9. (20%). : 7. (16%) , 22. (51%) -, 10. (23%) , 4. (9%) . - , . - , - .

: 1) 84% - - , 31% .

2) - - , - , .

152

. ., . ., . ., i ., . ., . ., . .

- . , ,

: - -

: - MMSE ( , , , , - ) Mini-Cog ( , - ).

: 43 - - , - - ... 599 (- 27, - 16). 5, - 3., - 34, - 1. MMSE 7. (16%) , 22. (51%) , 10. (23%) , 4. (9%) . - , -. 15 35. Mini-og - 11 (25%). , , 3 5.

: MMSE , - . Mini-og , .

153

. ., . ., . .-

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: - ( PFIZER) 5 II . () , (). 2 27 . 1- , 2- - . .

: - () (), () () - , . 5 .

. 1- 30 5 , 1 . 2- 30 11 , 0,9 6 . 1- 9 , , 2- 23 18 . 1 .

: - . -, , .

, 2013; 12 ()66

154-156

154

. ., . ., . .-

, , ,

: - - () () .

. 30 - II 6070 . 3 .

2 : () : 5 2,5 . (, ) 100 .

: - () 08.00 22.00 (), - () , , , . . : , , , -.

: - , . , , , , - , , - . 3- - , . 1- - 4- , 10 . 2- .

: , , - .

155

. ., . ., . ., . .

, ,

- () () - () () . 28 -, -

48 , 11 (39%) 17 (61%). 761,29 . - - - - . NIHSS 1 21 . , - . 4872 - . , 80. - (), . 1 2,5 5 (15 , 54%), 2 - 10 (13 , 46%). , 2 1 (761,05 652,08 ). 1 2 4 - 2 (=0,044 =0,026). - 2 . - 13 - (46%). 2 - 1 (=0,021). 1 2 - . - 1 : 21 NIHSS 1 6,5 [1; 9] , 2 11 [5,5; 13] , (=0,018). 21 1 (=0,055 =0,06 ). , -, 4872 , --, . .

156

. ., . ., . ., . .

, ,

. () ().

. 100 (60 40 , 589,5 ) , 50 . () - -, . () .

- R-R-. - R-Ri - on line -

, 2013; 12 () 67

157-158

, - . S - () , S S -, ( ), , .

. () () (, ) : =0,360,07, =0,180,06; =0,380,06, =0200,04; =0,950,12 .. =1,00,2. - S (=0,680,06., =0,660,06) (S, =0,480,06., =0,470,06). S=0,480,04 .., S=0,300,02 ..

10 - () (), (

, 2013; 12 ()68

159-160

68 . - ( - , . .), 20 , - . - , -. , , , .

( 50%) - , . - - , -10 - .

, -, , , .

159

. ., . ., . . , -

4, ,

: - () ().

: 14 , 66,7 [57;75] , 1 31 2012 . (2007 .) 14 , 10 (71%) Q (), 4 (28%) Q. 48 - RIFLE (ADQI, 2002), R- , I-, F-, L- , E-- . 1- (< 0,5 // 6 ), 48 ( 25%) / ( 26,4 /). () -, MDRD, EPI. , - (). (Micral-test, , ). , - 1, 3, 6, 14 - .

: 14 . RIFLE 4 (29%) R, 10 (71%) I. - , F, L E . 14 : - 12 (86%) 50 /, 2 (14%) , I , 100 /. -EPI . -EPI 1, 3, 6, 14 : 54,5 [39;82], 61,7 [36;88], 63,6 [29;90], 63,4 //1.73 2 [33;99] (//1.73 2). - , ,

, .

: - 100%. - -, - , - -.

160 ,

. ., . ., . ., . ., . ., . .

, ,

: , , - 65 .

30 696,8 , (). 20 , 65 ( 496,3 ). 26 , 12, 17 ( ) 3 -. , , , -. , 7 , - . -, -, , , (19 2, ). , - 6 , .

, (60%) , - , - , , . - 25%. - , . - - : , - --1 , 5060% .

-, : , -, -, , , , , . (, ) - , ( 6 14 ) - .

, - , , . -, , .

, 2013; 12 () 69

161-163

161 ,

. ., . ., . ., . ., . .

, ,

: - , .

: 36 -, 29 , 7, . 54,78,1 . , , -. II ( , - , , - ) 10 . - () 86 6,8 ., , - . - , ( () 455,7%. - , - . - , , , , - 5 2 . 7 (15%) - 7,5 2 - . 3 - .

. 2 10,34,1 /, - . 3 70 ./, - 50%, 90% -. 1,9 0,78%. , . , , -.

. 5,0 7,5 2 - , , , - , . - , .

162

. ., . ., . ., . ., . ., . ., . ., . ., .

, , ,

: - .

38 ,

48 9,6 , - . 22 , 10 . 16 . 21 , 17. - , , - (). 12 , , -, , - . -: 180 , 90 2 . 30 , - , -, . - .

- -, - , , , . . , , . 2 - .

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163

. ., . ., . ., . ., . .

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48 , 29 19 . 30 , ( 664,1 ), ( 794,0 ). () - . 1 15 . 7 - . -, . - , , - . - - - , . -, - , , , - . - 2,0 3,0.

. 8 , 2 , 2- . 3 -

, 2013; 12 ()70

164-166

, . - . .

, - . - - .

164

. ., . ., . ., . ., ., . ., . .

, , ,

() . 504 , 1 - , 31% (157 ). 626,8 , , , 548,9 . 136 (87%) - , 36 (23%) . 222 (64%) 48 (14%) . 96 (28%) 25 (25%). , , - , -, .

- , , -. . , , , - . , , . - . , , . , . . - ST , . - . , , . . - . () - 52% , 29%. - , .

, , -.

165

. ., . ., . ., . ., . .

, ,

. .

. 32 - , - II$5II , 4373 ( 58,4+/- 9,31). 14 . - Toshiba, 0,5 - 370 80 . - Philips Integris Allura - . - . 50%. 384 , 24 - .

. 104 (28,9%) 360 . 96 (26,7%) .

256 (71,1%) , 238 (66,1%) .

14 (3,9%) , - , ; 12 (3,3%) - - -.

- .

. . .

166 -

. ., . ., . . -

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: -- .

: 44 - 19 35 2 . , Tei. 2 : 1 (n=21) - () - II ., 2 (n=23) - .

, 2013; 12 () 71

167-168

. - , 38,1% 1 - - , 4,3% (

, 2013; 12 ()72

169-170

17% , ), . - 50% - . - , .

: , - -. , 50 / 2 2005 .

169

. ., . ., . ., . .

, ,

: .

: , - 430 (174 - 256 ) 20 79 ( 51,40,6 ) , - . , () . : , 25 29,9 / 2; - I , 30 34,9 / 2; - II , 35 39,9 / 2; - III : 40 49,9 / 2 - 50 / 2. -. (/), (, , , \). - , -.

: . , I 8% 11% (0,01). II 9% 12% (0,01). 4050 / 2 12% (0,01) (6% 0,05). 50 / 2

22% (0,01) - (7% 0,05). , -. 50 / 2 25% .

: , ( -

) 820%, -. , - , , . , -.

170 -

. . 1, . . 1, . . 1, . . 2

1 , , ; 2 , ,

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. 89 (89 , 53,70,73 ), 60 29 - .

- ( 16 - ).

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: (s, /), (e, /) (a, /) - e/a.

2. - ( strain,%) .

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. ( 162 ) : 1. : s (/) (5,340,19 5,10,21 p

, 2013; 12 () 73

171-173

. . -- .

171

- .., . ., . ., . ., . .

52 , ,

. () () ().

. - 253 , - , . 156 . 97 , , . . : - -, . - . --.

. -- , 70,97,3 59,08,7 (

, 2013; 12 ()74

174-175

: , - ( - 1- II) 12 .

. , - , () 90109 .., () 179 .., () - >135/85 .. , - . , . - -. 30 , (13 17 -). 51,25,1 , 11,85,2 . 27,44,1 / 2. 1 3 . 4 90 .. 2 3 . 6 .

. - ( 6,6%) ( 6,7%), ( 20,1%) ( 32,4%). - , , , . - .

: - 6 - , 6,6% - 6,7%. 12 12 3 .

174

. ., . ., . . . . . , -

,

() - () - .

. - , (), 12 .

. 137 42 75 ( 570,8) , , - . () 75 125 75 , - (), /, . . . - .

. 8 (5, 8%) () . 4-

, 2- () - ( ) . 2- - . 2- (1,4%) 12 . . 2- (1,4%) - . 1- . 1- .

. 12 . - 8 (5,8%), , - , , . , . - 12 , .

175

. ., . ., . ., . ., .

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. 46 5112 , 75% ; 24 (), 22 - (), IIIIV NYHA. - . - 40 . - . 57 612 . - EnVisor Philips ASE. - (S) - . SPSS 19,0.

. . 6 29 . (63%). 17 . (37%), -6 . (25%), 11 (50%). ( ) ,

, 2013; 12 () 75

176-177

. - 15% - 6 . S -, (9,51.9 12,52.1, =0,0001. . ROC- , S - (UC 0.85 95% (0,710,93)

, 2013; 12 ()76

178-180

178

1 .., 2 .., 2 ..1

-, ; 2 -- , , ,

: () 2 .

: 2 ( 4555 ). (), n=20, , (), n=20, - . ( - ) . - -. . , - - . , .

: (). 23,2% () 28,8% (), 17,6% 20,5% . (< 0,05). , , - . ( , 27,1%), , 36,6%. - 54,7% 27,5% . , - (< 0,05). (< 0,05), - , .

: , , , . - . - - - .

179

1 .., 2 .., 2 ..1

-, ; 2 --

, , ,

- , - . , - , . - - .

: - ().

: - 250 25 50 . , , - , , . , - , . - - . .

. : , - (85%), . , ( 84% ), - (62%), (90%), (30%), - (86%).

. , - , - - - .

180 ,

. ., . ., . ., . . ,

, ; 3, (),

. () - , () - . , , () .

: 78 (59,28,6 ; 72% ) - . 30 . - -

, 2013; 12 () 77

181-183

. QT (QTd). spackle tracking. / ().

: () (32,4% 33,3%; 2=1,2, =0,90), - . , , - (8,1%; 2=5,2, =0,01). QTd 1,9 , - (p10% - .

: QUICKI - 2 : 1 11 - (4 7 ), 2 19 (9 10 -). , , - . , - () 1 145,33,1 .., 2 1422,0 . .; () 86,63,3 84,22,1, . : 1 144,72,9 . ., 2 141,24,2 ..; 1 -- 151,34,5 .., 2 147,55,3 ..; 1 - 132,15,4 .., 2 129,46,3 ..; 1 84,45,6 .., 2 88,53,8 ..; 1 87,36,7 . ., 2 91,25,6 . .; 1 79,15,4 .., 2 74,56,9 ..; 1 44,65,1%, 2 42,72,2%; - 1 30,93,4%, 2 32,32,3%. ( > 0,05). 1 , : 11 19 (64% 47%, , =0,001). , , Ai, . , Ai 1 19 -, 2 11 (55% 42%, , =0,05).

: , , .

183 -

. ., . . . . , -,

: - () -

, 2013; 12 ()78

184-185

(). : 30 12 -

( III ) ( = 18,524,9 /) 3050 , , . , (), - , -. - - - QUICKI. QUICKI < 0,32 .

: QUICKI - 2 : 1 11 (4 7 ), 2 19 (9 - 10 ). , - . , () 1 145,33,1 .., 2 1422,0 ..; () 86,63,3 84,22,1, -. : 1 144,72,9 .., 2 141,24,2 ..; 1 151,34,5 .., 2 147,55,3 ..; 1 132,15,4 .., 2 129,46,3 ..; 1 84,45,6 .., 2 88,53,8 ..; 1 87,36,7 .., 2 91,25,6 . .; 1 79,15,4 .., 2 74,56,9 ..; 1 44,65,1%, 2 42,72,2%; - 1 30,93,4%, 2 32,32,3%. - ( > 0,05). () - 11 1 (72%) 19 2 (63%), (=0,05). - () >0,9 1 2 11 19 (18% 42%, ,

, 2013; 12 () 79

186-187

( 61,41,7 70,12,3 .., p

, 2013; 12 ()80

188-190

41,5% , . . .

188 ,

. ., . .

, ,

: - () , - / - (, ) .

. - 356 (204 152 ) 42 70 ( 598 ), / - . - 12 . , - , - (-- ), . - , , RIFLE . AKIN . 3 : 1- - ( 0,30,49 / ); 2- - ( 0,50,9 /) 3- ( 1,0 /).

. - - 78 117 /. 62 (17,4%) , 21 (5,9%) , 28 (7,9%) 13 (3,6%) . ( ) 43 - (69,4%) () 19 (30,6%), 85,7% , 60,7% 46,2%. Q- , : 48,4 22,8% .

, 2 (29,0% 17,3%; p

, 2013; 12 () 81

191-192

. 103 -. , 32 . / () MDRD. 236 80 (33,9%) (1- ), 107 (45,3%) 79 60 //1,73 2 (2- ) 49 - (20,8%) 60 //1,73 2 (3- ). () - RIFLE AKIN - .

. 37 (15,7%) 0,30,4 / ( ), 11 (13,8%) - 26 (16,7%), : 18 (16,8%) 2- 8 (20,4%) 3- . 0,5-,9 / ( ) 44 (18,6%) 0,9 / ( ) 15 (6,4%). -, / 13,8% 54,5% , .

, - , (IIIV . ), 1- 15 (18,8%), 2- 23 (21,5%) 3- 17 (34,7%). - 1- 5 (6,3%), 2- 9 (8,4%) 3- 7 (14,3%). 21 15 (71,4%) - . (> 2 ) 1- 10,0% , 2- 14,0% 3- 28,6%. , - , - 6,3; 9,3 16,3%. , - : 1- 3,8%, 2- 5,6% 3- 10,2%.

. , - - , -.

191

. .,1 . .,1 . .2

1, , 2,

: - (): Deceleration Capacity (DC) () -

. 29 32 75 19 60 . 4 25 . - 56,91,62 . - (--, ). DC - Calc-PRSA Technische Universitt Mnchen. () .

STATISTIA, 10 ( ).. DC 6,38 .

DC (< 4,5 ) 5 . - (< 2,5 ), 1,41 1,58. , DC . DC , , , , , . - DC : () (r=+0,43), (r=+0,51), 1 . (r=+0,54), (r=+0,42), (r=+0,54). - . T (r=+0,53) - 1 . (r=+0,48). , , .

. DC , .

192

. ., . . ,

,

- - . - - . - , . - .

: - , - - .

: 437 (. 55,78,5 , 28,23,1 / 2), - 20082011 . , / . (Grass Comet PSG). -, , , .

: - 175 (40%) , - 206 (47%) . , , ( 67%), - ( 4,72.2 --), ( 2,2+1,7 ) . ,

, 2013; 12 ()82

193-195

, - ( = 1.8), ( = 1.3); - ( = 2.3), ( = 1.9).

: -, , - , , - - . - - .

193

. ., . ., . ., . .

, ,

- - , - , - . , - , (), - -. - .

: - - .

: 57 - II . - (39 18 , . 54,5,85,4 , 30,52,7 / 2, -- 32,415,6, Sp0272,512,4) 58 - II . . - . Comet PSG (). - , 30 300 . - , (17,15,3 ). - 912 .

: - 38 (67%) 21 (36%) . 14 38 (37%), 912 25 38 (66%).

: , ( -, - .) . -

.

194

. ., . ., . .

, - , ,

: () / - , - , - ().

. 167 (75 92 ), , - 43 65 (55,24,7 ). 18 53 (37,43,8 .). / . - . 6 .

. 133 (79,6%) - . 123 (92,5%) / (): 78 (58,6%) , 31 (30,8%) 2- 10 - (7,5%) 12 . 14 (10,5%) . , 67 , 36 30 . - . - , 38 (22,8%), 7 , - : 15 (9,0%) () 23 (13,8%) IIIII . 18 -. / . 6 133 23 , 28 - 82 .

() . , - ( ) , , -. , 24 . , () , - .

. (79,6%), , , / ( 78,9% ) 10,5% , .

195

, 2013; 12 () 83

196-197

. ., . ., . .

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: () - ().

. - 167 , - 133 (79,6%) - 34 . 43 65 (56,14,5 ). - , , 18 53 36,23,6 . / . 133 , 34 . 6 .

. 6 - 3 . 1- 28 , (); 2- 23 , (12 ) 3-