<p>Endotelin-1 je najpotentniji vazokontstriktorni peptid koji značajno doprinosi funkcionalnim i strukturnim bubrežnim promenama i poslednjih godina se izdvojio kao značajan faktor u razvoju i progresiji dijabetesne nefropatije. Cilj ovog istraživanja bio je odrediti nivo plazmatskog endotelina-1 kod bolesnika sa tipom 2 &scaron;ećerne bolesti u odnosu na zdravu populaciju kao i ispitati odnos plazmatskog endotelina-1 i funkcionog statusa bubrega kod bolesnika sa &scaron;ećernom bolesti tip 2 i dijabetesnom nefropatijom. U istraživanje je uključeno sto dvadeset ispitanika sa tipom 2 dijabetesa i sekundarno inzulin zavisni, koji&nbsp; su podeljeni u dve grupe u odnosu na izmerenu jačinu glomerulske filtracije: Grupa I (n=60) ispitanici sa jačinom glomerulske filtracije većom od 60 ml/min/1.73m2 i grupa II (n=60) ispitanici sa jačinom glomerulske filtracije manjom od 60 ml/min/1.73m2. Kod svih ispitanika izmerena je plazmatska vrednost endotelina-1 i izvr&scaron;ena procena funkcionog statusa bubrega merenjem jačine glomerulske filtracije, efektivnog bubrežnog protoka plazme i ostalih parametara bubrežne funkcije: serumske koncentracije cistatina C, uree, kreatinina, mokraćne kiseline kao i određivanje 24h albuminurije i proteinurije. Dobijeni rezultati upoređivani su sa rezultatima kontrolne grupe ispitanika (n= 30). Postoji statistički značajna razlika u medijanama vrednosti endotelina-1 između ispitivanih grupa (p&lt;0.001). Značajno niže vrednosti plazmatske koncentracije endotelina-1 su imali ispitanici kontrolne grupe (0.80 &plusmn;0.3) u odnosu na ispitanike sa &scaron;ećernom bolesti i JGF&gt;60 ml/min (1.4&plusmn;0.4) kao i u odnosu na dijabetesne bolesnike sa JGF&lt;60ml/min (2.5 &plusmn;0.8). Značajno vi&scaron;e vrednosti endotelina-1 su&nbsp; imali bolesnici sa &scaron;ećernom bolesti i većim stepenom redukcije jačine glomerulske filtracije u odnosu na bolesnike sa manjim stepenom redukcije jačine glomerulske filtracije (p&lt;0.001). U grupi bolesnika sa tipom 2 &scaron;ećerne bolesti postoji statistički značajna inverzna korelacija između plazmatskog nivoa endotelina-1 i izmerene vrednosti jačine glomerulske filtracije i efektivnog bubrežnog protoka plazme (r= -0,75; p=0,000; r= -0,74; p=0,000) odnosno bolesnici sa &scaron;ećernom bolesti kod kojih postoje povi&scaron;ene vrednosti plazmatskog endotelina-1 imaju veći stepen redukcije jačine glomerulske filtracije i efektivnog bubrežnog protoka plazme. Kod bolesnika sa tipom 2 dijabetes melitusa i različitim stepenom bubrežne hipofunkcije endotelin-1 u značajnoj meri utiče na vrednosti jačine glomerulske filtracije i efektivnog bubrežnog protoka plazme ali i druge funkcijske parametre bubrega i samim tim može imati važnu ulogu u nastanku i razvoju dijabetesne nefropatije.</p> / <p>Endothelin-1, potent vasoconstrictor peptide may contribute to the functional and structural renal changes and in recent years emerged as a significant factor in the development&nbsp; and progression of diabetic nephropathy. The aim of&nbsp; this study was to determine the level of plasma endothelin-1 levels in patients with type 2 diabetes and compared to healthy&nbsp; population as well as to examine the relationship of plasma endothelin-1 and the functional status of the kidneys in patients with type 2 diabetes. The study included one hundred&nbsp; and&nbsp; twenty patients&nbsp; with type 2 diabetes and insulin-dependent secondary, which are divided into two groups with respect to the measured GFR: Group I (n = 60) subjects with by glomerular filtration rate greater than 60 ml /min/1.73m2 and group II (n&nbsp; =&nbsp; 60) subjects with by glomerular filtration rate of less than 60ml/min/1.73m2 . Plasma levels of endothelin-1, glomerular filtration rate and effective renal plasma flow were determined using appropriate methods in all subjects. Other renal function parameters such as serum&nbsp; concentrations of cystatin C, urea, creatinine, uric acid, 24h albuminuria and proteinuria were measured additionaly. The results were compared with control groups of subjects (n= 30). There was a statistically significant difference in median values of endothelin-1 between the groups (p&lt;0.001). Significantly lower plasma concentrations of endothelin-1 had control subjects (0.80&nbsp; &plusmn;&nbsp; 0.3) compared to subjects with diabetes and GFR&gt;60 ml/min (1.4 &plusmn; 0.4) and in relation to diabetic patients with GFR &lt;60 ml/min (2.5 &plusmn; 0.8). Significantly higher values of endothelin-1 had patients with diabetes and a higher degree of reduction of glomerular filtration rate compared with patients with a lower degree of&nbsp; reduction of glomerular filtration rate (p &lt;0.001). In the group of patients with type 2 diabetes, there was a statistically significant inverse correlation between plasma levels endothelin-1 and the measured values of glomerular filtration rate and effective renal plasma flow (r= -0.75; p=0.000; r= -0.74; p=0.000) and patients with diabetes who have the higher values of&nbsp; plasma endothelin-1 have a higher degree of reduction of glomerular filtration rate and effective renal plasma flow. In patients with type 2 diabetes mellitus and various degrees of renal hypofunction endothelin-1 significantly affects the value of the glomerular filtration rate and effective renal plasma flow or other parameters of renal function and thus can play an important role in thedevelopment of diabetic nephropathy.</p>

Conselho Nacional de Desenvolvimento Científico e Tecnológico / A síndrome dos ovários policísticos é uma desordem frequente e complexa, com grande variabilidade fenotípica, predominando os sinais de disfunção ovariana. Alterações metabólicas, inflamatórias e vasculares vinculadas à resistência à insulina são muito prevalentes nessa desordem podendo manifestar-se precocemente. O objetivo principal deste estudo foi investigar a presença de alterações microvasculares em mulheres jovens e não obesas portadoras da síndrome dos ovários policísticos, através de videocapilaroscopia periungueal e dosagem dos níveis séricos de endotelina-1. O objetivo secundário foi verificar a existência de associações entre os achados vasculares, níveis séricos de androgênios, parâmetros clínicos, bioquímicos, metabólicos e inflamatórios relacionados ao risco cardiovascular. Em estudo observacional, transverso e controlado avaliamos 12 mulheres com diagnóstico de síndrome dos ovários policísticos, segundo os critérios estabelecidos pelo consenso de Rotterdam e nove voluntárias saudáveis. A idade (22,82,3 X 24,62,7), o índice de massa corporal (22,53,4 X 23,73,1) e a circunferência da cintura (7510,1 X 77,38,1) foram semelhantes nos dois grupos. As portadoras da síndrome apresentavam hiperandrogenismo clínico. Não foram observadas diferenças significativas entre os grupos quando analisados os níveis séricos de estradiol, testosterona total, androstenediona ou o índice de testosterona livre, entretanto a SHBG mostrou-se significativamente mais baixa no grupo de estudo (p=0,011). A glicemia de jejum, insulina, HOMA-IR e o perfil lipídico foram normais e sem diferença entre os grupos. A amostra com síndrome dos ovários policísticos não apresentava intolerância à glicose ou Diabetes Mellitus pelo teste oral de tolerância à glicose. Os níveis séricos dos marcadores inflamatórios (leucócitos, ácido úrico, adiponectina, leptina e proteína c reativa) e do marcador de função endotelial avaliado também foram similares nos dois grupos. A velocidade de deslocamento das hemácias no basal e após oclusão foram significativamente menores nas pacientes de estudo (p=0,02), mas o tempo para atingir a VDHmax e os parâmetros relativos à morfologia e densidade capilar foram semelhantes. Não observamos correlação entre a velocidade de deslocamento das hemácias e níveis plasmáticos de endotelina-1, androgênios ou parâmetros de resistência insulínica. A velocidade de deslocamento das hemácias associou-se positivamente aos níveis plasmáticos de estradiol (r= 0,45, p<0,05) e negativamente aos de colesterol total e LDL colesterol (r= -0,52, p<0,05; r=-0,47, p<0,05, respectivamente). Em conclusão nossos resultados fornecem evidência adicional de dano precoce à função microvascular em mulheres portadoras de síndrome dos ovários policísticos. Através da capilaroscopia periungueal dinâmica, demonstramos que mulheres jovens com moderado hiperandrogenismo, sem obesidade, RI, hipertensão ou dislipidemia, já apresentam disfunção microvascular nutritiva, caracterizada por redução na velocidade de fluxo das hemácias no basal e após oclusão. Estes achados micro-circulatórios não foram acompanhados de elevações nos níveis plasmáticos de endotelina-1. / Polycystic ovary syndrome is a frequent and complex disorder, showing a great phenotypic variability, with predominance of signs of ovarian dysfunction and, more particularly, of hyperandrogenism and oligo-anovulatory cycles. This disorder shows a high prevalence of insulin resistance -related metabolic, inflammatory and vascular alterations, which may present at early stages. The main purpose of this study was to investigate the presence of microvascular alterations in young and non-obese women with polycystic ovary syndrome through periungueal videolaparoscopy and dosage of endothelin-1 serum levels. The secondary purpose was to verify further associations between vascular findings, serum androgen levels, and clinical, biochemical, metabolic and inflammatory parameters related to cardiovascular risk. We conducted an observational, transversal and controlled study to evaluate 12 women who, according to Rotterdam criteria, were diagnosed with polycystic ovary syndrome, and also nine healthy volunteers. Our selective process excluded from both groups women with smoking habits, as well as those who had made use of oral contraceptive, metformin or antilipemic drugs within three months prior to the beginning of the study. The age range (22,82,3 X 24,62,7), body mass index (22,53,4 X 23,73,1), and waist circumference (7510,1 X 77,38,1) were similar in both groups. Our patients with polycystic ovary syndrome presented clinical hyperandrogenism. Analysis of serum estradiol, total testosterone, androstenedione levels or testosterone free index disclosed no significant differences between the groups, although SHBG appeared to be expressively lower in the studied group (p=0.003). Fasting blood glucose test, insulin level, HOMA-IR and lipid profile showed normal results, and without difference between the groups. As disclosed by the oral glucose tolerance test, the group with PCOS did not present tolerance to either glucose or diabetes mellitus. When evaluated, the serum levels of inflammatory markers (leukocytes, uric acid, adinopectin, leptin and c-reactive protein) and of endothelial function marker (endothelin-1) were also similar in both groups. The red blood cell velocity at baseline and peak were significantly lower in patients with PCOS (p=0.02), although the timeframe to reach blood cell velocity at baseline and peak and the parameters referring to morphology and capillary density were similar between the groups. No association was observed between the speed of movement of red blood cells and plasma levels of endothelin-1, androgens or insulin resistance parameters. The velocity of movement of red blood cells was positively related to estradiol plasma levels (rho= 0.45, p<0.05) and negatively to the levels of total cholesterol and LDL cholesterol (rho= -0.52, p<0.05; rho=-0.47, p<0.05 respectively). Taken together, our results provide an additional evidence of early lesion to microvascular function in women with polycystic ovary syndrome. By using a simple procedure, namely the dynamic nailfoldvideocapillaroscopy, we demonstrated that young women with mild hyperandrogenism, who do not present obesity, insulin resistance, high blood pressure or dyslipidemia, already show a nutritional microvascular dysfunction, characterized by a reduced speed of red blood cells flow at basal level and after occlusion. Such microcirculatory findings were not accompanied by an increase of endothelin-1 plasma levels.

Conselho Nacional de Desenvolvimento Científico e Tecnológico / A síndrome dos ovários policísticos é uma desordem frequente e complexa, com grande variabilidade fenotípica, predominando os sinais de disfunção ovariana. Alterações metabólicas, inflamatórias e vasculares vinculadas à resistência à insulina são muito prevalentes nessa desordem podendo manifestar-se precocemente. O objetivo principal deste estudo foi investigar a presença de alterações microvasculares em mulheres jovens e não obesas portadoras da síndrome dos ovários policísticos, através de videocapilaroscopia periungueal e dosagem dos níveis séricos de endotelina-1. O objetivo secundário foi verificar a existência de associações entre os achados vasculares, níveis séricos de androgênios, parâmetros clínicos, bioquímicos, metabólicos e inflamatórios relacionados ao risco cardiovascular. Em estudo observacional, transverso e controlado avaliamos 12 mulheres com diagnóstico de síndrome dos ovários policísticos, segundo os critérios estabelecidos pelo consenso de Rotterdam e nove voluntárias saudáveis. A idade (22,82,3 X 24,62,7), o índice de massa corporal (22,53,4 X 23,73,1) e a circunferência da cintura (7510,1 X 77,38,1) foram semelhantes nos dois grupos. As portadoras da síndrome apresentavam hiperandrogenismo clínico. Não foram observadas diferenças significativas entre os grupos quando analisados os níveis séricos de estradiol, testosterona total, androstenediona ou o índice de testosterona livre, entretanto a SHBG mostrou-se significativamente mais baixa no grupo de estudo (p=0,011). A glicemia de jejum, insulina, HOMA-IR e o perfil lipídico foram normais e sem diferença entre os grupos. A amostra com síndrome dos ovários policísticos não apresentava intolerância à glicose ou Diabetes Mellitus pelo teste oral de tolerância à glicose. Os níveis séricos dos marcadores inflamatórios (leucócitos, ácido úrico, adiponectina, leptina e proteína c reativa) e do marcador de função endotelial avaliado também foram similares nos dois grupos. A velocidade de deslocamento das hemácias no basal e após oclusão foram significativamente menores nas pacientes de estudo (p=0,02), mas o tempo para atingir a VDHmax e os parâmetros relativos à morfologia e densidade capilar foram semelhantes. Não observamos correlação entre a velocidade de deslocamento das hemácias e níveis plasmáticos de endotelina-1, androgênios ou parâmetros de resistência insulínica. A velocidade de deslocamento das hemácias associou-se positivamente aos níveis plasmáticos de estradiol (r= 0,45, p<0,05) e negativamente aos de colesterol total e LDL colesterol (r= -0,52, p<0,05; r=-0,47, p<0,05, respectivamente). Em conclusão nossos resultados fornecem evidência adicional de dano precoce à função microvascular em mulheres portadoras de síndrome dos ovários policísticos. Através da capilaroscopia periungueal dinâmica, demonstramos que mulheres jovens com moderado hiperandrogenismo, sem obesidade, RI, hipertensão ou dislipidemia, já apresentam disfunção microvascular nutritiva, caracterizada por redução na velocidade de fluxo das hemácias no basal e após oclusão. Estes achados micro-circulatórios não foram acompanhados de elevações nos níveis plasmáticos de endotelina-1. / Polycystic ovary syndrome is a frequent and complex disorder, showing a great phenotypic variability, with predominance of signs of ovarian dysfunction and, more particularly, of hyperandrogenism and oligo-anovulatory cycles. This disorder shows a high prevalence of insulin resistance -related metabolic, inflammatory and vascular alterations, which may present at early stages. The main purpose of this study was to investigate the presence of microvascular alterations in young and non-obese women with polycystic ovary syndrome through periungueal videolaparoscopy and dosage of endothelin-1 serum levels. The secondary purpose was to verify further associations between vascular findings, serum androgen levels, and clinical, biochemical, metabolic and inflammatory parameters related to cardiovascular risk. We conducted an observational, transversal and controlled study to evaluate 12 women who, according to Rotterdam criteria, were diagnosed with polycystic ovary syndrome, and also nine healthy volunteers. Our selective process excluded from both groups women with smoking habits, as well as those who had made use of oral contraceptive, metformin or antilipemic drugs within three months prior to the beginning of the study. The age range (22,82,3 X 24,62,7), body mass index (22,53,4 X 23,73,1), and waist circumference (7510,1 X 77,38,1) were similar in both groups. Our patients with polycystic ovary syndrome presented clinical hyperandrogenism. Analysis of serum estradiol, total testosterone, androstenedione levels or testosterone free index disclosed no significant differences between the groups, although SHBG appeared to be expressively lower in the studied group (p=0.003). Fasting blood glucose test, insulin level, HOMA-IR and lipid profile showed normal results, and without difference between the groups. As disclosed by the oral glucose tolerance test, the group with PCOS did not present tolerance to either glucose or diabetes mellitus. When evaluated, the serum levels of inflammatory markers (leukocytes, uric acid, adinopectin, leptin and c-reactive protein) and of endothelial function marker (endothelin-1) were also similar in both groups. The red blood cell velocity at baseline and peak were significantly lower in patients with PCOS (p=0.02), although the timeframe to reach blood cell velocity at baseline and peak and the parameters referring to morphology and capillary density were similar between the groups. No association was observed between the speed of movement of red blood cells and plasma levels of endothelin-1, androgens or insulin resistance parameters. The velocity of movement of red blood cells was positively related to estradiol plasma levels (rho= 0.45, p<0.05) and negatively to the levels of total cholesterol and LDL cholesterol (rho= -0.52, p<0.05; rho=-0.47, p<0.05 respectively). Taken together, our results provide an additional evidence of early lesion to microvascular function in women with polycystic ovary syndrome. By using a simple procedure, namely the dynamic nailfoldvideocapillaroscopy, we demonstrated that young women with mild hyperandrogenism, who do not present obesity, insulin resistance, high blood pressure or dyslipidemia, already show a nutritional microvascular dysfunction, characterized by a reduced speed of red blood cells flow at basal level and after occlusion. Such microcirculatory findings were not accompanied by an increase of endothelin-1 plasma levels.

Abstract The incidence of adverse cardiovascular events is higher among spectators of exciting sports events, particularly in patients with coronary artery disease (CAD), but the mechanistic link between the events is not known. We assessed the hemodynamic, autonomic function, plasma catecholamines, endothelin-1, interleukin-6, and markers of platelet activation and blood coagulation of enthusiastic male ice hockey spectators with CAD (n=55, 60±9 years) and healthy subjects (n=16, 48±6 years) during Finnish national league ice hockey final play-off matches and on a control day. Blood markers were also measured before and after a maximal exercise test with a bicycle ergometer. Systolic and diastolic blood pressure (BP) were significantly higher one hour before, during, and one hour after the match than on the control day. During the match the highest systolic BP was 180±14 vs. 145±15 and diastolic BP was 103±13 vs. 82±11 mmHg (respectively, p&#60;0.001 for both). Heart rate (HR) was higher throughout the match (p&#60;0.05) and remained elevated two hours after the match (p&#60;0001), and measures of HR variability were decreased during the match (p&#60;0.01). Plasma endothelin-1 (ET-1), interleukin-6 (IL-6) and noradrenaline (NOR) increased during the match (p&#60;0.01 for all), but markers of platelet activation and coagulation remained unchanged. ET-1 did not change during exercise but NOR, adrenaline, IL-6, and markers of platelet activation and blood coagulation increased statistically significantly (p&#60;0.0001 for all). A statistically significantly more marked increase in both endothelin-1 and interleukin-6 was observed in CAD patients compared with healthy subjects during the match (time x group interaction p&#60;0.05 for both). The high-frequency power of R-peak-to-R-peak intervals decreased in CAD patients (p&#60;0.001) but did not change in healthy subjects during the match. Maximal metabolic equivalens (METs) were most strongly correlated with ET-1 response during the match (&#946; =-0.45, partial correlation r=-0.43, p=0.002) when age, body mass index, METs, left ventricular ejection fraction, basal ET-1 and subjective experience of excitement were entered into the model as independent variables in a linear stepwise regression analysis. In conclusion, autonomic reactions and vasoconstriction may partly explain the vulnerability to cardiovascular events caused by this type of leisure-time emotional excitement. Emotional excitement causes concomitant increases in markers reflecting vulnerability to atherosclerotic plaque complications, while physical exercise causes more prominent changes in markers of coagulation. Emotional excitement causes more significant increases of markers of vasoconstriction and acute inflammation and withdrawal of cardiac vagal regulation in patients with CAD than in healthy subjects. Exercise capacity may protect against further cardiovascular events in CAD patients because it is associated with reduced ET-1 release during emotional excitement. / Tiivistelmä Jännittävän urheilutapahtuman on havaittu lisäävän sydäntapahtumia erityisesti sepelvaltimotautipotilailla. Syyt eivät ole selvillä. Tutkimuksen kohteena oli jääkiekon mestaruussarjan pudotuspelien seuraamisen vaikutus sekä sepelvaltimotautisten (n=55, 60±9 vuotta) että terveiden (n=16, 48±6 vuotta) jääkiekkofanien verenkiertoon, autonomiseen hermostoon, veren katekolamiinien, endoteliini-1:n (ET-1) ja interleukiini-6:n (IL-6) pitoisuuksiin sekä veren hyytymiseen paikan päällä jäähallissa seurattuna. Muuttujat mitattiin jäähallissa ottelun aikana. Ne mitattiin myös ennen ottelua ja eri päivänä sairaalassa ennen kuntopyörällä tehtyä maksimaalista sydämen kuormitustestiä ja heti sen jälkeen. Sepelvaltimotautipotilaiden ylä- ja alaverenpaineet kohosivat tilastollisesti merkitsevästi tuntia ennen jääkiekkopeliä ja sen aikana, ja ne olivat koholla vielä tunnin ajan pelin jälkeen kontrollipäivään verrattuina. Ottelun aikana yläpaineet olivat 180±14 vs. 145±15 ja alapaineet 103±13 vs. 82±11 mmHg (p&#60;0.001 molemmille painetasoille). Sydämen syke oli korkeampi pelin ajan (p&#60;0.05), ja se pysyi koholla kahden tunnin ajan pelin jälkeen (p&#60;0.001). Lisäksi sykevaihtelu heikentyi pelin aikana (p&#60;0.01) kontrollipäivään verrattuna. Veren ET-1-, IL-6- ja noradrenaliinipitoisuudet (p&#60;0.01) nousivat pelin aikana, mutta veren hyytymistä kuvastavat lukemat säilyivät muuttumattomina. ET-1 ei noussut fyysisessä kuormitustestissä, mutta noradrenaliini- ja adrenaliinipitoisuudet sekä IL-6:n ja veren hyytymistä kuvaavat lukemat kasvoivat tilastollisesti merkitsevästi (p&#60;0.0001). Pelin aikana sepelvaltimotautipotilaiden ET-1 ja IL-6 pitoisuudet kohosivat enemmän kuin terveiden vastaavat arvot (p&#60;0.05). Lisäksi ottelun aikana sydämen sykevaihtelu laski sepelvaltimopotilailla (p&#60;0.001), muttei muuttunut terveillä. Polkupyörätestin maksimaalinen suorituskyky (METs) oli voimakkaasti yhteydessä ET-1 vasteeseen pelin aikana (&#946; =-0.45, r=-0.43, p=0.002), kun ikä, painoindeksi, METs, sydämen supistusvireys, ET-1:n lähtötaso ja koehenkilöiden kokema jännitystaso huomioitiin itsenäisinä muuttujina regressiotyyppisessä tilastolaskennassa. Yhteenvetona todetaan itsenäisesti toimivan hermoston muutosten ja verisuonten supistumisen voivan osittain selittää aiemmin havaitun sydäntapahtumien lisääntymisen tutkimuskohteen tyyppisessä vapaa-ajan tunne-elämyksessä. Jääkiekkopelin jännitys aiheuttaa muutoksia sepelvaltimotautialueiden repeämisherkkyyttä kuvaaviin tekijöihin, kun taas fyysinen rasitus vaikuttaa voimakkaammin veren hyytymistä ilmaiseviin lukemiin. Potilailla jännitys lisäsi enemmän suonten supistuvuutta, akuuttia tulehdusreaktiota ja nosti parasympaattisen hermoston vetäytymistä kuvaavia lukemia terveisiin koehenkilöihin verrattuna. Hyvä suorituskyky voi suojata korkean riskin sepelvaltimotautipotilaita sydäntapahtumilta vähentämällä ET-1:n vapautumista jännityksen aikana.

Hypoxic-ischemic insult is a most common form of perinatal brain damage that threatens a newborn's life and can leads to permanent neurological sequelae. However, detailed aspects of the cerebral ischemia in the immature brain stay unanswered. We decide to use the model of focal cerebral ischemia induced by intrahippocampal endothelin-1 (ET-1) in 12-days-old rats. The knowledge about consequences of ET-1 induced ischemia and the role of endothelin receptors (ETA and ETB) in ischemia-induced consequences in immature brain are poor at present. Agonists and selective antagonists of the ETA and ETB receptors were used to determine the role of these receptors in the development of ischemia, changes in regional blood flow and tissue oxygenation, local changes of biochemical parameters and acute neuronal death. Our results indicates, that activation of the ETA receptors causes a strong decrease of the blood flow, induced related hypoxia and subsequent neuronal degeneration, whereas activation of ETB receptors has likely modulatory role. Moreover, ischemia causes increase of excitatory amino acids concentration, whereas inhibitory amino acid, except taurine, decreased after ischemia. These facts provides new insights in a case of perinatal ischemia. This thesis demonstrates the wide range of different effects of...

Part I. The aldosterone synthase gene (CYP11B2) polymorphism T-344C in blood pressure and left ventricular hypertrophy. BACKGROUND: Aldosterone is a key cardovascular hormone, it significantly influences volume, pressure and electrolyte balance. Aldosterone plays an important role in development of left ventricular (LV) hypertrophy and myocardial fibrosis. The aldosterone synthase gene (CYP11B2) is an important candidate gene region in essential hypertension. DESIGN AND METHODS: We assessed the influence of the T-344C polymorphism of aldosterone synthase - the rate-limiting enzyme in aldosterone biosynthesis - on the structure of the left ventricle in young normotensive men. The population included 113 normotensive mid-European Caucasian men aged 18-40 years (mean 27 +/- 5 years). We also studied the association of -344T/C polymorphism of the CYP11B2 gene with the presence and severity of hypertension in 369 individuals, of whom 213 were hypertensive patients (139 controlled hypertensive, 74 resistant hypertensive) and 156 were healthy normotensive subjects. The genotype was assessed using polymerase chain reaction with subsequent cleavage with restriction enzyme HAEIII (restriction fragment length polymorphism method) and visualization with ethidium bromide. Plasma renin activity (PRA) and plasma...