Shapkin A. Morphofunctional changes in the heart conducting system in heart failure.

The work is devoted to studying of the morphofunctional conditions of conducting system of the heart in dynamic of the heart failure progressing which has appeared on background of the ischemic heart disease and essential hypertension combination, and to substantiation of the arrhythmia's and blockades originating mechanisms. The research is revealed that the increasing of sclerotic and atrophic processes in cardiac conducting system are directly proportional to the heart failure stages that in a complex with their dystrophic changes results to the arrhythmia's originating on background of endothelin-1 hyperproduction. The complex of the adaptive reactions directed for increasing of metabolic-synthetic processes is develops in conducting cardiomiocytes on the IIА stage of heart failure, and, further, it results to the exhaustion of morphofunctional reserves with the subsequent failure of compensative-adaptive processes. Interrelations are revealed between a stage of chronic heart failure and the character of quantitative and qualitative compounds of conducting system of cardiac stroma. It is marked, that damage of intramural nervous system is important in development of cardiac conducting system functional disturbance at chronic cardiac insufficiency. The morphological equivalents of cardiac rhythm disturbance are developed on the basis of the performed complex research.