Latvian Institute of Cardiology

A short history

Latvian Institute of Cardiology was founded in 1977 during the process of creation of specialized unit for cardiological service. In 1970s cardiovascular diseases were clearly the main cause of transient or chronic disability as well as high rates of mortality in the developed countries. This was the reason for the development of an integrated cardiovascuolar disease care system. Latvian Institute of Cardiology incorporated the researchers from the laboratories of Riga Medical Institute and Latvian Institute of Experimental and Clinical Medicine, focusing on different aspects of cardiovascular pathology. The institute co-ordinated all preventive, treatment and scientific research activities in Latvia, as well as performed theoretical and clinical researches projects in this field. In 1993 the institute was registered as a nonprofitable scientific organization according to the existing legislation.

Main tasks

• To evaluate the main effect of cardiovascular diseases on social and economical situation in Latvia and to arrange the risk factors and their combinations considering demographical situation in the country, as well as paying attention to such interdisciplinary questions as food production, diet, physical activity, negative notions, psycho-emotional stress, ecological peculiarities, etc.;
• To develop data bank concerning patients with cardiovascular diseases and their risk groups enabling to elaborate and implement primary and secondary health care corresponding to principles of health care insurance system;
• To co-ordinate and expand theoretical research of the genesis and development of cardiovascular diseases;
• To develop clinical research concerning new non-invasive and invasive diagnostic and treatment methods, as well as to introduce the world-wide accepted methods in Latvia considering specific economical situation of the country.

Staff and structure

In 2000 there were 32 full time positions and 18 out of them are for scientific associates.

At present there are: 1 Member of Latvian Academy of Science, 2 Dr.habil.med., 15 Dr. med., working in the institute.

There are 6 research laboratories in the institute:
• Laboratory of Cardiovascular Disease Prevention
• Laboratory of Arterial Hypertension
• Laboratory of Ischemic Heart Disease
• Laboratory of Pharmacology and Toxicology
• Laboratory of Clinical Physiology
• Laboratory of Biochemistry

At the moment scientists of Latvian Institute of Cardiology performs studies in the framework of 5 research grants and participates in following programs:

State Program "Population of Latvia and people's health"
Finnish-Latvian Pilot Project on Prevention of Cardiovascular Diseases Countrywide Integrated Non communicable Disease Intervention (CINDI) Programme

They include:
• Social and economic losses from cardiovascular diseases in Riga population (programme No. 18 1-2-015)
• Epidemiological survey of cardiovascular risk factors in Kuldiga region (CINDI Program)
• The effect of left ventricle hypertrophy, myocard remodulation, tissue electrolyte disbalance and autonomic nervous system activity on myocard contractility and electrical stability in essential hypertension patients (grant No. 96.0624)
• Coronary angioplasty: reduction of risk for early complications and restenosis using stents coated with biological active substances (grant No. 96.0628)
• Studies on the therapeutic correction of hypodynamia at chronic myocardium ischemia and chronic heart failure using non-invasive radiocinetocariographic methods (grant No. 96.0627)
• Influence of interaction of neurogenic and local factors on vessel tone on heterogenic regulation of skeletal muscle blood flow and physical work capacity in healthy subjects and patients with main cardiovascular diseases (grant No. 96.0626)
• The study of tryptophan and kynurenine metabolites significance to favour the development of atherosclerosis (grant No. 96.0625)

Main achievements

Considerable results has been achieved in Preventive cardiology, clinical physiology, pharmacology and biochemistry making our presence felt on international level.

For the first time in Latvia, the prevalence of cardiovascular disease, its correlation with individual risk and social factors were investigated in 0.5 % randomized population. It included 2637 men and women in the range between 20 and 69 years. The databases was formed according to 200 parameters. The economic losses from cardiovascular diseases were accounted.

It was stated that fatigue resistance of skeletal muscles to local static exercise in essential hypertension patients (without signs of heart failure) was reduced comparing to healthy people due to existence of discrepancy between oxygen delivery and demands for increasing rate of phosphagens resynthesis. Observed peculiarities are not only the consequence of modifications in microvasculature functional organisation, but also conjoint with modified properties (electromechanical and metabolic) of muscle fibres. It was stated that baroreceptor reflex heart rate reaction amplitude at rest and its dynamic during pressor reaction (accompanying static exercise) at essential hypertension was modified due to increased vessel stiffening and reduced efferent vagal effect on sinus node.

The up-to-date digital angiography system has been installed and a new unit for Interventional Cardiology has been organised in the Centre of Cardiology at the P.Stradins Clinical Hospital. It is equipped with the Boston Scientific Corporation Intravascular ultrasound equipment and with high tech VINGMED system FIVE ehocardiography. Specialists in interventional cardiology are improving techniques for performing angioplasty and for stenting of coronary lesions. Investigations on biologically active materials, also on biologically active substances for covering the internal surface of connary stends as well as investigations on plasma lipoproteins and on platelet functions are carrying out.

A new non-invasive method based on the application of the high frequency electromagnetic waves was elaborated. The described method is original and there is no analogies in the world. In the recent years radiokinetocardiograph "Videocard 2" was improved using computer technique. Effectiveness and diagnostic informativity of radiokinetocardiography in the arterial hypertension, in ishemic heart disease, arrhythmia cases and in drug studies are studied.

There was studied a hitherto little described phenomenon - regional heterogeneity in blood flow supply of human skeletal muscles. It was found that the equilibrium between the rate of resynthesis of phosphogens and oxygen delivery at low range of static voluntary contraction of forearm is ensured by several factors: spatial dispersion of muscle fibres of motor unit, contraction of motor units with minimal contraction frequency, ability to accumulate phosphocreatine debt and mechanism regulating tone of microvessels securing additional blood supply only to the active muscle fibres. Peculiarities in regional circulation in patients with different cardiovascular diseases characterising with the decreased exercise tolerance are investigated. It was shown that muscle vasting (in patients with atherosclerosis obliterance of magistral arteries in lower limbs) determines the reduction of maximal force of voluntary contraction and more significant augmentation of intramuscular pressure than in healthy leg during contraction with the same contraction force.

It was shown that impairment of tryptophan-nicotinic acid pathway associated with elevated accumulation of kynurenine in blood serum forms one of the pathogenic basis for angina pectoris, sinus node disease, chronic atrioventricular block and some cases of cardiomyopathics. Kynurenine takes part in the regulation of arterial blood pressure by stimulation of norepinephrine accumulation both in blood serum and heart tissue. Tryptophan, its metabolites and related compounds such as norepinephrine and pteridines impair phospholipid biosynthesis by changing the amount of phospholipid classes and by deviation of fatty acids incorporation into phospholids. It is suggested that above mentioned metabolites participate in the regulation of membrane fluidity, cell transformation and keeping the cholesterol in the state of solution.

Research programmes on population health problems

During the last few years researchers of the institute have performed a cross-sectional epidemiological study of the most widespread chronic noninfectious diseases in Latvia and till present they work on epidemiological investigation concerning cardiovascular disease risk factors and cardiovascular disease prevalence in Riga, as well as the economical loss caused by the morbidity from cardiovascular diseases . This is done in the framework of the programme "Population of Latvia and People's Health". This study includes the assessment of epidemiological situation concerning cardiovascular diseases in different regions of Latvia, the determination of the prevalence of the main cardiovascular diseases risk factors and the analysis of the relationship between ecological factors and mortality from cardiovascular diseases, the development of database of epidemiological research results on the bases of the personal computer, the elaboration of intervention programmes for primary and secondary prevention considering regional peculiarities. Special attention will be paid to high blood pressure control programme.

Recent publications

V.Rudzite, E.Jurika, J.Jirgensons. Changes in membran fluidity induced by trytophan and its metabolites. Adv. in Exp. Med. and Biol., 1999, 467, 353-368.
V.Rudzite, E.Jurika, B.Winder, D.Fuchs. Similarity between the action of pteridines and trypthopan metabolites on lipid metabolism. Pteridines, 1999, 10, 3, 133-140.

J.Gailans, V.Dzerve, I.Kukulis, D.Matisone, P.Ozolins, L.plakne. Ascending dilatation of the magistral artery during isometric contraction of cat skeletal muscle. Proceedings of the Latvian Academy of sciences, 1999, 53, B, 4, 212-215.

A.Vitols, D.Liepina. Characteristics of skeletal muscle at essential hypertension (data of handgrip test). Proceedings of the Latvian Academy of sciences, 1999, 53, B, 3, 168-173.

D.Voita, V.Mackevics, A.Vitols. Handgrip test as a tool to assess modification in autonomic control of heart rate at essential hypertension. Amer. J.Hypertension, 1999, 12, 4, part 2, 73 A.

D.Klincare, A.Vitols. Vagal modulatory effect of sinus node is related to baseline pulse interval. J.Hypertension, 1999, 17, suppl. 3, S 245.

A.Pukitis, A.Skutelis, V.Mikazans, E.Karasevska. Early heart failure signs: diastolic disfunction evaluation using radiocinetocardiography method. European J. of Heart Failure, 1999, 1 , 41.

P.Tretjakovs, U.Kalnins, A.Erglis, I.Dinne, I.Dabina, A.Jurka. Interaction between arachidonic acid and platelet phospholipids, and HDL-cholesterol metabolism in patient with coronary heart disease. Acta Medica Austriaca, 1999, suppl.49, 6-7.

V.Dzerve, J.Kukulis, D.Matisone, D.Urbane, D.Klincare, J.Gailans. Verapamil effectively potentiate baroreceptor reflex mediated vasodilation in skeletal muscles of hypertensive subjects. Physiological Research, 1999, 48, suppl. 1, S 67.
V.Dzerve, E.Pahomova, N.Bricina, I.Markovica, K.Rinkuzs, G.Sileniece, G.Mitjuseva, J.Zabarovskis. Smoking and causes of quitting in Latvia. Abstr. of 2nd European Conference on Tobacco or Health, 1999, Las Palmas (23-27 february).

I.Kukulis, V.Dzerve, G.Jegorovs, J.Gailans, E.Cukure. Effect of repetitive palm blood flow arrest in patients with Raynauds phenomenon. International Angiology, 2000, 19, suppl.1, 2, p.33, 124.

Assessment of cardiovascular diseases and their risk factors in the Riga population (prevalence, interaction, health care costs). Latvian Institute of Cardiology, Riga, 2000. ppp.1-48 (book).