bluuebunny/crossref_metadata_2025 huggingface dataset:
Phylogenetic, structural and pathogenetic basis of classiﬁcation of hypertension
Authors: Titov V.
Published: December 2018

Classifi cations of clinical forms of arterial hypertension (AH) are based on differentiating its etiology; we propose a classifi cation that is based on the common pathogenesis of hydrodynamic pressure elevation in the intravascular pool of the intercellular medium, i.e., arterial blood pressure (BP). We believe that there are only three options for hydrodynamic pressure elevation in a mechanical model of the cardiovascular system: 1) a decrease in the arterial bed volume at a constant volume of the intravascular fl uid, 2) an increase in the volume of intravascular fl uid at a constant volume of the vascular bed and 3) an increased blood fl ow resistance at constant volumes of the vascular bed and intravascular fl uid. These options include all clinical forms of AH in which BP increases by common mechanisms. The fi rst option can be related to AH occurring in pheochromoblastoma, glucocorticoid hyperproduction and psychoemotional stress. The second is associated with AH developing in excessive NaCl consumption, increased aldosterone production in Conn syndrome (primary aldosteronism) and reduced production of atrial natriuretic peptide by phylogenetically modifi ed myocytes of the right atrium. The third option can be linked to all forms of increased peripheral blood fl ow resistance in the arterial bed presented at coarctation of the aorta, renovascular hypertension, impaired fl ow/endothelium-dependent vasodilation and moderate spasm of muscular arterioles, arterial wall atherosclerotic lesion (atheromatosis and atherothrombosis), Takayasu syndrome and obliterating endarteritis. BP elevation in erythremia, under the effect of leukocyte colony-stimulating factor and after injection of a recombinant erythropoetin can also be regarded within the frames of the third option. From the general biology viewpoint, all forms of AH developing against the background of impaired biological function of transcytosis (macropinocytosis) and crossing by food substrates and humoral mediators of bilayer structures between common and local pools of the intercellular medium, i.e., blood-brain barrier can be referred to as hematoencephalitic form. AH developing in impaired transcytosis across the bloodbrain barrier (endothelium + astrocytes bilayer) is an encephalopathic form; across endothelium + podocytes bilayer - renal form; endothelium + trophoblasts - placental AH; endothelium + pneumocytes - pulmonary AH; and endothelium + intimal macrophages - atherosclerosis-related AH. Normal BP points at the physiological level of transcytosis between all pools of the intercellular medium, the absence of peripheral blood fl ow resistance in the arterial bed, normal function of muscle arterioles, and the physiological levels of metabolic processes in all paracrine cell communities in vivo.
Antihypertensive therapy in patients with liver diseases. Can we decrease the risk of liver fibrosis by affecting renin-angiotensin system?
Authors: Drapkina O. M. , Dubolazova Y. V.
Published: December 2018

The paper summarizes data on antihypertensive treatment in hypertensive patients with concomitant hepatic diseases when inflammation and fibrosis result in liver cytoarchitecture changes. Rennin-angiotensin-aldosterone system blockade enables to reduce tissue damage and fibrosis development regardless of blood pressure decrease. The majority of hypertensive patients requiring combination antihypertensive therapy can benefit in achieving target blood pressure faster, decreasing side effects risk, and in improving liver function. Key words: hypertension, liver diseases, rennin-angiotensin-aldosterone system blockade.
Matrix metalloproteinases and cardiovascular diseases
Authors: Tourna A. A. , Toguzov R. T.
Published: December 2018

The paper reviews the role of matrix metalloproteinases of proteolytic system that perform a great variety of function and control almost all biological processes. According to the classification all proteases are divided into four families serine, cysteine, aspartate and metalloproteinases (last also called matrix metalloproteinases (MMP)). Up to now 28 MMP are known (from MMP-1 to MMP-28). Based on structural features and substrate specificity MMP family was divided into identified 4 subfamilies: collagenases, gelatinases. stromelizines and unclassified MMP. Study of MMP family in cardiology significantly expands the understanding of the pathogenetic mechanisms of cardiovascular diseases and demonstrates different MMPs functions: stromelizine MMP-3, collagenase - MMP-8, gelatinase - MMP-9. It is assumed that MMP-3 and MMP-9 play an important role in acute myocardial infarction, unstable angina, rehabilitation after a heart attack, left ventricular remodeling. There are data of special role of MMP-3, MMP-9 gene polymorphism associated with susceptibility to cardiovascular disease, atherosclerosis of the arteries, heart attack, aneurysm of the aorta. However, role of MMP-2, MMP-7 and unclassified MMPs in cardiac pathology is not well investigated and remains controversial.
Predictors of complications and of unfavorable outcomes in myocardial infarction
Authors: Bobrovskaya E. E. , Burova N. N. , Kon V. E.
Published: December 2018

The prognosis of complications and outcomes of myocardial infarction in the course of some years is one of the most important problems in cardiology. With a wide choice of drugs and preventive techniques used for the treatment of myocardial infarction, the most important task is to identify groups of patients at high risk of developing complications such as cardiogenic shock, recurrent myocardial infarction, acute left ventricular failure, ventricular fibrillation, early postinfarction angina pectoris.
Combination therapy with diuretic and different calcium antagonists in hypertensive patients: The comparison of antihypertensive and hemodynamic effects
Authors: Iskenderov B. G. , Gridneva E. V. , Sisina O. N. , Saushkina S. V.
Published: December 2018

54 patients 42-65 years old with uncomplicated hypertension (stage 2) were studied. The 24-hour blood pressure (ВР) monitoring and doppler-echocardiograpy were performed at baseline and after 16 weeks of treatment. Patients were randomized into 2 groups. In the 1st group patients received combination indapamide with verapamil retard, and in 2nd group, combination of indapamide with amlodipine. The circadian rhythm of BP profile was normalized in 83,9 % of patients in 1st group and in 78,6 % of patients in the 2nd group. In the 1st group, the combination therapy is more effective in patients with diastolic left ventricular dysfunction (DDLV) type I, non-dipper profile of circadian rhythm of BP, and with a hyperkinetic type of circulation. In the 2nd group, combination therapy was effective in patients with DDLV type 2-3 and with a hypokinetic type of circulation.
Significance of thrombinemia in patients with aortic valve stenosis
Authors: Goncharova N. S. , Moiseeva O. M. , Aleshina G. M. , Shlyakhto E. V.
Published: December 2018

4 patients with non-rheumatic aortic valve stenosis were assessed before the aortic valve replacement and 6 month the operation. It was found out that inflammation, thrombocytes and coagulation activation tightly interacted with each other and with left ventricular remodeling. There is a negative correlation between left ventricular hypertrophy regression thrombin level in plasma. Key words: aortic stenosis, thrombin, myocardial hypertrophy, inflammation, thrombocytes.
Treatment of hypertension in young men
Authors: Bubnova V. S. , Shaposhnik I. I. , Palko N. N. , Lisun T. M. , Levin A. A. , Nefedova E. V.
Published: December 2018

Objective. To assess effi ciency of in hypertensive men capable of working. Design. Clinical study and instrumental (Ageing Male Score, AMS) examination were performed in 15 hypertensive men aged 32,8 ± 6,9 years old. Results and conclusions. Target blood pressure was achieved in 14 hypertensive men treated with eprosartan 600 mg/hydrochlorthiazide 12,5 mg during six month. Moreover, this therapy was associated with a signifi cant increase of normotonic reaction rate at physical load during veloergometry, and a signifi cant reduction in symptoms of androgen defi cit assessed by AMS in men.
Mineral metabolism in various pathogenetic types of inflammation
Authors: Tourna A. , Toguzov R. T. , Kolyshkina N. A. , Poyarkova S. N.
Published: December 2018

Background. A large amount of experimental and clinical data on the content and the role of chemical elements in the human body is accumulated by nowadays. However, the state of mineral metabolism, mechanisms of action and the role of chemical elements in the etiology and pathogenesis of infl ammatory, autoimmune and other diseases are to be studied. Objective. To examine the state of mineral metabolism (calcium - Ca, magnesium - Mg, iron - Fe, cobalt - Co, copper - Cu, zinc - Zn) in various pathogenetic variants of infl ammatory processes in the blood serum of patients with acute coronary syndrome, community-acquired pneumonia and rheumatoid arthritis.
Local amyloidosis of the oral cavity in patients with inflammatory periodontal disease and chronic heart failure
Authors: Barmasheva A. A. , Semernin E. N. , Kuznetsova I. A. , Shirshova N. A. , Rybakova M. G. , Shlyakhto E. V. , Orekhova L. U. , Gudkova A. Y.
Published: December 2018

Background. Systemic and local amyloidosis can be evident in the oral cavity. Biopsy including oral mucosa biopsy is a standard of amyloidosis diagnosis. Oral mucosa species of the cheek, gingiva, tongue and lip were admitted for the histological investigation. Material and methods. Cheek and gingival biopsies of 32 patients with I-IV NYHA functional class of chronic heart failure (CHF) and suspected systemic amyloidosis were investigated histologically with heama toxylin-eosin and Congo red staining and immunohistochemical analysis to  and  antibodies (DAKO) and following investigation in the polar light. Results. Positive reaction was observed in 71,9 % cases, while systemic AL-amyloidosis (confi rmed by : disbalance) and genetic form of the amyloidosis with predominantly skin disease were diagnosed only in 3 cases (9,4 %). Dental investigation of the patients with CHF and congo-positive reaction determined high prevalence of the severe generalised periodontitis (37,5 %). Conclusion. Chronic generalized infl ammation of the periodontium may be the cause of the local amyloid deposition in the oral cavity.
Endothelial function in patients with asthma according to circadian blood pressure profile
Authors: Karoli N. A. , Roschina A. A. , Rebrov A. P.
Published: December 2018

Objective. The aim of study is asses of the endothelial functional features in patient with bronchial asthma with different types of blood pressure (BP) circadial rhythm.
Design and methods. 62 patients with bronchial asthma (from 25 to 60 years old) were included in our study. Control group was represented by 30 healthy people for examination of endothelial function and 77 patients with essential arterial hypertension for 24-h blood pressure rhythm analysis. We described 2 groups of patients («dippers» and «non-dippers») by ambulatory 24-h blood pressure monitoring.
Results. «Non-dipper» type was significantly prevalent in patient with asthma in comparative with patients with essential arterial hypertension (51,6% opposite 33,7%). The flow-depended endothelial dysfunction is most common in patient with asthma (dippers and non-dippers) than in control group. Negative correlation between nitroglycerin-depended vasodilatation and night-depressing systolic and diastolic blood pressure degree was presented in the study.
Conclusion. We founded associations between endothelial dysfunction and BP circadial rhythm in patients with bronchial asthma, especially in «non-dippers».
Evaluation of the clinical efficacy of antihypertensive drugs in elderly patients with isolated systolic hypertension
Authors: Oleynikov V. E. , Budanova V. A. , Gusakovskaya L. I. , Sergatskaya N. V.
Published: December 2018

Objective. To evaluate the antihypertensive and organoprotective effects of the calcium antagonist - slow release Nifedipine (Cordaflex RD) and diuretic Indapamid MR in patients with isolated systolic hypertension (ISH). Design and methods. 46 patients with ISH (66,2 ± 4,8 years) were included. Patients were divided into 2 clinical groups: 1st group (n = 26) took cordaflex RD, and 2nd group (n = 20) was given the Indapamide MR. The cardio- and angioprotective effects of the medications was evaluated. Results and conclusions. Cordaflex leads to the decrease of both systolic and diastolic blood pressure (SBP and DBP), whereas Indapamide influences SBP more, than DBP. Based on echocardiography results, both medications decreased the heart wall thickness, improved systolic and diastolic left ventricular function. Cordaflex RD significantly improved the diastolic left ventricular function. Both Cordaflex RD and Indapamide favorably influenced peripheral arteries endothelial function in elderly subjects with ISH. Both medications effectively reduced the index of the true stiffness CAVI.
Randomized comparative study of the moxonidine effectiveness in patients with uncomplicated hypertensive crisis. (AVES)
Authors: Tereschenko S. N. , Gaponova N. I. , Abdrakhmanov V. R.
Published: December 2018

Objective. Evaluate the clinical efficacy and safety of moxonidine selective inhibitor of imidazoline I1-receptors, compared with angiotensin-converting enzyme inhibitor captopril in patients with uncomplicated hypertensive crisis (UHC). Material and Methods used in Study.The Study has been conducted on 225 patients (125 female and 100 male), average age 56.2±14.4 with uncomplicated hypertensive crisis (UHC). All patients were randomly divided into two groups: patients in moxonidine group (n=113) received a single dose of 0.4 mg moxonidine orally and patients in captopril group (n=112) received a single dose of 25 mg captopril. Along with general clinical tests, the following tests were conducted: dynamic measurement of blood pressure (BP), heart rate, electrocardiogram, creatinine, potassium and glucose levels in blood. Performance indicators for patients were the time of onset of antihypertensive effect, blood pressure level and duration of antihypertensive effect. To evaluate each medicament effectiveness, the blood pressure monitoring has been performed daily. Output dynamics were analyzed for 12 hours. Results. Anti-hypertensive effect, expressed in terms of a significant reduction in systolic blood pressure in both groups, has been reached after 30 minutes, significant reduction in diastolic blood pressure - after 60 minutes, following the administration of drugs. Level of BP reduction did not exceed 25% of the baseline. Moxonidine advantage was detected primarily in the course of anti-hypertensive action with sustained drop in blood pressure over the entire period of observation. The favorable metabolic effects of moxonidine were confirmed. In particular, its effects were manifested in significant reduction of serum creatinine. When compared, in moxonidine group 26.9% more of the patients were with efficiency above satisfactory, tolerance above satisfactory - 18.8% more than in captoril group.Conclusions. The results show a higher level of moxonidine efficacy and a good degree of tolerability in comparison with captopril in patients with uncomplicated hypertensive crises. The drug can be successfully used for treatment of uncomplicated hypertensive crises, starting in the phase prior to admission to hospital, especially in patients with concomitant illnesses (diabetes, metabolic syndrome, chronic renal failure).
Type 1 angiotensin II receptor antagonists in cardiovascular diseases: Valsartan
Authors: Sviryaev Y. V. , Zvartau N. E.
Published: December 2018

The article focuses on antihypertensive effect, organoprotection properties and clinical use of angiotensin II receptor antagonist valsartan in patients with cardiovascular diseases.
Rational combination therapy in resistant arterial hypertension
Authors: Emelianov I. V. , Konradi A. O.
Published: December 2018

The article reviews therapy in drug-resistant hypertension. Current therapeutic approaches to treatment and rational combination therapy are discussed.
Mechanisms of arterial hypertension in metabolic syndrome
Authors: Krasilnikova E. I. , Baranova E. I. , Blagosklonnaya Ya. V. , Bystrova A. A. , Volkova A. R. , Chilashvili M. A.
Published: December 2018

Arterial hypertension in patients with metabolic cardiovascular syndrome (MS) has a number of features which are of great theoretical and practical significance. It has been shown that hypertension is the most frequent component of MS and chronologically follows abdominal obesity while clinical manifestations of atherosclerosis and carbohydrate metabolism disturbances develop much later. In addition, the disorders of hypothalamic-pituitary-adrenal axis contribute to the development of arterial hypertension in patients with abdominal obesity. Besides the abnormalities of central regulatory mechanisms, increased sympathetic tone, insulin resistance and hyperinsulinemia, functional state of adipose tissue is an established important factor for the development of systemic hypertension in patients with abdominal obesity, and in some cases the dysfunction of adipocytes, which can be genetically determined or acquired, may cause the whole cascade of MS. Search for the causes and mechanisms of arterial hypertension in patients with MS can help to find the possible targeted treatment and prevention of the disease.
Lipid-lowering therapy in elderly patients: Focus on statins and outcome
Authors: Barsukov A. V. , Talantseva M. S. , Sveklina T. S. , Bagaeva Z. V. , Zobnina M. P.
Published: December 2018

Elderly age and dyslipidemia are known high risk factors for cardiovascular morbidity and mortality. The article focuses on the evidence of statin benefits in primary and secondary prevention of cardiovascular complications in very elderly subjects. Importance of the achievement of target lipid levels regardless the age and possibilities of combined lipidlowering therapy in elderly patients are demonstrated. Some aspects of statin safety in elderly subjects are highlighted in the paper.
Parameters of 24-hour blood pressure monitoring in young men at initial stage of hypertension
Authors: Multanovsky B. L. , Lenig S. A.
Published: December 2018

Objective. To compare parameters of 24-hour blood pressure (BP) monitoring in young men with normal, high normal BP and arterial hypertension 1 degree. Design and methods. 102 men (group 1 — 32 subjects with optimal and normal BP, group 2 — 34 subjects with high normal BP, group 3 — 36 men with 1 degree hypertension) underwent 24-hour BP monitoring, and parameters of BP loading and BP changes during the day night were assessed. Results. To a considerable extent subjects with high normal BP demonstrated hypertension at 24-hour BP monitoring, and are characterized by higher «loading pressure» and higher morning BP elevation compared to those with normal and optimal BP; in the group with higher BP the number of patients with normal night profile of BP decreases. Conclusions. Our data confirm that 24-hour BP monitoring should be performed in all patients with high normal BP, and the latest should be considered a group of a higher cardiovascular risk. The disorders of daily BP profile become more profound as arterial hypertension develops.
Emotional and cognitive disturbances in hypertension in adolescents
Authors: Gluschenko V. V.
Published: December 2018

Objective. To evaluate the influence of hypertension on emotional and cognitive decline. Design and methods. We have studied 87 adolescents, aged 17-19 years, with arterial hypertension. All patients underwent neurological examination by A.M. Vein, psychopathological test, self-assessment depression and anxiety scale, M. Luscher and Landolt tests. Results. The following somatoautonomic disorders were defined: subdepressive, subjective-cognitive and quantitative (productivity deficit) and qualitative (concentration deficit) disorders were identified. Deficit of emotional-motivational self-regulation was found. Conclusion. Arterial hypertension is a risk factor for cognitive decline and for the deficit of emotional-motivational self-regulation.
The biological reaction of arterial pressure and pathogenesis of programmed arterial hypertension
Authors: Titov V. N.
Published: December 2018

Phylogenetically, the following scheme is relevant in vivo: cell → cell community → structural unit of an organ → organ → organ system. A paracrine-regulated cell community is a structural and functional unit of an internal organ; the nephron composed of renal capillary, afferent (efferent) muscular arteriole, and paratubular loose connective tissue is the basic unit of the kidney. In primates the nephron is induced from three germ layers within the first 16 weeks of embryogenesis, which is followed by nephron development during prenatal period; neonephrogenesis does not occur in the postnatal period. Impaired biological function of exotrophy, protein deficiency in mother's diet, and glucocorticoid therapy reduce the number of nephrons, which is reflected by low body weight of the newborn. If a newborn weights less than 2,5 kg, the number of nephrons is so small that they cannot provide the biological function of endoecology in adults without compensatory hypertrophy, which leads to the hydrodynamic pressure elevation in the arterial bed over glomerular filter and increased glomerular filtration. However, hypertrophy is not optimal for compensation of the nephron function. Low body weight at birth and small number of nephrons are risk factors of programmed arterial hypertension in an adult organism.
Cost-effectiveness of therapy with a selective aldosterone antagonist eplerenone in patients with heart failure
Authors: Rudakova A. V. , Moiseeva O. M.
Published: December 2018

Objective. To assess cost-effectiveness of selective aldosterone antagonist eplerenone in patients with chronic heart failure (CHF), including those with prior myocardial infarction. Design and methods. Markov modeling was performed on the basis of the results of multicenter clinical trials EMPHASIS and EPHESUS. Cost analysis was performed on the basis of obligatory medical insurance foundation tariffs in St Petersburg in 2011 year. Results. Eplerenone therapy preserved 17 lives per 1000 patients during 6 months in patients with CHF after myocardial infarction (EF ≤ 40 %) and 24 lives in patients with EF ≤ 30 %. The additional cost per patient is only 15,100-15,200 rubles for 6 months. For patients aged 70 years with CHF FC II, receiving eplerenone therapy, the ratio of cost/effectiveness is 360,800 rubles for one additional year lived. Conclusions. Eplerenone therapy is economically feasible in patients with prior myocardial infarction and left ventricular systolic dysfunction. Maximum effectiveness of eplerenone was found in an early phase of myocardial infarction and in patients with ejection fraction ≤ 30 %. These data prove that the inclusion of eplerenone in the list of the medications used in the state system of drug supply, as well as standards of the medical care is possible and highly required.
The cognitive dysfunction in patients with obesity. Role of the endocannabinoids
Authors: Zueva I. , Vanaeva K. I. , Shlyakhto E. V.
Published: December 2018

The endocannabinoid system plays an important role in different physiological processes including memory and learning. Its activation can affect cognitive function and cause cognitive deficit in obese patients. Objective. To assess the association between cognitive function and activity of the endocannabinoid system in obese patients. Design and methods. 32 subjects (18 females and 14 males) aged 35-55 years old (mean age — 47,8 ± 2,3 years) were included in the study. All participants underwent neuropsychological testing, assessment of cognitive evoked potentials and plasma level of the endocannabinoids. Results. Our study showed that obese patients demonstrate cognitive dysfunction. Cognitive evoked potential is an objective and early sing of cognitive dysfunction. Activation of the endocannabinoid system is associated with cognitive deficit in obese patients.
Left ventricular diastolic function in hypertensive patients with atrial fibrillation
Authors: Bartosh F. L. , Bartosh L. F. , Adonina T. S.
Published: December 2018

Objective. To study the features of the impact of atrial fibrillation on left ventricular diastolic function in hypertensive patients. Design and methods. We examined three groups of patients: hypertensive patients with atrial fibrillation, hypertensive patients with sinus rhythm and patients with idiopathic form of atrial fibrillation. All patients underwent cardiac ultrasound examination (Vivid 7 Dimension, General Electric). Results. The integral of blood flow linear velocity (VTI), period of pressure gradient half decrease (PHT) between left chambers of heart and time of transmitral blood flow (TE) were greater in patients of second and third groups compared to first group. They did not differ in second and third groups. The time of isovolumic relaxation (IVRT) was 0,102 ± 0,015; 0,091 ± 0,012 and 0,073 ± 0,013 seconds in first, second and third groups, respectively. The differences between all groups are significant (p = 0,001). The mean values of maximal (Vmax) and middle velocity (VMN), maximal (Gmax) and middle (GMN) pressure gradient between left heart chambers did not differ between groups. Conclusion. Atrial fibrillation contributes the development of left ventricular diastolic dysfunction: it reduces VTI, decelerates IVRT and shortens PHT significantly.
Resistant hypertension and fetal loss in a patient with fibromuscular dysplasia of the renal artery
Authors: Bolshakova O. O.
Published: December 2018

We present a clinical case of a young female patient with resistant hypertension and fetal loss. The examination showed a fibromuscular dysplasia of renal artery. Brief literature review of fibromuscular dysplasia is included.
Adiposopathy as a key factor in the development of insulin resistance
Authors: Krasilnikova E. I. , Blagosklonnaya YA. V. , Bystrova A. A. , Baranova E. I. , Chilashvili M. A. , Stepanova V. L. , Ryumina I. L. , Simanenkova A. V.
Published: December 2018

The metabolic cardiovascular syndrome (MS) is a common cluster of metabolic abnormalities (abdominal obesity, hypertension, dyslipidemia and carbohydrate metabolism disorders) that are related to insulin resistance and hyperinsulinemia and are associated with accelerated atherogenesis. Insulin excess is known to promote the development of the whole metabolic cascade. Recently it has been shown that the inflammatory and hemostatic abnormalities, immunological disorders, endothelial dysfunction, hyperhomocysteinemia and hyperuricemia are also important features of MS. Despite the numerous studies of MS its underlying cause is still not established. The dysfunction of visceral adipocytes (adiposopathy) might be genetically determined, and is considered nowadays as the main factor contributing to the development of the MS. Understanding the underlying mechanisms is of particular interest for prevention and target therapy of all the components of MS.
An approach to antihypertensive therapy in sleep deprivation conditions
Authors: Tsfasman A. Z. , Alpaev D. V. , Gorokhov V. D.
Published: December 2018

Objective. To assess the effects of several antihypertensive drugs on diurnal rhythms of blood pressure (BP) in sleep deprivation. Design and methods. The research included 58 patients with initial stages and levels of arterial hypertension (AH) divided into four groups (no medication, lisinopril, metoprolol, anaprilin before night with sleep deprivation). All patients underwent 24-hour blood pressure monitoring during the day with and without sleep deprivation. Results. Sleep deprivation was found to cause either inversion of daily blood pressure profile (DBPP) with higher night BP values, or at least reduction of night BP dipping. Among all mentioned medications only Anaprilin had some corrective effect on DBPP in sleep deprivation, and it can be recommended for night workers with arterial hypertension immediately before a night shift.
Pathogenic role of tissue factor in atherothrombosis and endothelial dysfunction
Authors: Krasilnikova E. I. , Sergeeva E. G. , Sakha D. .. , Sakha S. .. , Gorbach A. V. , Ionova ZH. I. , Bystrova A. A.
Published: December 2018

Vessel occlusion by rupture or atheroma erosion leading to thrombosis is the underlying cause of severe complications, including sudden cardiac death, myocardial infarction, and stroke. Tissue factor is known to play the key role in the initiation of the majority of stages of coagulation cascade. Recent studies explained the structure, synthesis and activation mechanisms of tissue factor. Tissue factor is the main component of atherothrombotic process and is associated with the immune inflammation, endothelial dysfunction, angiogenesis, and cell migration that play an important role in the development of cardiovascular, inflammatory and oncological pathology. Basal activity of tissue factor is the independent parameter of cardiovascular risk, the predictor of thrombolysis efficacy and affects the results of angioplasty interventions. The effects of medications (e.g. statins), including those in drug-eluting stents, on tissue factor are the objective of further investigation. Studies of physiological and pathogenic role of tissue factor will have a great impact on our understanding of cardiovascular pathology and other diseases.
Contrast-induced nephropathy in cardiology practice: Risk factors and approaches to prevention
Authors: Salakhova YU. F. , Duplyakov D. V. , Perunova E. R. , Burnazyan S. E. , Bazhenova E. I. , Kositsina G. V. , Khokhlunov S. M.
Published: December 2018

Objective. To study the incidence and risk factors of contrast-induced nephropathy (CIN) resulted from percutaneous coronary interventions in cardiology practice. Design and methods. Retrospective analysis of 100 history cases of patients aged 37-73 years (mean age 56,1 ± 6,0 years) was preformed. 0mnipac-350 was used as a contrast agent during angiography. Glomerular filtration rate (GFR) was assessed by Cockroft-Gault formula before and 48 hours after the intervention. The patients were divided into 2 groups depending on the type of intervention: the first group included the patients with planned intervention and the second — with urgent endovascular intervention. Results. In the first group 3,0 % (n = 2) patients developed CIN, and one case was registered (2,95 %) in the second group. It developed in patients with initial decrease of GFR, in patients with diabetes mellitus and with the combination of both factors.
Risk reduction of cardiovascular risk in a patient with both heart rhythm and conduction disorders and obstructive sleep apnea-hypopnea syndrome by CPAP therapy
Authors: Shchekotov V. V. , Jankina T. I. , Luchnikova E. A.
Published: December 2018

A clinical case of a patient with heart rhythm and conduction disorder, and uncontrolled arterial hypertension is described. Severe obstructive sleep apnea-hypopnea syndrome was found by cardiopulmonary monitoring. Combined treatment (medication + CPAP-therapy) enabled the achievement of goal blood pressure and lipid levels. No heart rhythm and conduction disorders were found by the control Holter ECG monitoring. As a result, almost 10-fold reduction of the calculated ten-year risk of myocardial infarction in PROCAM was achieved.
Spontaneous baroreflex in patients with resistant hypertension: Changes during salt loading
Authors: Emelyanov I. V. , Konradi A. O. , Bagrov A. Y.
Published: December 2018

Objective. To assess spontaneous baroreflex sensitivity (BRS) in patients with resistant hypertension (RH) and changes during acute salt loading according to changes of blood pressure (BP). Design and methods. Thirty four patients with RH were included. Patients were on standard antihypertensive medication: lisinopril 20 mg per day, amlodipine 10 mg per day and hydrochlorothiazide 25 mg per day. Control group consisted of 11 age- and sex-matched healthy subjects. Salt loading test was performed with i.v. saline infusion (100 ml during 1 hour). Beat-to-beat BP was registered by Finometer Pro device and BRS was assessed by slope method. Results. BRS is reduced in RH patients both at baseline and after salt loading. The level of BP elevation during salt loading is related to BRS reduction, and both parameters are related to salt-sensitivity.
Attitude to disease in patients following cardiac emergencies
Authors: Alekhin A. N. , Trifonova E. A. , Chernoray A. V.
Published: December 2018

Objective. To assess attitudes toward disease in patients following cardiac emergencies at early stages of rehabilitation. Design and methods. The study sample consisted of 70 patients (23 females, 47 males) aged 35-67 years (54,5 ± 6,4 years old) hospitalized with myocardial infarction (MI; 55,7 %), unstable angina (18,6 %) or for planned cardiac surgery (25,7 %). The following methods were used: interview, medical records analysis, «Method for psychological diagnostics of attitude towards disease» (Wasserman L.I. et al., 2005). Results. Most patients (48,6 %) have «ergopathic» attitude toward disease characterized by aspiration to overcome disease in order to maintain the level of social activity they had had before the hospitalization. Denial of illness itself was found in 22,9 % cases, denial of possible illness consequences — in 51,4 %. Females, patients with recurrent cardiac attack and those, who had emergent (versus planned) hospitalization were more frustrated by the disease. Males and patients, who survived MI for the first time, were more prone to deny the fact of the disease as well as its possible consequences. Denial of the fact of illness was typical only of patients with the most life-threatening states — MI (compared to unstable angina). This may be regarded as an evidence of defensive/protective character of illness denial. Conclusion. Resistance, active overcoming and denial are predominant psychological tendencies in reaction to illness in patients following cardiac emergencies at early stages of rehabilitation. In case of ineffectiveness of these psychological strategies there is an increased risk of psychosocial disturbances. These characteristics of attitude toward illness in cardiac patients should be taken into account in the treatment and rehabilitation process.
Evaluation of antiproliferative efficacy of valsartan in patients with coronary artery disease during myocardial revascularisation (the PROLIV study)
Authors: Alugishvili M. Z. , Kozulin V. Y. , Usova E. A. , Gevorkova L. V. , Mitrofanova L. B. , Gordeev MX. .. , Panov A. V.
Published: December 2018

Background. Nowadays coronary artery bypass graft (CABG) surgery is the most widely used treatment option in patients with multivessel coronary artery disease (CAD) including left main artery lesion. The long-term prognosis of these patients is determined by the properties of the grafts. Objective. To investigate antihypertensive and antiproliferative activity of the angiotesin-converting enzyme inhibitor Valsartan (Valz, Actavis Group, Iceland). Design and methods. Sixty CAD patients who underwent CABG surgery, were enrolled. Antihypertensive effects of Valsartan were assessed by 24-hour blood pressure monitoring. Venous specimens were taken during CABG surgery. Morphological changes in saphenous veins were studied by microscopy, histochemistry and immunological methods. Results. Antihypertensive effects of valsartan and perindopril were comparable. The mean systolic and diastolic blood pressure did not differ in valsartan and perindopril groups. No changes between groups were found by morphological methods. Proliferative activity of endothelial cells was significantly lower in valsartan group. Conclusion. Valsartan in CAD patients after CABG surgery is an effective therapeutic approach regarding the prevention of the intimal hyperplasia of venous grafts.
Left ventricular hypertrophy and outcomes: A five-year retrospective analysis of patients with essential hypertension
Authors: Barsukov A. V. , Zobnina M. P. , Talantseva M. S.
Published: December 2018

Left ventricular hypertrophy (LVH) is the most important element of cardiovascular continuum in patients with essential hypertension (EH). The results of a five-year retrospective analysis of EH patients cohort with initially different types of left ventricular geometry (491 subjects) are presented. It is shown that the overall mortality in patients with concentric and eccentric LVH does not differ significantly (37 and 35 %, respectively) but exceeds that in subjects with normal LV geometry (20 %). Associated and concomitant pathology determine the total and cardiovascular prognosis more in patients with concentric LVH than in subjects with eccentric LVH. The presence of ECG valid quantitative and strain diagnostic LVH criteria (Sokolow-Lyon index and Perugian university sign) determines the worst remote prognosis in patients with both concentric and eccentric LVH. The enlarged size of the left atrium is an universal marker of poor outcome in hypertensive patients regardless the type оf left ventricular geometry.
Assessment of the effectiveness of antihypertensive therapy in early postoperative period in patients with kidney tumors after nephrectomy
Authors: Davydova S. S. , Komissarenko I. A.
Published: December 2018

Objective. To analyze the dynamics of blood pressure in the early postoperative period in hypertensive patients with kidney tumor after nephrectomy. Design and methods. We examined 96 patients with cardiovascular diseases and kidney tumors, at the age from 41 up to 75 years (mean age — 57 ± 6,3 years), who were planned for nephrectomy (I group). Group II included 53 patients aged 37-65 years (mean age — 49 ± of 7,2 years) who underwent laparoscopic nephrectomy. Daily monitoring of blood pressure MECG-DS-HC-01 («LCA Advanced technologies», Russia) was performed in all subjects. Results. Young hypertensive patients (from 40 to 48 years, mean age — 43,7 ± 4,6 years) demonstrated blood pressure elevation in the early postoperative period after nephrectomy even when antihypertensive medication was taken. At the same time elderly patients (from 56 to 85 years of age, mean age — 65,3 ± 7,5 years) develop hypotension episodes. Calcium channel blockers appeared to be highly effective in young patients who also demonstrated higher blood pressure levels in the postoperative period after laparoscopic nephrectomy, as compared with patients after open surgery. On the second day after the open nephrectomy 22,9 % (22 of 96) patients required antihypertensive treatment correction, and on the tenth only 1 % (1 patient out of 96) required treatment enhancement, whereas in group II on the second day after the intervention 100 % patients required therapy enhancement, and on the tenth day 60,4 % (32 out of 53) patients needed some correction of the treatment. Conclusions. Hypertensive patients with kidney tumors require precise control of blood pressure before the operation and correction of antihypertensive therapy, as almost one third of the patients develop increase of blood pressure in postoperative period. Calcium channel antagonists should be considered as a drug of choice in the young patietnts (mean age — 44 years) as they allow to achieve target blood pressure, that is necessary to improve renal blood flow and protects the kidney. At the same time 20 % of elderly patients (age 66) develop hypotension episodes requiring lower doses of antihypertensive drugs.
Fibrosis and renin-angiotensin-aldosterone system activity. Reality and future prospects
Authors: Drapkina O. M. , Drapkina Yu. S.
Published: December 2018

Myocardial fibrosis plays a key role in the pathogenesis of cardiovascular diseases. Renin-angiotensin-aldosterone system (RAAS) is the key regulator of vascular tone, potassium and water homeostasis, and response to the tissue damage. The effects of angiotesin II are mediated by 1 type angiotensin II receptors, together with angiotensin-converting enzyme, forming the «classical regulation axis» of RAAS. At chronic high cardiac afterload the genes of procollagen and collagen synthesis are overexpressed leading to the increased production of collagen, fibrosis and myocardial hypertrophy. Both hemodynamic and non-hemodynamic factors affect fibrosis development. RAAS blockers are suggested to have antifibrotic activity. There is a strong evidence of losartan efficiency that can be, at least, partly mediated by antifibrotic activity.
Blood pressure control in patients with uncontrolled hypertension by switching from the mono - or combined therapy to the fixed combination of angiotensin II converting enzyme inhibitor and calcium blocker
Authors: Karpov Y. A.
Published: December 2018

Objective. The paper presents the results of the blood pressure (BP) control by switching from unsuccessful monotherapy and combination therapy to fixed combination «perindopril/amlodipine» in the routine practice. Design and methods. PRORYV (BREAK) program included 589 outpatient general practitioners (GPs) and cardiologists from medical and preventive institutions in 50 Russian cities and 4 115 patients with uncontrolled hypertension (HT). PRORYV is an open, multicentered, observational non-comparative study. Inefficient anti-HT therapy (except for treatment with beta-blockers) was cancelled. Results. With fixed-dose combination therapy perindopril/amlodipine BP level lowered from 167,1/97,6 to 130/80,1 mm Hg (by 37,1/17,5 mm Hg) on average in all patients, and the effect was comparable in both males and females, regardless age, coronary artery disease or diabetes. Target BP was achieved in 80 % patients. Results. Switching to fixed-dose combination perindopril/amlodipine (Prestance, Servier, France) from mono- or combination therapy leads to fast and persistent anti-HT effect in all patients with previously uncontrolled BP.
Influence of paroxetine and hydroxyzine hydrochloride therapy on anxiety-depressive disorders and platelet serotonin level in CAD patients
Authors: Kozlova S. N. , Golubev A. V. , Krylova Y. S. , Shlyakhto E. V. , Neznanov N. G. , Kadisheva N. S.
Published: December 2018

Objective. Open, comparative, randomized study of efficiency, safety and assessment of influence of paroxetine and hydroxyzine hydrochloride therapy on platelet serotonin level in patients with coronary artery disease (CAD) and comorbid anxiety-depressive disorders were examined. Design and methods. We included 40 patients with chronic CAD and comorbid anxiety-depressive disorders, confirmed according to ICD-10. Patients with score more than 18 by Hamilton’s scale of anxiety and depression were enrolled. Results. We observed significant decrease Hamilton’s scale scores after 4 weeks of treatment, and after 8 weeks of treatment the reduction reached 50 %. Side effects were registered in both groups and quickly passed after the drug withdrawal. Platelet serotonin level decreased significant during paroxetine therapy. Conclusion. Treatment by paroxetine and hydroxyzine hydrochloride was associated with high anti-anxiety and anti-depressive activity. Use of paroxetine was associated with significant reduction of platelet serotonin level.
EFFICACY OF CAPTOPRIL, MOXONIDINE AND THEIR COMBINATIONS WITH NIFEDIPINE IN THE NON-THREATENING HYPERTENSION
Authors: Ruksin V. V. , Grishin O. V. , Chiritso M. M. , Malakhov A. N. , Onuchin M. V.
Published: December 2018

Objective. To study several medications and their combinations in non-threatened hypertension worsening captopril, and moxonidine, captopril + nifedipine, captopril + moxonidine.

Design and methods. We include326 patients (253 females) aged 45–89 years who referred for the urgent health care due to the non-threatene hypertension worsening. Mean duration of hypertension was 20,6 ± 0,6 years. Special questionnaires were ﬁlle in, heart rate, blood pressure by Korotkoff method, and electrocardiogram were registered.

Results. Moxonidinwas shown to be more effective in patients with the sympathetic hyperactivity, captopril — in patients withouincreased sympathetic activity. The combination of captopril and nifedipine was associated with the reductioof therapy efﬁ  ciency, and the combination of moxonidine and nifedipine — with its increase. Moreover, administration of captopril and nifedipine led to the higher rate of side effects, compared to the combination moxonidine and nifedipin.
ANGIOTENSIN II RECEPTOR ANTAGONISTS IN THE TREATMENT OF HYPERTENSION: PERSPECTIVES FOR CLINICAL USE
Authors: Poteshkina N. G. , Selivanova G. V. , Zhalsaraev T. Zh.
Published: December 2018

The review of literature presents evidence of the relevance of the wider application of angiotensin II receptor antagonists in the treatment of cardiovascular diseases. The advantages of this class of antihypertensive drugs on the effect on blood pressure and regression of target organ damage in patients with hypertension. The data on nephroprotective, neuroprotective, antiarrhythmic effects of angiotensin II receptor antagonists, as well as the opportunity of effective correction of the metabolic abnormalities are presented.
THE EFFECT OF THE 8-WEEK ATORVASTATIN TREATMENT ON THE QUALITY OF LIFE OF HYPERTENSIVE PATIENTS WITH METABOLIC SYNDROME
Authors: Bespalova I. D. , Kalyuzhin V. V. , Ryazantseva N. V. , Medyantsev Yu. A. , Murashev B. Yu. , Osikhov I. A.
Published: December 2018

Objective.To study the effect of the 8-week treatment with atorvastatin on the quality of life (QOL) of hypertensive patients with metabolic syndrome.

Design and methods.An 8-week open prospective study included 35 patients with essential hypertension (stage II), associated with metabolic syndrome. Along with the complete clinical, laboratory and instrumental examination, taken in a specialized cardiology clinic, MOS SF-36® questionnaire was used to study the QOL during atorvastatin treatment.

Results and conclusions.The 8-week atorvastatin treatment (20 to 40 mg/day titrated individually) both contributes to statistically signifi cant reduction of atherogenic fractions of cholesterol and provides a positive dynamics of subjective evaluation of QOL by SF-36® scales in hypertensive patients with metabolic syndrome.
RENAL SYMPATHETIC DENERVATION FOR THE TREATMENT OF RESISTANT HYPERTENSION — SAFETY CONTROL BY ULTRASOUND TECHNIQUE
Authors: Ripp T. M. , Mordovin V. F. , Pekarskiy S. E. , Ryabova T. R. , Zlobina M. V. , Krilov A. L. , Lechikaki V. A. , Popov S. V. , Karpov R. S.
Published: December 2018

Objective.To assess the safety of transcatheter radiofrequency denervation (TRFD) of renal arteries (RA) in patients with resistant hypertension (RH) by ultrasound of the kidneys.

Design and methods.We assessed estimated glomerular filtration rate (eGFR) and performed ultrasound examination of the kidneys and RA at 1, 24 and 48 weeks after TRFD in 35 patients (mean age — 52 +- 10 years) with blood pressure (BP) > 160/100 mmHg despite 3 full-dose antihypertensive drugs as a part of the single-center prospective safety/efficacy study (NCT01499810).

 Results.Office BP decreased by 34,9/18,2 mmHg (p < 0,001/0,001) and -42,7/-21,7 mmHg (p < 0,01/0,01) at 24 and 48 weeks after TRFD, respectively. No significant changes of eGFR and renal blood flow were found, however, the resistive index (RI) decreased significantly in segmental RA: from 0,62 Ѓ} 0,05 initially till 0,58 +-0,06 and 0,59 +- 0,06, respectively, at follow-up points (p = 0,003; p = 0,049 and p =0,063).

Conclusions.TRFD of RA has no adverse effect on either renal function or blood flow in the trunk and segmental branches of the RA. On the contrary, the decrease of resistive index in segmental RA after the intervention indicates improvement of renal blood flow.