bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of development of cardiovascular events after stenting of coronary arteries at patients with obesity
Authors: Veselovskaya N. G , Chumakova G. A , Gritsenko O. V , Mironova N. G
Published: February 2021

Aim. Study predictors of development of cardiovascular events after stenting of coronary arteries at patients with the coronary heart disease (CHD) with obesity.Material and methods. The study population included 186 (54,4±9,1 years) patients with coronary artery disease (CAD) and obesity undergoing percutaneous coronary intervention (PCI) with bare-metal stenting and at least 12 months of follow. The all patients research main and additional metabolic risk factors and epicardial fat thickness (EFT) with determination of echocardiography. Cardiovascular events were registered at 58 (31%) patients. The lipoprotein a - LP(а), leptin, blood glucose, interlaken-6, diastolic arterial pressure and index prevalence of coronary atherosclerosis on Gensini scale became predictors of cardiovascular events. The indicator of EFT showed interrelation with risk of a cardiovascular events. Conclusion. Determination of additional parameters of a lipid profile, carbohydrate metabolism, pro-inflammatory activity of plasma, neurohumoral activity of visceral fat and degree of epicardial adiposity is necessary for the purpose of formation of group of high risk of complications and carrying out prevention of risk factors before carrying out a coronary revascularization.
Self-monitoring of blood glucose as an essential component of exerting total control over diabetes
Authors: Biryukova E. V
Published: February 2021

Diabetes mellitus (DM) is a chronic disease associated with the development of micro-and macrovascular complications, prevention of which is an important task of modern medicine. Achieving and maintaining blood glucose levels close to normal, however, is almost impossible without the full participation of the patient in the treatment of diabetes. Self-monitoring of blood glucose (SAG) is the basis of the effectiveness of glucose-lowering therapy and prevention of hypoglycemia. This article discusses the recommended frequency of SCG depending on the type of diabetes. For measuring blood sugar at home now a variety of devices is available. Selection of quality meter is determined by ease of use, ease of operation of the device, ease of preparation and fair presentation of results of the results of measurement.
Current approaches to diagnosis, treatment and prevention of pulmonary embolism
Authors: Bershteyn L. L
Published: February 2021

Pulmonary embolism (PE) is one of the most common diseases, comparable in frequency with acute coronary syndrome, and is one of the leading causes of cardiovascular mortality. The high mortality associated with pulmonary embolism (PE) is determined by the severity of the disease and the difficulties of diagnosis and in large part by a lack of awareness of doctors on standards for primary prevention.The last decade has been marked by qualitative improvement in the efficiency of diagnosis of pulmonary embolism, which resulted from the achievements in echocardiography and increased availability of computer tomography imaging in real practice. The list of availbale anticoagulant drugs which are the basis of pathogenetic treatment, secondary and primary prevention of pulmonary embolism expanded significantly. The present review covers the principles of diagnosis, therapy and prevention of this disease.
Opportunities of ivabradine to reduce heart rate before CT coronary angiography in young patients with connective tissue dysplasia
Authors: Druk I. V , Nechayeva G. I , Ignatyev Yu. T , Aksenov S. I , Orlova N. I
Published: February 2021

To assess the efficacy and safety application ivabradine to control the heart rate before the procedure computed tomography coronary angiography (CTCA) in young patients with connective tissue dysplasia (CTD) were surveyed 65 patients (age 24,9±6,4 years; 40 men). Patients were divided into 2 groups: group 1 (n=47; 29 men) to achieve the heart rate
Trimetazidine modified release in treatment of patients with the serious course of chronic ischemic heart disease: from the theory to real clinical practice
Authors: Barsukov A. V , Glukhovskoy D. V
Published: February 2021

The paper considers modern conceptions about the role of citoprotective therapy in persons with ischemic heart disease. Special attention is given to the justification of Trimetazidine modified release (TMZ MV) application in patients with severe multi-vessel coronary lesions in conjunction with left ventricular systolic dysfunction. There described the clinical case with emphasis on possibility of inclusion in conservative treatment scheme of TMZ MB to poly morbid elderly patient with severe ischemic heart disease.
Primary spontaneous pneumothorax as a manifestation of connective tissue dysplasia (literature review)
Authors: Pimenov L. T , Smetanin M. Yu , Remnyakov V. V , Suslonova S. V
Published: February 2021

Based on analysis of current literature data provides information about the diagnostic criteria of primary spontaneous pneumothorax (PSP), which is one of the manifestations of connective tissue dysplasia. Discussed in detail the classification, etiology, pathogenesis, diagnosis and treatment of PSP.
Medical psychological and social rehabilitation in patient with myocardial infarction
Authors: Baysultanova M. B , Elgarov A. A , Betuganova L. V , Elgarov M. A , Kalmykova M. A
Published: February 2021

Complex therapy effectiveness in patients with myocardial infarction and chronic heart failure is established; authors monitoring positive influence on medical psychological and social aspects of rehabilitation in post infarction patients is shown, using as monitoring core individual and complex medical psychological educational program.
Dynamics and correlation anxious-depressive, cognitive disorders and quality of life of patients undergoing coronary artery bypass grafting
Authors: Chugunova Yu. V , Chumakova G. A , Demenko T. N
Published: February 2021

Neuropsychological complications can appear at patients after coronary artery bypass surgery (CABG) and significantly worsen their quality of life (QoL). The purpose of this research was to study neuropsychological patients’ status before and after CABG and its effect on patients’ QOL. Materials and methods: 90 men were included in this study. Neuropsychological status was evaluated with the use of Zung Self-Rating Depression Scale, Russian version; State-Trait Anxiety Inventory; the Short Form General Health Survey (SF-36); hardware-software complex “Status PF”. Results. There were lower cognitive performances among patients with depression symptoms then among those without those before CABG. 2 weeks after CABG patients with depression symptoms had significantly lower cognitive performances such as mechanical, sense and image memory volume, “finding numerals” test, “induction” and “abstraction” tests, and number of mistakes in complex visual-motor reaction as compared with patients without depression symptoms. Neurodynamics performance was worse in patients with high trait anxiety (HTA) then it was in those with moderate trait anxiety (MTA) before CABG. Also patients with HTA had lower cognitive performances 2 weeks and 6 months after CABG. Patients with depression or HTA had significantly lower QoL levels then patients without depression or MTA before and after surgery. Thus, severe cognitive performances are exposed among patients with depression and high anxiety before and after CABG. Depression and anxiety negatively influence on patients’ QoL before and after surgery.
Questions of secondary prevention and rehabilitation of patients with myocardial infarction at different stages
Authors: Kuimov A. D , Shurkevich A. A , Moskalenko I. V
Published: February 2021

Research objective: increase of efficiency of secondary prevention of a myocardial infarction (MI) and rehabilitation of patients at an out-patient stage.Materials and methods: 164 patients of both floors with the transferred MI with enzymatic and endovascular restoration of a blood-groove of an ischemic myocardium are surveyed. The diagnosis of a MI is established according to standards of diagnostics of ESC/ACCF/AHA (European Society of Cardiology/American College of Cardiology Foundation/American Heart Association, 2007) also it is documented by an extract from the clinical record of office of medical institution where hospital treatment of the patient according to emergency indications was carried out. Patients were divided into 3 groups: the 1st (supervision with rehabilitation in out-patient conditions), the 2nd (rehabilitations in the round-the-clock specialized office), the 3rd (comparisons). To all patients continuous reception of pharmacological therapy according to standards of treatment of patients with the sharp coronary syndrome (SCS) was appointed; recommendations of the general character about healthy lifestyle observance are made; laboratory blood tests, electrocardiography and heart echocardiography, holter (daily) monitoring of the electrocardiogram, assessment of degree of heart failure on the scale of an assessment of a clinical state and the test of 6 minute walking, a commitment assessment to treatment with use of test of Moriski-Green, quality of life of patients with heart failure on the Minnesota questionnaire, episodes of repeated hospitalization concerning SCS and lethal outcomes are carried out. In addition to the 1st group of patients «Health school» and medical physical culture, the 2nd group - a rehabilitation course in specialized office of recovery treatment of City clinical hospital №19 were on an outpatient basis carried out.Results: on achievement of commitment to treatment, estimates of an average value of quality of life, episodes of repeated SCS, to reduction of weight of a functional class of heart failure indicators of patients of the 1st group surpassed data on patients of the 3rd group, but conceded to the 2nd.Conclusion. Use of rehabilitation actions at an out-patient and polyclinic stage of treatment of patients with transferred MI as element of secondary prevention of cardiovascular complications positively influence final points irrespective of a method of a myocardium revascularization.
Diagnostic value of determination of galectin-3 - the new biomarker of the chronic heart failure
Authors: Gyamdzhyan K. A , Maksimov M. L
Published: February 2021

The reviewsummarizes the results of clinical trials in which galectin-3 was assessed as biomarker of heart failure. In addition, most relevant information on galectin-3 received in in vitro and in vivo research is given with respect of heart failure.
Drug therapy of patients with myocardial infarction as the most important component of a polyclinic stage of cardiorehabilitation
Authors: Garganeeva A. A , Kuzheleva E. A , Efimova E. V , Tukish O. V
Published: February 2021

Myocardial infarction (MI) is one of the most common causes of temporary incapacity, disability and mortality in the adult population of developed countries. Despite a trend in recent years to reduce mortality from cardiovascular disease, the indicator remains high in Russia. One of the main conditions to improve immediate and long-term prognosis of patients after MI, is to conduct a comprehensive cardio-rehabilitation, which is an important component of drug therapy. The article presents the characteristics of drug therapy and its influence on the course of post-MI at 5-year follow-up on the basis of "Register of acute MI". As a result of the frequency, VEN-analysis revealed no significant differences in the main groups of drugs prescribed in different periods after acute MI. At the same time it found that patients with unfavorable course of postinfarction period, significantly more often treated with inadequate doses of b-blockers, who were appointed at hospital discharge and then titrated with the annual and 5-year follow-up. The lower frequency of the appointment of vital medicines (based on VEN-analysis) was detected in patients with unfavorable course of postinfarction period as the baseline, and after a year, and 5 years after MI. Installed features of drug use have an impact on the clinical course of postinfarction period and the development of negative cardiovascular events.
Therapeutic possibilities of myocardial cytoprotector trimetazidine MR incoronary heart disease
Authors: Trukhan D. I
Published: February 2021

The results of numerous foreign and Russian researches allow us to consider trimetazidine MR as an essential component of effective therapy in patients with coronary heart disease. The article highlights the proven and promising therapeutic possibilities trimetazidine MR.
The clinical efficacy of a fixed combination of angiotensin receptor blockers valsartan II with a calcium antagonist amlodipine - drug Exforge® smokers patients with cardiovascular disease and chronic obstructive pulmonary disease
Authors: Bubnova M. G , Aronov D. M , Sulim Yu. N , Vygodin V. A
Published: February 2021

The Aim. A study of the clinical efficacy and safety of a fixed combination of valsartan (ARB) with amlodipine (AK), appointed as part of the standard therapy of hypertension and coronary heart disease smoking patients with chronic obstructive pulmonary disease. Material. The study included 36 men aged 40 to 65 years. All patients were treated with statins, aspirin, selective b-blockers; 16.7% of patients received diuretics, and 19.4% - long-acting nitrates. After randomization, patients were divided into 2 groups: group 1 (n=18, mean age 55.8±5.9 years) in addition to those receiving treatment angiotensin-converting enzyme (ACE) and group 2 (n=18, average age 58.0±4.9 years) - combined preparation Eksforzh® (amlodipine 5-10/160 mg valsartan). Study duration - 4 months.Methods. In a study clinical examination wasconducted, bicycle stress test (HEM-test), echocardiography (echocardiography), daily monitoring of blood pressure (BP), spirometry, determination of the concentration of lipids and lipoproteins, glucose, fibrinogen, uric acid, creatinine with calculation of glomerular filtration rate by MDRD.Used questionnaires: Hospital Anxiety and Depression Scale (HADS), St George's Hospital (SGRQ) and quality of life (QOL) SF-36. The Results. The appointment of the drug to patients Eksforzh® accompanied by a significant reduction in levels of “office” in systolic blood pressure at 39.2±9.7 mm Hg. Art. ( p
Impact myocardial cytoprotection and inotropic stimulation at the annual prognosis in patients with myocardial infarction lifting segment ST, complicated heart failure
Authors: Sinkova M. N , Isakov L. K , Pepelyaeva T. V , Tarasov N. I , Teplyakov A. T , Mukharlyamov F. Yu
Published: February 2021

The article analyzes the effectiveness and safety of treatment cytoprotectant meldonium dihydrate and inotropic stimulator of levosimendan on an annual prognosis in patients with myocardial infarction complicated by acute heart failure II-III class Killip, subjected to percutaneous transluminal coronary angioplasty.
The increased risk of cardiovascular events in chronic kidney disease: pathogenetic mechanisms, the possibility of correction
Authors: Barysheva O. Yu , Melentieva A. A , Kheyfetz L. M , Balashov A. T
Published: February 2021

The paper discusses the pathogenetic mechanisms linking cardiovascular risk and chronic kidney disease (CKD). Presents data on the role of hypercalcemia, hyperphosphatemia, secondary hyperparathyroidism, fibroblast growth factor-23, Klotho, an important the components of the pathogenesis of mineral and bone disorders increase the risk cardiovascular events in CKD. Discussed the causes and features dyslipidemia in CKD, particularly correction. Presents data on options calciphylaxis, causes, development, peculiarities of treatment.
Statin therapy and atherosclerosis stabilization in carotid arteries
Authors: Luginova Z. G , Koshurnikova M. V , Solovieva E. Yu , Balakhonova T. V , Susekov A. V
Published: February 2021

Atherosclerosis and it’s clinical implications (myocardial infarction, stroke, intermittent lameness) is a serious medico-social problem in Russia. Statins (or HMG-CoA reductase inhibitors) are the first-choice agents to prevent cardiovascular disease events. The paper presents the results of early regression studies and modern regression studies using MRI imaging concerning the regression or stabilization atherosclerosis and rationale and baseline characteristics of russian regression study “FREGAT”.
Phenotype receptor gene mutations in low-density lipoprotein in patients with familial hypercholesterolemia in Karelia
Authors: Korneva V. A , Bogoslovskaya T. Yu , Kuznetsova T. Yu , Mandelshtam M. Yu , Vasilev V. B
Published: February 2021

Familial hypercholesterolemia (FHC) - hereditary dyslipidemia, which is based on mutations in the gene for low-density lipoprotein receptor.However, there is variability in the clinical manifestations of the disease difficult to assess individual risk.Materials and methods. Under our supervision for 10 years were 109 patients with FHC, 17 mutation in the receptor density lipoprotein. FHC diagnosis established by the criteria of the British leadership Simon Broom. To search for mutations in low-density lipoprotein receptor was performed automated fluorescent SSCP-analysis of exons of the gene analysis of restriction fragment length polymorphism and the direct sequencing of DNA on a gel sequencer ALFExpress-2 (Amersham Biosciences) using the program ALFwin Sequence Analyzer.The Results. We analyzed five clinical cases of patients with genetically confirmed diagnosis of FHC. Shows a wide phenotypic variability FHC: the possibility of early debut of coronary heart disease, coronary tropism for the pool some patients and cerebral - others, the possibility of a long asymptomatic disease.Conclusion. The absence of clinical manifestations of atherosclerosis and wide phenotypic variability at FHC require targeted screening for FHC, at least among patients with coronary heart disease in order to timely and adequate preventive measures, especially in cases where the mutation is set low density lipoprotein receptor.
Acetylsalicylic acid therapy in patients undergoing planned surgery
Authors: Altarev S. S , Barbarash O. L
Published: February 2021

In a review, we described risks and benefits of surgery performed while continuing aspirin therapy in perioperative period. Aspirin therapy is associated with mild increase in surgery related bleeding risk. On the other hand, aspirin therapy leads to significant decrease of mortality and perioperative cardiovascular risk in most cases.
Multiple myeloma with monoclonal immunoglobulin A exhibiting and hypercholesterolemia: case report and literature review
Authors: Livandovskii U. A , Rybina O. B
Published: February 2021

Multiple myeloma with monoclonal immunoglobulin (Ig) A exhibiting is a type of the classic multiple myeloma, occurring every fifth patient. This type of disorder is associated with hypercholesterolemia that is refractory to the conventional therapy with anti-hyperlipidemic agents.This article presents a case of a patient B., 72 years old, whose disease debuted with high numbers of ESR and hypercholesterolemia. Ig Ak was identified by immunochemical analysis. Patient was diagnosed as having stage IA IgAk type multiple myeloma, diffuse lobular shape, with hyperlipidemia. Positive effect sustained after three courses of chemotherapy: level of IgA eventually subsided, and lipid metabolism returned to normal values.
Modern approaches to the treatment and long-term management of arterial hypertension in clinical practice. Pharmacological and clinical characteristics of angiotensin II receptor blockers: focus on azilsartan medoxomil. Part II
Authors: Bubnova M. G
Published: February 2021

The article discusses the problem of the use for the treatment of hypertension combination therapy. Advantages of application as a component of chlorthalidone therapy are discussed. Proofs of its effectiveness in lowering both blood pressure and risk of cardiovascular events compared with hydrochlorothiazide are stated. Anti-hypertensive effectiveness of one of the last appeared on the pharmacological market of receptor-blockers like angiotensin II azilsartan medoxomil in combination with chlorthalidone is discussed as well.
Markers of subclinical atherosclerosis in the ten-year risk estimation of cardiovascular events
Authors: Bovtyushko P. V , Grishaev S. L , Filippov A. Ye , Obrezan A. G
Published: February 2021

The information content of SCORE model in the evaluation of the total ten-year cardiovascular risk in an isolated sample of 207 males without clinical manifestations of atherosclerosis was investigated. It was revealed that the most of the observations from persons who had attained over a 10-year period of the combined end point, the model qualified incorrectly, which didn’t meet the requirements of individual risk assessment in a limited sample group of males. It is shown that the inclusion of subclinical atherosclerosis markers in SCORE model can significantly improve its sensitivity. At the same time, a group of poor prognosis gets a significant number of observations for individuals free of cardiovascular events due to the high probability of false positive response.
Therapeutic effects of fosinopril - ACE inhibitor
Authors: Aronov D. M
Published: February 2021

The review article dials with the characteristics of fosinopriltherapeutic features, apparently associated with the fact that it contains phosphorus. It has special specter possessing the numerous of organotropic effects and good tolerability and safety, allowing tochange the drug tofosinoprilin patients,who has dry cough, and have been treated using different ACE inhibitors. We discuss the possible prospects of drugs appointment in case of unconventional diseasesfor ACE inhibitors application.
Strategy and tactics of emergency treatment of atrial fibrillation: a modern approach to the problem
Authors: Bunin Yu. A
Published: February 2021

Atrial fibrillation (AF) is the most common tachyarrhythmiac detection which in the general population is 1.0-2.0%. It is the cause of 20% of all strokes, associated with an increase in mortality and the risk of chronic heart failure. Paroxysms are often accompanied by deterioration of the patient's hemodynamic instability, requiring emergency medical care.The article presents a modern view on strategy and tactics cupping AF indication for pharmacological cardioversion and cardioversion. As the basis of the material made by the international guidelines on the management of patients with atrial fibrillation, as well as data from a number of modern-controlled studies and own clinical experience treating arrhythmias.However, the article dealt with some of the controversial issues of emergency treatment of AF and expresses the point of view of the author on a number of studies in this area arrhythmology.
Left ventricle myocardial hypertrophy in women with arterial hypertension: justification of medical tactics
Authors: Kislyak O. A , Starodubova A. V
Published: February 2021

Arterial hypertension (AH) is the most common cardiovascular disease risk factor. After the menopause the prevalence of AH in women greatly exceeds than in men. Hemodynamic characteristics in case of AH in postmenopausal women determine the higher risk and the speed of left ventricle myocardial hypertrophy (LMVH), diastolic and systolic dysfunction development. There 80 women aged 44-62 years (mean age of 53.2±4.1 years) in the early postmenopausal period were enrolled in the study and we found that the main influence on LV mass index and LMVH in addition to AH and the level of systolic blood pressure play the body mass index, the level of diastolic blood pressure and the indicators characterizing the distribution of adipose tissue, presence of abdominal obesity. Guidelines for the treatment of AH in men and women have no fundamental differences. However, taking into account the high prevalence of obesity, isolated systolic hypertension and LMVH in women with AH in postmenopausal period, the drugs of choice become angiotensin receptor blocker (ARBs) and the combinations of antihypertensive drugs on the basis of the ARBs, all these data for the first time ever were shown in the study LIFE concerning the application of losartan in the treatment.
Blocker, angiotensin II receptor olmesartan to interrupt cardiovascular continuum: vesselsand cardioprotective, anti-atherosclerotic and metabolic pleiotropic effects (part 2)
Authors: Bubnova M. G
Published: February 2021

The article provides an overview of pleiotropic activity and clinical efficacy of one of the representatives of the class of angiotensin receptor blockers II - olmesartan medoxomil. Analyzed is a wide range of established in experimental and clinical studies and vasoconstriction, cardioprotective, anti-atherogenic, anti-inflammatory and other effects of olmesartan medoxomil. Given clinical studies evaluating anti-atherosclerotic effects of this drug.
The effectiveness of a two-component renin-angiotensin aldosterone system blockade after renal transplantation in patients with chronic terminal renal failure
Authors: Ostanina A. A , Fomin I. V , Polyakov D. S , Lipatov K. S , Shcherbakova G. A
Published: February 2021

Conducted a study to determine the effectiveness of blood pressure (BP) control in patients after renal transplantation using a two renin-angiotensin aldosterone system (RAAS) blockade. Within 6 months after kidney transplantation is observed syndrome uncontrolled blood pressure (BP) in 51.6% patients; 13 transplant patients (69.2% men and 30.8% women; mean age 34.7±11.8 years) had chronic glomerulonephritis (100% of cases) as the main cause of end-stage chronic kidney disease. Patients received a dose of aliskiren 150-300 mg in combination with a sartans and calcium antagonist after signing informed consent. Within 2 months of treatment there was a significant deterioration in graft function in achieving optimal BP
The role of calcium antagonists in the treatment of cardiovascular disease: Focus on diltiazem
Authors: Baryshnikova G. A , Chorbinskaya S. A , Stepanova I. I
Published: February 2021

The article deals with the use of calcium antagonists (CA) with a focus on diltiazem for the treatment of hypertension, angina pectoris, and cardiac arrhythmias, for secondary prevention of coronary heart disease, to evaluate their cardiac, angiography, nephroprotective effect, the ability to prevent the development of left ventricular hypertrophy. The problems of tolerability and safety of CA in short and prolonged action.
Options for antiarrhythmic therapy after surgical treatment of the atrial fibrillation
Authors: Bazylev V. V , Nemchenko E. V , Abramova G. N , Karnakhin V. A
Published: February 2021

Aim. To assess the afficiency of using different shcemes of the antiarrythmic therapy (AAT) after the surgical treatment of the atrial fibrillation (AF).Material and methods. This retrospective study included 279 patients: 141 (49%) females and 168 (51%) males, aged 59±7.9 years who had got Сox-Maze IV procedure at Federal cardiovascular center (Penza). 27 patient (9.7%) had the paroxysmal AF, 252 (90.3%) - the persistent one. The AF’s duration was 36 months (from 1 to 180). The size of the left atrium was average 52.4±8.4 mm (from 40 to 82 mm). The medium functional class (FC) of heart failure (HF) (NYHA) was 2.8±0.4: II FC-63 (22.6%), III FC - 213 (76.3%), IV FC - 3 (1.1%). There were 3 groups of patients:1 group had 57 patients who had got amiodaron over 6 months; 2 group - 126 patients who had got b-blocker (b-B) (bisoprolol) long monotherapy; 3 group - 96 patients who had got amiodaron during 3-6 months then had got bisoprolol long therapy. All patiens got Cox-Maze IV procedure.Results. Remote results assessed after 6 months-3 years period after the operation. In all groups the number of patients with I and II FC HF increased; there was significant difference at 2 group (p1-2=0.01; p2-3=0.01; p1- 3=0.73). And there were more patients with sinus rhythm at 2 group than at 3 group significantly. The freedom from AF at 1 group was 77%±0.89, at 2 group - 68%±0.98, at 3 group - 85%±0.95 with the significant difference between 2 and 3 groups (р1-2=0.61; p1-3=0.13; p2-3=0.01).Conclusions. AAT by amiodaron during 3-6 months and then by beta-blocker (bisoprolol) longly after Cox-Maze IV procedure allows to keep sinus rhythm to 85% patiens at the distant period of time and comparing with the b-blocker-monotherapy allows to keep sinus rhythm more effectively. The difference of efficiency by long amiodaron-monotherapy and amiodaron-therapy during 3-6 months is not got statistical significant after Cox-Maze IV procedure.
Ticagrelor in patients with acute coronary syndrome without ST elevation and a conservative treatment strategy
Authors: Erlikh A. D
Published: February 2021

The article provides an overview of the relevance of the use of dual antiplatelet therapy (DAT) in patients with acute coronary syndrome (ACS) without lifting ST (ACSwl ST ) receiving conservative treatment. Compared with those patients with ACSwl ST who underwent percutaneous coronary intervention, conservative treatment, patients traditionally have more comorbidities, risk factors and prognosis is worse. It is in this subgroup of patients to improve outcomes most important to carry out the most correct treatment of ACS, most strictly corresponding to current clinical guidelines. In particular this applies to that therapy, with which you can try to influence the mechanism of development of ACS, namely antirombocit therapy. The results of a clinical study PLATO showed that the use as a DAT combination with acetylsalicylic acid (ASA) and ticagrelor due to a decrease in the incidence of cardiovascular death, heart attack or stroke (primary adverse events) as compared to the combination of ASA and clopidogrel. The results of further analysis of PLATO study showed that when comparing the groups of patients with ACSwl ST treatment of invasive and conservative, noted a similar proportional reduction in the incidence of primary adverse events when using ticagrelor compared to clopidogrel group (hazard ratio of 0.86 compared with 0.85; p-value for interaction 0.89), which is consistent with the overall results of the study. Among patients with ACSwl ST treated conservatively, receiving ticagrelor as compared with clopidogrel was associated with a significantly smaller number of all deaths (relative risk, 0.73; 95 CI 0.57-0.93). The frequency of the "big" bleeding among patients treated conservatively with ACSwl ST treated with ticagrelor and clopidogrel did not differ significantly. PLATO study results identified the mandatory use of ticagrelor as DAT in patients with ACSwl ST regardless of the chosen treatment strategy.
Correlation of quality of life and significant seasonal fluctuations blood pressure in the morning hours in patients with arterial hypertension
Authors: Andreeva G. F , Deev A. D , Gorbunov V. M , Molchanova O. V
Published: February 2021

The aim of the present study was to identify the relationship between the quality of life of patients with arterial hypertension (AH) and the degree of seasonal fluctuations in blood pressure (BP) in the morning hours in these patients, as well as to trace the seasonal dynamics of the average morning levels of blood pressure in this group of patients. We analyzed the database of various studies carried out in our center between 1996 and 2011, which contained data 953 ambulatory BP monitoring (ABPM). ABPM data were analyzed in patients with hypertension, without serious comorbidities, who conducted blood pressure monitoring on a weekly background of antihypertensive therapy. Results of the study. It has been shown that diastolic blood pressure (DBP) in the morning (at) was the highest in winter (83.5±13.7 mm Hg), at the lowest - in summer (80.2±11.5 mm Hg), which was typical of the seasonal dynamics of blood pressure generally. The systolic blood pressure (SBP) was characterized by the highest level of the fall in blood pressure (133.3±18.7 mm Hg). The smallest - in the winter (131,8 B±17,6 mm Hg). The differences between the seasons are not reliable. When analyzing the results by using generalized linear models (Generalized Linear Models) and calculating the Fisher's exact test (F) The following patterns were identified. Intensity of seasonal increases in blood pressure (compared with the average level of blood pressure) was inversely related to the level of social support of friends, colleagues, relatives (Scale VI Quality of Life Questionnaire) (for F DBP was 4.29 (p
Fixed subaortic stenosis - rarecomplication of ankylosing spondyloarthritis
Authors: Lebedev P. A , Paranina E. V , Mishchenko O. V , Suslina E. A
Published: February 2021

Spondyloarthritis (SA) is a well known systemic chronic inflammatory disease involving spine, sacroileac and peripherial joints with extra-articular manifistations. Predominant connective tissue inflamation reflects the typical characters as enthesitis and aortitis, complicated by aortic insufficiency. Authors presents the case of high activity HLA-B27 positive SA young woman, that was complicated at debut with aortic ridge, caused uncommon severe left ventricular outflow fixed obstruction. Pecularities of aortic root structure and it’s involvement in SA, also as dynamic of aortic ridge growth by serial echocardiographic investigations are discussed.
Correlation between vascular endothelial function parameters with indicators of suboptimal health status and the factors of cardiovascular risk
Authors: Marutina E. Yu , Kupaev V. I , Lebedev P. A , Borisov O. Yu
Published: February 2021

The problem of prevention of chronic non-communicable diseases continues to be relevant. It is a promising non-invasive integration of new screening methods to assess the patient's health system. The goal was to establish the relationship of vascular endothelial function parameters with indicators of suboptimal health status and the factors of cardiovascular risk. Materials and methods. A total of 327 residents of Samara, who had no history of disease and did not receive treatment in the last 3 months. We used a questionnaire diagnostic screening suboptimal health status SHSQ-25, the risk factors of cardiovascular diseases, endothelin-1, human blood index of endothelial function was determined by computer photopletismography. Results and discussion. Suboptimal health status is associated with the prevalence and severity of cardiovascular risk factors, smoking, overweight, total cholesterol, glucose, blood endothelin, vascular endothelium reactivity, indicating that their dominant influence on the quality of life in a population of healthy individuals. Vascular reactivity non-invasively evaluated in terms of endothelial function in the sample with ischaemia of the upper limb by computer photopletismography reflects systemic vascular endothelial function as a negative associated with endothelin blood and the main factors of cardiovascular risk: age, male gender, body mass index, the nature of work activity, blood pressure value.
Non-invasive stimulation of angiogenesis with shock-wave therapy in patients with coronary artery disease (literature review)
Authors: Matskeplishvili S. T , Borbodoeva B. M
Published: February 2021

The article presents a review of published data regarding the most important problem in cardiology - treatment of patients with coronary artery disease and left ventricular dysfunction and improvement of quality of life in this group. The discussion covers the management of coronary artery disease in modern cardiology, new approaches to the treatment of coronary artery disease in patients without possibility of myocardial revascularization or after revascularization. The safety and effectiveness of shock-wave therapy in this group of patients is presented.
Current representation of endovascular treatment of patients with left main coronary artery disease
Authors: Vlasov V. Yu , Rudenko B. A , Shanoyan A. S , Mazaev V. P , Akhadova A. Sh , Shukurov F. B
Published: February 2021

Coronary artery bypass grafting (CABG) is known as the gold standard treatment of unprotected left main coronary artery (LMCA) disease and has the highest level of evidence in European and American recommendations. However development of endovascular methods of treatment, and first of all decrease of in-stent-restenosis allow us to consider angioplasty and stenting of LMCA as an alternative method to CABG. The comparative world analysis of results of percutaneous coronary interventions and CABG is provided in article. It tells also how efficiency of percutaneous coronary interventions depends on such factors as lesion localization, diabetes, type of drug-eluting stent.
Actual questions of clinical pharmacology by amlodipine: should we prefer the original or a generic drug?
Authors: Dukhanin A. S
Published: February 2021

Selection of amlodipine (tablets) as a drug based on three basic criteria: clinical efficacy, safety / tolerability and quality is discussed below. The article deals with the successive stages of clinical pharmacology and pharmacotherapy from amlodipine tablets (pharmaceutical stage) to clinical response (therapeutic step). An algorithm for evaluating the interchangeability of reference and reproduced preparations containing Amlodipine is presented.
Self-control as prevention of cardiovascular disease
Authors: Manuylova Yu. A
Published: February 2021

Diabetes mellitus is a common problem with high levels of morbidity and mortality. Economic costs of treating the disease and its complications are very high. Diabetic complications arise with chronic hyperglycaemia in the case of hypoglycemia. Prevention of these conditions contributes to the maintenance of normoglycemia, what a crucial role it plays an adequate self-control. Precise instruments for measuring blood glucose at home with minimal errors make it possible to take measures to achieve a compensation of the disease, thereby preventing the occurrence of acute and late complications, improving the quality and duration of life for the patient and reducing the cost of its treatment.
Comparison of the effect of treatment with the main groups of antihypertensive drugs on the quality of life in patients with stable arterial hypertension
Authors: Andreeva G. F , Gorbunov V. M , Molchanova O. V , Deev A. D
Published: February 2021

When appointing antihypertensive drugs to patients with stable mild to moderate arterial hypertension (AH) it is necessary to take into account the effect of treatment on the quality of life (QoL) of these patients. The aim of the study was to compare the effect of prolonged use of antihypertensive drugs from the main treatment groups on QoL of patients with stable AH in 5 controlled trials. The results of monotherapy efficacy were assessed by 24-hour blood pressure monitoring and QoL patients were studied before and after long-term monotherapy according to the results of a database analysis of 5 studies performed in our center for the last 4 years. After the period of withdrawal of antihypertensive therapy, patients underwent 24-hour blood pressure monitoring, QoL was evaluated. According to 24-hour blood pressure monitoring, diltiazem had an antihypertensive effect, comparable to the effect of enalapril. Both drugs had no effect on the circadian rhythm of arterial pressure and the outpatient heart rate. Long-term use of none of the antihypertensive drugs (diltiazem, amlodipine, enalapril, metoprolol, telmisartan) did not worsen QoL. The greatest impact on QoL was provided by the group of angiotensin-converting enzyme inhibitors, enalapril, significantly improving QoL.
Psychoemotional status and neuroendocrine changes in patients with hypertension and obesity according to the level of physical activity
Authors: Ivanchenko V. S , Gordienko A. I , Matveeva N. V , Gagarina A. A , Ushakov A. V
Published: February 2021

Aim. To study psychoemotional status and serum cortisol changes in patients with arterial hypertension (AH) and obesity, depending on the level of physical activity. Material and methods. 76 male patients with AH stage I and II were examined. Group 1 consisted of 36 patients with AH and obesity, group 2 - 40 hypertensive patients without obesity. Serum cortisol level was determined by enzyme-linked immunosorbent assay. To access level of psycho-emotional strain in patients PSM-25 scale was used. The level of reactive and personal anxiety was measured using a Spielberger-Khanin questionnaire. To assess physical activity a brief international physical activity questionnaire (IPAQ) was used. Results. Each group was divided into two subgroups depending on the level of physical activity. According to results of psychological questionnaires physically inactive patients showed significantly higher levels of psychoemotional stress and serum cortisol concentrations as compared to physically active patients. There was an inverse correlation between the level of physical activity with reactive anxiety in group 1 (r=-0.35; p=0.04), and between physical activity with personal anxiety (r=-0.36; p=0.02) and psychoemotional strain in group 2 (r=-0.42; p=0.006). There also was an inverse association between the level of physical activity with systolic (group 1 - r=-0.52; p=0.001; group 2 - r=-0.52; p=0.0006) and diastolic (group 2 - r=-0.45; p=0.004) blood pressure. All groups showed an inverse relationship between physical activity level and serum cortisol concentration that was statistically significant in group 2 (r=-0.36; p=0.04). Conclusion. Our results support the hypothesis that regular physical activity confers resilience by oftimizing physiological and neuroendocrine responses and acts as a buffer against stressors.
Observation of adolescents with high blood pressure, involved in physical activity
Authors: Balykova L. A , Ivianskiy S. A , Shirokova A. A , Shchekina N. V , Varlashina K. A
Published: February 2021

The article provides a brief overview of the literature data on the prevalence and causes of hypertension in athletes. Different points of view on the effect of regular physical exertion on the level of arterial pressure are considered. In addition, the available diagnostic approaches to the detection of high blood pressure are described. Based on the available data, domestic and foreign experience, oftimal algorithms for diagnosing arterial hypertension in young people involved in sports are presented.
Tolerance to physical activity and mental performance of patients in the second stage of rehabilitation after aortocoronary bypass surgery
Authors: Aleksandrov P. V , Perepech N. B , Misiura O. F
Published: February 2021

The article is devoted to the study of the dynamics of the restoration of physical activity tolerance (PAT), cognitive functions and mental performance (MP) in patients who completed the program of cardiac rehabilitation after aortocoronary bypass surgery. The results of the study showed that for the majority of patients before inclusion in the program of cardioresistance, PAT and MP indicators were reduced, mild and moderate cognitive impairment was detected. At the end of the rehabilitation program, the normalization of PAT was noted in 80% of patients, there were no signs of cognitive impairment in 60% of patients. The indicators of MP corresponded to the norm in the majority of those surveyed. Thus, the majority of patients who completed the program of cardiac rehabilitation II stage after aortocoronary shunting achieved restoration of cognitive functions, MP and physical performance.
Risk factors of subclinical atherosclerosis of obesity women
Authors: Shenkova N. N , Chumakova G. A , Veselovskaya N. G , Osipova E. S , Ott A. V
Published: February 2021

Research objective: study the metabolic risk factors (RF) of subclinical atherosclerosis of obese women. Material and methods. 89 women have been included in research, 50.6±6.6 years old with abdominal obesity and waist circumference >80 cm without coronary heart disease and atherosclerosis of other localisation. According to the results of the ultrasound study of brachiocephalic arteries (BCA), two groups were formed for comparison: Group 1 (n=60) without atherosclerosis BCA, Group 2 (n=29) with atherosclerosis BCA. Definitions of classical and additional metabolic RF, of adipokines of visceral adipose tissue (VAT) and ghrelin were spent to the surveyed patients. The thickness of epicardial fat (tEF) was defined at transthoracic echocardiography. Results. In the group 2 there were the highest indexes of: LDL 3.7 (2.9; 4.6) mmol/L, Apo B 1.32±0.29 g/L, CRP 2.8±0.96 mg/l, leftin 20.0 (16.4; 23.1) ng/ml, tEF 7 (6; 8) mm; lower indexes of Apo A1 1.16±0.31 g/l and ghrelin 40.7 (39.1; 42.8) pg/dl. Conclusion. The signs of subclinical atherosclerosis of the carotid arteries of obese women were associated with higher amount of VAT (tEF), inflammatory activity of plasma (CRP) and neurohumoral disorders (leftin, ghrelin).
Quality of life after surgical treatment of atrial fibrillation
Authors: Bazylev V. V , Nemchenko E. V , Abramova G. N , Karnakhin V. A
Published: February 2021

Aim - to evaluate quality of life (QOL) of patients with atrial fibrillation (AF) after surgical treatment of arrhythmia during open heart surgery. Materials and methods. The retrospective single-center randomized study involved 71 patients whose QOL was analyzed after the Cox-Maze IV surgery and mitral valve correction. The follow-up period was from 6 months to 6 years. The study included 35 (49%) women and 36 (51%) men, whose average age was 61±12.3 at the time of surgical treatment. AF duration was 47.6±22.3 months. The left atrium was dilated to 60.9±10.5 mm. Functional class II of heart failure (NYHA) included 25 patients (35%), functional class III - 46 patients (65%). The control group included 48 patients with AF who had not got the ‘labyrinth’ procedure performed during the surgical treatment. There were no statistically significant differences between the main clinical and demographic characteristics in reference to the groups. All patients had a long-term persistent AF. The SF-36 questionnaire was used for studying QOL. Results. 47 (66%) patients in the experimental group kept a sinus rhythm within 6 years. The patients of the RFA-group had a higher rate of vitality (NBS VT 54.5±8.2, p=0.03, SBS VT 54.1±8.5, p=0.001) and social functioning (SBS SF 45.0±10.2, p=0.001), with regard to other scales there were no statistically significant differences. The presence of AF after surgical treatment increased the probability of a low QOL in the long term. Conclusions. QOL after surgical treatment of mitral valve disease and AF is significantly higher with regard to vitality and social functioning. The physical component of health is significantly reduced as compared with that in the general population, but the characteristics of QOL in accordance with other scales approach the general indices. The presence of AF after surgical treatment increases the probability of a lower QOL in the long term.
Treatment of atherogenic dyslipidemia: modern principles and new possibilities
Authors: Bubnova M. G
Published: February 2021

The review presents the main provisions of the current recommendations of the European and American communities on the diagnosis and treatment of atherogenic dyslipidemia. Evidence of the importance of reducing the level of low-density lipoprotein cholesterol as a key factor in the development of cardiovascular diseases caused by atherosclerosis and the primary goal of lipid lowering therapy are given. Unresolved problems of statin therapy are indicated. A characteristic of a new class of lipid-lowering drugs is the inhibitors of the subtilisin/kexin type 9 proprotein convertase (PCSK9). The results of the first large studies with the PCSK9 inhibitor evoloucumab were discussed, which allowed to formulate the main indications for the prescriftion of this group of drugs in clinical practice.
Effect of exercises on the patients receiving hemodialysis
Authors: Frolov A. V
Published: February 2021

This article gives an overview of the scientific evidence on the impact of physical activity on various parameters of the health of people with end-stage renal disease. With examples of clinical observations, interrelations are established between nutritional status, menstrual disorders, osteopenia, erectile dysfunction and the impact on them of methods of physical rehabilitation.