Pub Date : 2022-11-03DOI: 10.20996/1819-6446-2022-10-01
A. Zakirova, N. E. Zakirova, D. F. Nizamova
Aim. To study the presence and nature of correlations between the level of Insulin-like growth factor-1 (IGF-1) and structural and functional parameters of the heart in the development of myocardial remodeling and fibrosis in patients with chronic heart failure (CHF) of ischemic origin.Material and methods. The study included 120 men with class II-IV CHF who have history of myocardial infarction, which are divided into 3 groups depending on the CHF class. The control group included 25 healthy men. Assessment of left ventricular (LV) structural-functional state was carried out by echocardiography. Investigation of IGF-1 and N-terminal precursor indices of cerebral natriuretic peptide (NT-pro BNP) was performed by enzyme immunoassay.Results. Patients with class II CHF were hyperexpression of IGF-1, with class III CHF were registered low-normal level, with class IV CHF was established a deficiency of IGF-1. The most significant structural-geometric rearrangement of LV and significant deficit of IGF-1 recorded in patients with class IV CHF (95,6±7,02 ng/ml with class IV CHF versus 178,3±11,36 ng/ml and 124,3±9,14 ng/ml with class II and III CHF; р<0,05). In patients of class III-IV CHF, correlation relationships between IGF-1 level and echocardiographic parameters (LV myocardial mass index are established: r=-0,59, p=0,05; end systolic volume index: r=-0,55, p=0,05; value of LV ejection fraction: r=0,61, p=0,05). Significant negative correlation are established in patients with class III-IV CHF between IGF-1 level and NT-pro BNP levels (r=-0,51; р=0,05).Conclusion. The intensity of myocardial remodeling and fibrosis processes in patients with a progressive course of CHF is related to deficit of IGF-1 and is associated with a high level of activity of natriuretic peptides.
{"title":"Insulin-like Growth Factor-1 and Myocardial Remodeling in Patients with Chronic Heart Failure of Ischemic Origin","authors":"A. Zakirova, N. E. Zakirova, D. F. Nizamova","doi":"10.20996/1819-6446-2022-10-01","DOIUrl":"https://doi.org/10.20996/1819-6446-2022-10-01","url":null,"abstract":"Aim. To study the presence and nature of correlations between the level of Insulin-like growth factor-1 (IGF-1) and structural and functional parameters of the heart in the development of myocardial remodeling and fibrosis in patients with chronic heart failure (CHF) of ischemic origin.Material and methods. The study included 120 men with class II-IV CHF who have history of myocardial infarction, which are divided into 3 groups depending on the CHF class. The control group included 25 healthy men. Assessment of left ventricular (LV) structural-functional state was carried out by echocardiography. Investigation of IGF-1 and N-terminal precursor indices of cerebral natriuretic peptide (NT-pro BNP) was performed by enzyme immunoassay.Results. Patients with class II CHF were hyperexpression of IGF-1, with class III CHF were registered low-normal level, with class IV CHF was established a deficiency of IGF-1. The most significant structural-geometric rearrangement of LV and significant deficit of IGF-1 recorded in patients with class IV CHF (95,6±7,02 ng/ml with class IV CHF versus 178,3±11,36 ng/ml and 124,3±9,14 ng/ml with class II and III CHF; р<0,05). In patients of class III-IV CHF, correlation relationships between IGF-1 level and echocardiographic parameters (LV myocardial mass index are established: r=-0,59, p=0,05; end systolic volume index: r=-0,55, p=0,05; value of LV ejection fraction: r=0,61, p=0,05). Significant negative correlation are established in patients with class III-IV CHF between IGF-1 level and NT-pro BNP levels (r=-0,51; р=0,05).Conclusion. The intensity of myocardial remodeling and fibrosis processes in patients with a progressive course of CHF is related to deficit of IGF-1 and is associated with a high level of activity of natriuretic peptides.","PeriodicalId":20812,"journal":{"name":"Rational Pharmacotherapy in Cardiology","volume":"62 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84492786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-03DOI: 10.20996/1819-6446-2022-09-03
N. Solomakhina, A. Lishuta, A. V. Dementieva
Aim. To study the role of hepcidin as a regulator of iron metabolism and a mediator of inflammation in elderly and senile patients with chronic heart failure (CHF) with anemia of chronic diseases (ACD).Material and methods. The levels of hemogram parameters, ferrokinetics (serum iron, ferritin, transferrin, erythropoietin, hepcidin), inflammation [C-reactive protein (CRP), interleukin-6 (IL-6)], as well as correlations between hepcidin and these parameters were studied in patients with CHF with ACD (n=35), with CHF without anemia (n=35) and in elderly and senile patients without CHF and anemia (control group; n=20).Results. Normal levels of hepcidin (9.17±0.97 ng/ml) and the only significant correlation of hepcidin with the ferrokinetic parameter – serum iron [r(S)=0.480, p<0.05] were found in the control group. Normal levels of hepcidin (12.01±1.19 ng/ml) and two significant correlations of hepcidin with the ferrokinetic parameter – ferritin [r(S)=0.525, p<0.05] and transferrin [r(S)=-0.343, p<0.05] were found in the CHF without anemia group. Significantly elevated levels of hepcidin (23.81±3.63 ng/ml) were found in the CHF with ACD group compared to the CHF without anemia group (p=0.008) and the control group (p=0.003). Also, five significant correlations of hepcidin with hemogram parameters – hemoglobin [r(S)=-0.461, p<0.05] and the average concentration of hemoglobin in the erythrocyte [r(S)=-0.437, p<0.05]; with ferrokinetic parameters – ferritin [r(S)=0.596,p<0.05] and transferrin [r(S)=-0.474, p<0.05]; with inflammation parameters – CRP [r(S)=0.561, p<0.05] were found in the CHF with ACD group.Conclusion. The increased level of hepcidin in CHF patients with ACD and the formation of links of hepcidin with indicators of inflammation reflect its role as a mediator of inflammation, and the formation of connections with indicators of hemogram and ferrokinetics – its role as a regulator of iron metabolism involved in the development of ACD in elderly and senile CHF patients.
{"title":"Hepcidin as a Regulator of Iron Metabolism and Mediator of Inflammation in Patients with Chronic Heart Failure and Anemia of Chronic Diseases of the Elderly and Senile Age","authors":"N. Solomakhina, A. Lishuta, A. V. Dementieva","doi":"10.20996/1819-6446-2022-09-03","DOIUrl":"https://doi.org/10.20996/1819-6446-2022-09-03","url":null,"abstract":"Aim. To study the role of hepcidin as a regulator of iron metabolism and a mediator of inflammation in elderly and senile patients with chronic heart failure (CHF) with anemia of chronic diseases (ACD).Material and methods. The levels of hemogram parameters, ferrokinetics (serum iron, ferritin, transferrin, erythropoietin, hepcidin), inflammation [C-reactive protein (CRP), interleukin-6 (IL-6)], as well as correlations between hepcidin and these parameters were studied in patients with CHF with ACD (n=35), with CHF without anemia (n=35) and in elderly and senile patients without CHF and anemia (control group; n=20).Results. Normal levels of hepcidin (9.17±0.97 ng/ml) and the only significant correlation of hepcidin with the ferrokinetic parameter – serum iron [r(S)=0.480, p<0.05] were found in the control group. Normal levels of hepcidin (12.01±1.19 ng/ml) and two significant correlations of hepcidin with the ferrokinetic parameter – ferritin [r(S)=0.525, p<0.05] and transferrin [r(S)=-0.343, p<0.05] were found in the CHF without anemia group. Significantly elevated levels of hepcidin (23.81±3.63 ng/ml) were found in the CHF with ACD group compared to the CHF without anemia group (p=0.008) and the control group (p=0.003). Also, five significant correlations of hepcidin with hemogram parameters – hemoglobin [r(S)=-0.461, p<0.05] and the average concentration of hemoglobin in the erythrocyte [r(S)=-0.437, p<0.05]; with ferrokinetic parameters – ferritin [r(S)=0.596,p<0.05] and transferrin [r(S)=-0.474, p<0.05]; with inflammation parameters – CRP [r(S)=0.561, p<0.05] were found in the CHF with ACD group.Conclusion. The increased level of hepcidin in CHF patients with ACD and the formation of links of hepcidin with indicators of inflammation reflect its role as a mediator of inflammation, and the formation of connections with indicators of hemogram and ferrokinetics – its role as a regulator of iron metabolism involved in the development of ACD in elderly and senile CHF patients.","PeriodicalId":20812,"journal":{"name":"Rational Pharmacotherapy in Cardiology","volume":"9 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90337230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-03DOI: 10.20996/1819-6446-2022-09-01
E. Bochkareva, E. K. Butina, E. K. Bayramkulova, O. Molchanova, N. Rozhkova, N. Gavrilova, O. Drapkina
Aim. To determine the frequency of detection and severity of breast arterial calcification (BAC) among women undergoing mammography on the basis of medical institutions in Moscow.Material and methods. The analysis included 4274 digital mammograms of women aged 40-93 who underwent preventive or diagnostic mammography. Standard full-format digital mammograms were performed in craniocaudal and mediolateral oblique projections. In addition to the standard diagnosis of breast disease, all mammograms were evaluated for the presence of BAC. The severity of BAC was assessed on a 12-point scale: mild 3-4 points, moderate 5-6 points, severe 7-12 points.Results. The average frequency of BAC was 10.1%, in the middle age group 50-59 years – 6.0%. The incidence of BAC increased with age, from 0.4% to 0.6% in women <50 years of age to >50% in women ≥80 years of age. A statistically significant and pronounced correlation was found between the woman's age and the presence of BAC r Pearson =0.769 (p<0.001). There was also a less noticeable but statistically significant correlation between age and severity of BAC r Spearman =0.319 (p<0.001). Regression analysis made it possible to estimate the probability of CAD depending on age. In women <50 years of age, only mild to moderate calcification occurred, while those ≥65 years of age had a significant increase in the incidence of severe CAD.Conclusion. There was an expected increase with age in both prevalence and severity of BAC. Cases of severe BAC in women younger than 65 years of age and any BAC in women younger than 50 years of age are atypical and require clarification of their association with cardiovascular and other diseases.
{"title":"Prevalence and Severity of Breast Arterial Calcification on Routine Mammography","authors":"E. Bochkareva, E. K. Butina, E. K. Bayramkulova, O. Molchanova, N. Rozhkova, N. Gavrilova, O. Drapkina","doi":"10.20996/1819-6446-2022-09-01","DOIUrl":"https://doi.org/10.20996/1819-6446-2022-09-01","url":null,"abstract":"Aim. To determine the frequency of detection and severity of breast arterial calcification (BAC) among women undergoing mammography on the basis of medical institutions in Moscow.Material and methods. The analysis included 4274 digital mammograms of women aged 40-93 who underwent preventive or diagnostic mammography. Standard full-format digital mammograms were performed in craniocaudal and mediolateral oblique projections. In addition to the standard diagnosis of breast disease, all mammograms were evaluated for the presence of BAC. The severity of BAC was assessed on a 12-point scale: mild 3-4 points, moderate 5-6 points, severe 7-12 points.Results. The average frequency of BAC was 10.1%, in the middle age group 50-59 years – 6.0%. The incidence of BAC increased with age, from 0.4% to 0.6% in women <50 years of age to >50% in women ≥80 years of age. A statistically significant and pronounced correlation was found between the woman's age and the presence of BAC r Pearson =0.769 (p<0.001). There was also a less noticeable but statistically significant correlation between age and severity of BAC r Spearman =0.319 (p<0.001). Regression analysis made it possible to estimate the probability of CAD depending on age. In women <50 years of age, only mild to moderate calcification occurred, while those ≥65 years of age had a significant increase in the incidence of severe CAD.Conclusion. There was an expected increase with age in both prevalence and severity of BAC. Cases of severe BAC in women younger than 65 years of age and any BAC in women younger than 50 years of age are atypical and require clarification of their association with cardiovascular and other diseases.","PeriodicalId":20812,"journal":{"name":"Rational Pharmacotherapy in Cardiology","volume":"45 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78570710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-02DOI: 10.20996/1819-6446-2022-09-02
E. D. Kartamysheva, Y. Lopatin
Aim. To research the effect of structured telephone support on the self-care in comorbid patients with chronic heart failure (CHF) over 12 months of follow-up.Material and methods. Self-care was assessed using The Self-care of Heart Failure Index (SCHFI, version 6.2) in 130 patients with CHF II-IV functional class according to NYHA, mean age 63.2±9.6 years old, left ventricular ejection fraction averaged 47.1±11.6%, men (70.8%) and patients with ischemic etiology of CHF (78.5%) prevailed. After fixed simple randomization by the envelope method, the patients were divided into groups of standard (control) and active outpatient follow-up (additional telephone contacts or correspondence using available messengers – structured telephone support). All patients received CHF therapy in accordance with the current Russian clinical guidelines. The indicators evaluated initially and after 12 months of follow-up.Results. Over 12 months, total SCHFI scores increased significantly by 62% in the telephone support group and by 34.7% in the comparison group (p<0.001). A significant maximum improvement in the score was noted in section B of this scale (self-care management) in patients in the telephone support group (by 100%; p<0.001).There was an improvement in the clinical condition and an increase in exercise tolerance in both groups, somewhat more in the telephone support group (p>0.05).However, there were no statistically significant differences in the intake of the main groups of drugs and the achievement of their target dosages (p>0.05).Conclusion. The study found a positive effect of structured telephone support on the self-care and the clinical condition of patients with CHF, although it did not reach the maximum possible acceptable values. Further studies are need to assess the self-care in patients with CHF.
{"title":"The Role of Structured Telephone Support in the Development of Self-care in Comorbid Patients with Chronic Heart Failure","authors":"E. D. Kartamysheva, Y. Lopatin","doi":"10.20996/1819-6446-2022-09-02","DOIUrl":"https://doi.org/10.20996/1819-6446-2022-09-02","url":null,"abstract":"Aim. To research the effect of structured telephone support on the self-care in comorbid patients with chronic heart failure (CHF) over 12 months of follow-up.Material and methods. Self-care was assessed using The Self-care of Heart Failure Index (SCHFI, version 6.2) in 130 patients with CHF II-IV functional class according to NYHA, mean age 63.2±9.6 years old, left ventricular ejection fraction averaged 47.1±11.6%, men (70.8%) and patients with ischemic etiology of CHF (78.5%) prevailed. After fixed simple randomization by the envelope method, the patients were divided into groups of standard (control) and active outpatient follow-up (additional telephone contacts or correspondence using available messengers – structured telephone support). All patients received CHF therapy in accordance with the current Russian clinical guidelines. The indicators evaluated initially and after 12 months of follow-up.Results. Over 12 months, total SCHFI scores increased significantly by 62% in the telephone support group and by 34.7% in the comparison group (p<0.001). A significant maximum improvement in the score was noted in section B of this scale (self-care management) in patients in the telephone support group (by 100%; p<0.001).There was an improvement in the clinical condition and an increase in exercise tolerance in both groups, somewhat more in the telephone support group (p>0.05).However, there were no statistically significant differences in the intake of the main groups of drugs and the achievement of their target dosages (p>0.05).Conclusion. The study found a positive effect of structured telephone support on the self-care and the clinical condition of patients with CHF, although it did not reach the maximum possible acceptable values. Further studies are need to assess the self-care in patients with CHF.","PeriodicalId":20812,"journal":{"name":"Rational Pharmacotherapy in Cardiology","volume":"32 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89301089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-02DOI: 10.20996/1819-6446-2022-09-06
A. A. Smirnov, M. Loukianov, S. Martsevich, A. Pulin, N. Kutishenko, E. Andreenko, V. P. Voronina, V. A. Dindikova, N. Dmitrieva, M. Kudryavtseva, O. Lerman, A. N. Makoveeva, E. Okshina, A. A. Maltseva, E. Belova, V. G. Klyashtorniy, E. V. Kudryashov, O. Karpov, O. Drapkina
Aim. To study the clinical and anamnestic characteristics, pharmacotherapy of cardiovascular diseases (CVD) and long-term outcomes in post-COVID-19 patients with cardiovascular multimorbidity (CVMM), enrolled in the prospective hospital registry.Material and methods. In patients with confirmed COVID-19 included in the TARGET-VIP registry, the CVMM criterion was the presence of two or more CVDs: arterial hypertension (AH), coronary heart disease (CHD), chronic heart failure (CHF), atrial fibrillation (AF). There were 163 patients in the CVMM group and 382 – in the group without CVD. The information was obtained initially from hospital history sheet, and afterwards – from a telephone survey of patients after 30-60 days, 6 and 12 months, from electronic databases. The follow-up period was 13.0±1.5 months.Results. The age of post-COVID patients with CVMM was 73.7±9.6 years, without CVD – 49.4±12.4 years (p<0.001), the proportion of men was 53.9% and 58.4% (p=0.34). In the group with CVMM the majority of patients had AH (92.3-93.3%), CHD (90.4-91.4%), and minority – CHF (42.7-46.0%) and AF (42.9-43.4%). The combination of 3-4 CVDs prevailed (58.9-60.3%). The proportion of cases of chronic non-cardiac pathologies was higher in the CVMM group (80.9%) compared to the group without CVD (36.7%; p<0.001). The frequency of proper cardiovascular pharmacotherapy during the follow-up period decreased from 56.8% to 51.3% (p for trend = 0.18). The frequency of anticoagulant therapy in AF decreased significantly: from 89.1% at the discharge from the hospital to 56.4% after 30-60 days (p=0.001), 57.1% and 53.6% after 6 and 12 months of monitoring (p for a trend <0.001). There were no other significant changes in the frequency of other kinds of the proper cardiovascular pharmacotherapy (p>0.05). There were higher rate of all-cause mortality among patients with CMMM (12.9% vs 2.9%, p<0.001) as well as rates of hospitalization (34.7% and 9.9%, p<0.001) and non-fatal myocardial infarction (MI) – 2.5% vs 0.5% (p=0.048). The proportion of new cases of CVD in the groups with CVMM and without CVD was 5.5% and 3.7% (p=0.33). The incidence of acute respiratory viral infection (ARVI)/influenza was higher in the group without CVD – 28.3% vs 19.0% (p=0.02). The proportion of cases of recurrent COVID-19 in groups with CVMM and without CVD was 3.7 % and 1.8% (p=0.19).Conclusion. Post COVID-19 patients with CVMM were older and had the bigger number of chronic non-cardiac diseases than patients without CVD. The quality of cardiovascular pharmacotherapy in patients with CVMM was insufficient at the discharge from the hospital with following non-significant decrease during 12 months of follow-up. The frequency of anticoagulant therapy in AF decreased by 1.6 times after 30-60 days and by 1.7 times during the year of follow-up. The proportion of new cases of CVD was 5.5% and 3.7% with no significant differences between compared groups. The rate of all-cause mortality, hospitalizations
的目标。目的:研究纳入前瞻性医院登记的2019冠状病毒病(covid -19)后合并心血管多发性疾病(CVMM)患者的临床和记忆特征、心血管疾病(CVD)药物治疗和长期结局。材料和方法。在TARGET-VIP登记的确诊COVID-19患者中，CVMM标准是存在两种或两种以上的cvd:动脉高血压(AH)、冠心病(CHD)、慢性心力衰竭(CHF)、心房颤动(AF)。CVMM组163例，无CVD组382例。这些信息最初是从医院病史表中获得的，然后在30-60天、6个月和12个月后从电子数据库中对患者进行电话调查。随访时间为13.0±1.5个月。合并CVMM的患者年龄为73.7±9.6岁，未合并CVD的患者年龄为49.4±12.4岁(p0.05)。CMMM患者的全因死亡率(12.9% vs 2.9%， p<0.001)、住院率(34.7% vs 9.9%， p<0.001)和非致死性心肌梗死(MI) (2.5% vs 0.5%， p=0.048)较高。CVMM组和无CVD组CVD新发病例比例分别为5.5%和3.7% (p=0.33)。急性呼吸道病毒感染(ARVI)/流感的发生率在无心血管疾病组较高，分别为28.3%和19.0% (p=0.02)。CVMM组和无CVD组中COVID-19复发的比例分别为3.7%和1.8% (p=0.19)。COVID-19后CVMM患者比无CVD患者年龄更大，慢性非心脏疾病的数量更多。CVMM患者出院时心血管药物治疗质量不足，随访12个月无明显下降。房颤抗凝治疗的频率在30-60天后下降了1.6倍，在随访期间下降了1.7倍。CVD新发病例比例分别为5.5%和3.7%，两组间差异无统计学意义。CVMM患者的全因死亡率、住院率和非致死性心肌梗死发生率显著高于CVD患者，但ARVI/流感发生率在无CVD患者中显著高于CVD患者。复发率分别为3.7%和1.8%，两组间差异无统计学意义。
{"title":"Clinical and Anamnestic Characteristics, Cardiovascular Pharmacotherapy and Long-term Outcomes in Multimorbid Patients after COVID-19","authors":"A. A. Smirnov, M. Loukianov, S. Martsevich, A. Pulin, N. Kutishenko, E. Andreenko, V. P. Voronina, V. A. Dindikova, N. Dmitrieva, M. Kudryavtseva, O. Lerman, A. N. Makoveeva, E. Okshina, A. A. Maltseva, E. Belova, V. G. Klyashtorniy, E. V. Kudryashov, O. Karpov, O. Drapkina","doi":"10.20996/1819-6446-2022-09-06","DOIUrl":"https://doi.org/10.20996/1819-6446-2022-09-06","url":null,"abstract":"Aim. To study the clinical and anamnestic characteristics, pharmacotherapy of cardiovascular diseases (CVD) and long-term outcomes in post-COVID-19 patients with cardiovascular multimorbidity (CVMM), enrolled in the prospective hospital registry.Material and methods. In patients with confirmed COVID-19 included in the TARGET-VIP registry, the CVMM criterion was the presence of two or more CVDs: arterial hypertension (AH), coronary heart disease (CHD), chronic heart failure (CHF), atrial fibrillation (AF). There were 163 patients in the CVMM group and 382 – in the group without CVD. The information was obtained initially from hospital history sheet, and afterwards – from a telephone survey of patients after 30-60 days, 6 and 12 months, from electronic databases. The follow-up period was 13.0±1.5 months.Results. The age of post-COVID patients with CVMM was 73.7±9.6 years, without CVD – 49.4±12.4 years (p<0.001), the proportion of men was 53.9% and 58.4% (p=0.34). In the group with CVMM the majority of patients had AH (92.3-93.3%), CHD (90.4-91.4%), and minority – CHF (42.7-46.0%) and AF (42.9-43.4%). The combination of 3-4 CVDs prevailed (58.9-60.3%). The proportion of cases of chronic non-cardiac pathologies was higher in the CVMM group (80.9%) compared to the group without CVD (36.7%; p<0.001). The frequency of proper cardiovascular pharmacotherapy during the follow-up period decreased from 56.8% to 51.3% (p for trend = 0.18). The frequency of anticoagulant therapy in AF decreased significantly: from 89.1% at the discharge from the hospital to 56.4% after 30-60 days (p=0.001), 57.1% and 53.6% after 6 and 12 months of monitoring (p for a trend <0.001). There were no other significant changes in the frequency of other kinds of the proper cardiovascular pharmacotherapy (p>0.05). There were higher rate of all-cause mortality among patients with CMMM (12.9% vs 2.9%, p<0.001) as well as rates of hospitalization (34.7% and 9.9%, p<0.001) and non-fatal myocardial infarction (MI) – 2.5% vs 0.5% (p=0.048). The proportion of new cases of CVD in the groups with CVMM and without CVD was 5.5% and 3.7% (p=0.33). The incidence of acute respiratory viral infection (ARVI)/influenza was higher in the group without CVD – 28.3% vs 19.0% (p=0.02). The proportion of cases of recurrent COVID-19 in groups with CVMM and without CVD was 3.7 % and 1.8% (p=0.19).Conclusion. Post COVID-19 patients with CVMM were older and had the bigger number of chronic non-cardiac diseases than patients without CVD. The quality of cardiovascular pharmacotherapy in patients with CVMM was insufficient at the discharge from the hospital with following non-significant decrease during 12 months of follow-up. The frequency of anticoagulant therapy in AF decreased by 1.6 times after 30-60 days and by 1.7 times during the year of follow-up. The proportion of new cases of CVD was 5.5% and 3.7% with no significant differences between compared groups. The rate of all-cause mortality, hospitalizations ","PeriodicalId":20812,"journal":{"name":"Rational Pharmacotherapy in Cardiology","volume":"10 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82072479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-02DOI: 10.20996/1819-6446-2022-09-05
K. A. Zhbanov, E. Y. Salakheeva, I. Sokolova, E. Zheleznykh, V. Zektser, E. Privalova, Y. Belenkov, A. Shchendrygina
{"title":"Neuregulin-1β, Biomarkers of Inflammation and Myocardial Fibrosis in Heart Failure Patients","authors":"K. A. Zhbanov, E. Y. Salakheeva, I. Sokolova, E. Zheleznykh, V. Zektser, E. Privalova, Y. Belenkov, A. Shchendrygina","doi":"10.20996/1819-6446-2022-09-05","DOIUrl":"https://doi.org/10.20996/1819-6446-2022-09-05","url":null,"abstract":"","PeriodicalId":20812,"journal":{"name":"Rational Pharmacotherapy in Cardiology","volume":"31 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87487562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-02DOI: 10.20996/1819-6446-2022-09-04
V. Podzolkov, A. Bragina, K. Osadchiy, J. Rodionova, D. Bayutina
Aim. To study a rate of excessive pararenal fat tissue (PRFT) thickness and its relationship with anthropometric obesity indices.Material and methods. 372 patients (152 men and 220 women) were included in the study, the average age was 63.5±13.3 years. There were measured: height, weight, waist circumference (WC), hip circumference (HC), body mass index (BMI), WC/height ratio, sagittal abdominal diameter (SAD), body fat percentage (BFP), body surface area (BSA), body adiposity index (BAI) and visceral obesity index (VAI). All subjects underwent abdominal multispiral computed tomography. PRFT thickness was detected on a single slice at the level of the left renal vein.Results. 27% of the examined group had BMI<25 kg/m2, 28% – excessive body mass, 45% – obesity. The median PRFT thickness was 1.61 (1.03; 2.46) cm. There were correlations between PRFT thickness and glucose (r=0,64, p<0,05) and uric acid (r=0,46, p<0,05) levels. The threshold of referential PRFT thickness was 1,91cm. The rate of pararenal obesity was 9,9% among those with normal body mass, 29,3% in excessive body mass, 66,1% – in 1 class obesity, 67,7% – in 2 class, and 90,1% – in 3 class. The correlation analysis revealed a significant positive correlation between the PRFT thickness and obesity indices with exception of VAI and BAI: with BMI (r=0.43, p<0.05), WC (r=0.57, p<0.05), SAD (r=0.58, p<0.05), BFP (r=0.48, p<0.05), WC/height ratio (r=0.46, p<0.05), and BSA (r=0.58, p<0.05).Conclusion. Excessive PRFT may be detected isolated without any external anthropometric signs of obesity, wherein it is an active component of metabolic disorders typical for obesity. The most significant indices for the detection of pararenal obesity may be WC, SAD, and BSA.
{"title":"Pararenalfat Tissue: Rate of Pararenal Obesity and Relation with Anthropometric Indices of Obesity","authors":"V. Podzolkov, A. Bragina, K. Osadchiy, J. Rodionova, D. Bayutina","doi":"10.20996/1819-6446-2022-09-04","DOIUrl":"https://doi.org/10.20996/1819-6446-2022-09-04","url":null,"abstract":"Aim. To study a rate of excessive pararenal fat tissue (PRFT) thickness and its relationship with anthropometric obesity indices.Material and methods. 372 patients (152 men and 220 women) were included in the study, the average age was 63.5±13.3 years. There were measured: height, weight, waist circumference (WC), hip circumference (HC), body mass index (BMI), WC/height ratio, sagittal abdominal diameter (SAD), body fat percentage (BFP), body surface area (BSA), body adiposity index (BAI) and visceral obesity index (VAI). All subjects underwent abdominal multispiral computed tomography. PRFT thickness was detected on a single slice at the level of the left renal vein.Results. 27% of the examined group had BMI<25 kg/m2, 28% – excessive body mass, 45% – obesity. The median PRFT thickness was 1.61 (1.03; 2.46) cm. There were correlations between PRFT thickness and glucose (r=0,64, p<0,05) and uric acid (r=0,46, p<0,05) levels. The threshold of referential PRFT thickness was 1,91cm. The rate of pararenal obesity was 9,9% among those with normal body mass, 29,3% in excessive body mass, 66,1% – in 1 class obesity, 67,7% – in 2 class, and 90,1% – in 3 class. The correlation analysis revealed a significant positive correlation between the PRFT thickness and obesity indices with exception of VAI and BAI: with BMI (r=0.43, p<0.05), WC (r=0.57, p<0.05), SAD (r=0.58, p<0.05), BFP (r=0.48, p<0.05), WC/height ratio (r=0.46, p<0.05), and BSA (r=0.58, p<0.05).Conclusion. Excessive PRFT may be detected isolated without any external anthropometric signs of obesity, wherein it is an active component of metabolic disorders typical for obesity. The most significant indices for the detection of pararenal obesity may be WC, SAD, and BSA.","PeriodicalId":20812,"journal":{"name":"Rational Pharmacotherapy in Cardiology","volume":"3 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89645931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sebastian Diebel, Diego Carrion-Alvarez, Wah Praise Senyuy, Marina Shatskikh, Juan C Puyana, Francisco J Bonilla-Escobar
{"title":"Advancing Research Through Early-Career Scientists' Publications and Training the Next Generation of Medical Editors: The First 10-Years of the International Journal of Medical Students.","authors":"Sebastian Diebel, Diego Carrion-Alvarez, Wah Praise Senyuy, Marina Shatskikh, Juan C Puyana, Francisco J Bonilla-Escobar","doi":"10.5195/ijms.2022.1934","DOIUrl":"10.5195/ijms.2022.1934","url":null,"abstract":"","PeriodicalId":20812,"journal":{"name":"Rational Pharmacotherapy in Cardiology","volume":"11 1","pages":"341-343"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10686320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90181158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-08DOI: 10.20996/1819-6446-2022-08-15
A. Safaryan, A. Lishuta, D. Nebieridze
Recently, hyperuricemia and its association with cardiovascular disease have been receiving more and more attention. The article talks about the role of uric acid in the body, the reasons for its increase and the impact of elevated uric acid levels on the cardiovascular system. The mechanisms of influence of hyperuricemia on the development and progression of cardiovascular diseases are presented. Medicinal and non-drug ways to reduce the level of uric acid in the blood are considered. From non-drug methods, attention is focused on the hypopurine diet, adequate drinking regimen and normalization of body weight. Separately, the effect on the level of uric acid of various drugs used in clinical practice is considered. In the light of current clinical guidelines, the issue of the need to prescribe drug therapy for asymptomatic hyperuricemia is discussed.
{"title":"Uric Acid as a Risk Factor for Cardiovascular Diseases","authors":"A. Safaryan, A. Lishuta, D. Nebieridze","doi":"10.20996/1819-6446-2022-08-15","DOIUrl":"https://doi.org/10.20996/1819-6446-2022-08-15","url":null,"abstract":"Recently, hyperuricemia and its association with cardiovascular disease have been receiving more and more attention. The article talks about the role of uric acid in the body, the reasons for its increase and the impact of elevated uric acid levels on the cardiovascular system. The mechanisms of influence of hyperuricemia on the development and progression of cardiovascular diseases are presented. Medicinal and non-drug ways to reduce the level of uric acid in the blood are considered. From non-drug methods, attention is focused on the hypopurine diet, adequate drinking regimen and normalization of body weight. Separately, the effect on the level of uric acid of various drugs used in clinical practice is considered. In the light of current clinical guidelines, the issue of the need to prescribe drug therapy for asymptomatic hyperuricemia is discussed.","PeriodicalId":20812,"journal":{"name":"Rational Pharmacotherapy in Cardiology","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90525554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-08DOI: 10.20996/1819-6446-2022-08-05
A. Vereshchagina, T. Uskach, O. Sapelnikov, V. A. Amanatova, I. Grishin, A. A. Kulikov, V. S. Kostin, R. Akchurin
Aim. To study the safety and tolerability of the subcutaneous implantable cardioverter defibrillator (S-ICD) after implantation.Material and methods. The results of 33 patients with implanted S-ICD 6 months follow-up. The criteria for inclusion in the observational study were: age over 18 years, indications for primary or secondary prevention of sudden cardiac death. The exclusion criteria were indications for implantation of transvenous ICD (patients with sustained monomorphic ventricular tachycardia, the need for anti-bradycardia or resynchronization therapy), as well as patients with a QRS complex of more than 130 msec. All patients underwent a standard preoperative examination (routine blood tests, chest X-ray, transthoracic echocardiography), quality-of-life questionnaires and transesophageal echocardiography. At follow-up, patients were examined after 6 months after implantation, the device was interrogated and a quality-of-life questionnaire was completed. All episodes of shock therapy and complications were documented.Results. Male patients predominated (84%), with a mean age of 57 [43;62] years. Left ventricular ejection fraction was 30% [26;34]. The mean QRS duration was 100 [94;108] msec. According to the of 24-hour Holter ECG monitoring, episodes of unstable VT were recorded in 42.4% of patients. The most common indications for S-ICD implantation were dilated (33%) and ischemic cardiomyopathy (42%). Primary prevention was indicated in 97% of patients. At the end of the implantation of the S-ICD, the patients underwent a defibrillation test and device configuration. In 63.6% of cases, during automatic tuning, the device selected the primary perception vector. In 27.2% of patients, optimal recognition of the subcutaneous signal was observed in the secondary vector, and in 9.2% of patients, the alternative vector was favorable. All patients underwent two-zone programming. The conditional shock zone was programmed at an average rate of 192 beats/min (range 180-210 beats/min) and the shock zone was programmed at an average rate of 222 beats/min (range 220-240 beats/min). Perioperative complications occurred in two patients. During the follow-up period, no shocks were recorded in 27 patients. Adequate shocks for 6 months were recorded in two patients. During 6 months of observation, one lethal outcome was noted due to complications of viral pneumonia. During the observation period, there were no rehospitalizations for cardiovascular diseases.Conclusion. The use of S-ICD, even in patients with structural myocardial disease who do not require antibradycardia pacing, is effective in preventing SCD. The number of inadequate discharges and the number of complications in clinical practice is comparable to the data of multicenter studies. S-ICD implantation was not accompanied by a decrease in quality of life. Careful selection of candidates, along with state-of-the-art device programming, is an important parameter for the selection and success of
{"title":"Safety and Tolerability of Implanted Subcutaneous Cardioverter-Defibrillator Systems","authors":"A. Vereshchagina, T. Uskach, O. Sapelnikov, V. A. Amanatova, I. Grishin, A. A. Kulikov, V. S. Kostin, R. Akchurin","doi":"10.20996/1819-6446-2022-08-05","DOIUrl":"https://doi.org/10.20996/1819-6446-2022-08-05","url":null,"abstract":"Aim. To study the safety and tolerability of the subcutaneous implantable cardioverter defibrillator (S-ICD) after implantation.Material and methods. The results of 33 patients with implanted S-ICD 6 months follow-up. The criteria for inclusion in the observational study were: age over 18 years, indications for primary or secondary prevention of sudden cardiac death. The exclusion criteria were indications for implantation of transvenous ICD (patients with sustained monomorphic ventricular tachycardia, the need for anti-bradycardia or resynchronization therapy), as well as patients with a QRS complex of more than 130 msec. All patients underwent a standard preoperative examination (routine blood tests, chest X-ray, transthoracic echocardiography), quality-of-life questionnaires and transesophageal echocardiography. At follow-up, patients were examined after 6 months after implantation, the device was interrogated and a quality-of-life questionnaire was completed. All episodes of shock therapy and complications were documented.Results. Male patients predominated (84%), with a mean age of 57 [43;62] years. Left ventricular ejection fraction was 30% [26;34]. The mean QRS duration was 100 [94;108] msec. According to the of 24-hour Holter ECG monitoring, episodes of unstable VT were recorded in 42.4% of patients. The most common indications for S-ICD implantation were dilated (33%) and ischemic cardiomyopathy (42%). Primary prevention was indicated in 97% of patients. At the end of the implantation of the S-ICD, the patients underwent a defibrillation test and device configuration. In 63.6% of cases, during automatic tuning, the device selected the primary perception vector. In 27.2% of patients, optimal recognition of the subcutaneous signal was observed in the secondary vector, and in 9.2% of patients, the alternative vector was favorable. All patients underwent two-zone programming. The conditional shock zone was programmed at an average rate of 192 beats/min (range 180-210 beats/min) and the shock zone was programmed at an average rate of 222 beats/min (range 220-240 beats/min). Perioperative complications occurred in two patients. During the follow-up period, no shocks were recorded in 27 patients. Adequate shocks for 6 months were recorded in two patients. During 6 months of observation, one lethal outcome was noted due to complications of viral pneumonia. During the observation period, there were no rehospitalizations for cardiovascular diseases.Conclusion. The use of S-ICD, even in patients with structural myocardial disease who do not require antibradycardia pacing, is effective in preventing SCD. The number of inadequate discharges and the number of complications in clinical practice is comparable to the data of multicenter studies. S-ICD implantation was not accompanied by a decrease in quality of life. Careful selection of candidates, along with state-of-the-art device programming, is an important parameter for the selection and success of","PeriodicalId":20812,"journal":{"name":"Rational Pharmacotherapy in Cardiology","volume":"52 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84322975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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