Pub Date : 2022-08-29DOI: 10.18705/1607-419x-2022-28-4-444-454
I. Pogonysheva, E. Shalamova, D. A. Pogonyshev, M. Bochkarev, O. Ragozin
Objective. The aim of study was to assess the state of cardiovascular system in female students in the northern region during the seasons with extreme photoperiod. Design and methods. The study was conducted in Nizhnevartovsk, Khanty-Mansi Autonomous Okrug-Yugra (a region equated to the Far North) in the seasons with extreme values of photoperiod. The female students of Nizhnevartovsk State University (n = 73) aged 18-21 years were examined. Anthropometric measurements were carried out. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were recorded automatically using UA-101 model tonometer. Pulse and mean dynamic pressure were calculated according to Hickam's formula. On the basis of HR we determined the average duration of cardiac cycle. Autonomic tone was assessed according to calculated Kerdo index (KI). We used CardioVisor-06c to determine the prenosological state of cardiac activity. Results. There was a significant increase in body weight in the short daylight period. The HR during the long daylight period was significantly higher than during light deprivation, leading to a shorter cardiac cycle duration. Seasonal dynamics of blood pressure characteristics were not evident, although during “white nights” at least 10 % female students had SBP higher than 130 mm Hg, and maximal SBP reached 135 mm Hg. KI values demonstrated significant changes in autonomic tone. During short daylight hours average characteristics of KI were negative and reflected activity of parasympathetic activity. Increase of sympathetic influences was during longer daylight hours. During “biological twilight” “Myocardium” index was significantly lower than during white nights. During short daylight hours only 10 % students showed “Myocardium” index over normal values (15 %), while half of respondents had higher values during white nights. “Rhythm” index was normal during the short daylight hours and significantly higher during the long daylight hours, only 10 % participants had normal values. Conclusions. The analysis of electrophysiological parameters of myocardium showed seasonal changes in female students and “white nights” were associated with more negative effects than “biological twilight”. During “white nights” we showed increase in integral indices of dispersion mapping, increase in resting HR and KI.
目标。本研究的目的是评估北方地区女大学生在极端光周期季节的心血管系统状况。设计和方法。该研究是在汉特-曼西自治区Okrug-Yugra(相当于极北地区)的下涅瓦托夫斯克进行的，该季节具有极端的光周期值。对下瓦尔托夫斯克国立大学18 ~ 21岁女大学生73名进行调查。进行了人体测量。采用UA-101型血压计自动记录收缩压(SBP)、舒张压(DBP)和心率(HR)。根据Hickam公式计算脉冲动压和平均动压。在心率的基础上确定心脏周期的平均持续时间。根据计算的Kerdo指数(KI)评估自主神经张力。我们使用CardioVisor-06c来测定心脏活动的先期状态。结果。在白天较短的时间内，体重显著增加。长日照条件下的心率显著高于无光照条件下，导致心脏周期持续时间缩短。尽管在“白夜”期间，至少有10%的女学生的收缩压高于130 mm Hg，最大收缩压达到135 mm Hg，但血压特征的季节性动态并不明显。KI值显示自主神经张力的显著变化。白天短时间KI的平均特征为负，反映副交感神经活动的活跃程度。在较长的白天时间内，交感神经的影响增加。“生物黄昏”时心肌指数明显低于白夜时。在白天较短的时间内，只有10%的学生显示“心肌”指数高于正常值(15%)，而一半的受访者在白夜时的数值更高。“节律”指数在白天较短的时间内是正常的，而在白天较长的时间内明显较高，只有10%的参与者是正常的。结论。对女大学生心肌电生理参数的分析显示，“白夜”比“生物暮光”的负面影响更大。在“白夜”期间，我们发现弥散映射的积分指数增加，静息HR和KI增加。
{"title":"Cardiovascular regulation in female students of northern university during extreme photoperiod seasons","authors":"I. Pogonysheva, E. Shalamova, D. A. Pogonyshev, M. Bochkarev, O. Ragozin","doi":"10.18705/1607-419x-2022-28-4-444-454","DOIUrl":"https://doi.org/10.18705/1607-419x-2022-28-4-444-454","url":null,"abstract":"Objective. The aim of study was to assess the state of cardiovascular system in female students in the northern region during the seasons with extreme photoperiod. Design and methods. The study was conducted in Nizhnevartovsk, Khanty-Mansi Autonomous Okrug-Yugra (a region equated to the Far North) in the seasons with extreme values of photoperiod. The female students of Nizhnevartovsk State University (n = 73) aged 18-21 years were examined. Anthropometric measurements were carried out. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were recorded automatically using UA-101 model tonometer. Pulse and mean dynamic pressure were calculated according to Hickam's formula. On the basis of HR we determined the average duration of cardiac cycle. Autonomic tone was assessed according to calculated Kerdo index (KI). We used CardioVisor-06c to determine the prenosological state of cardiac activity. Results. There was a significant increase in body weight in the short daylight period. The HR during the long daylight period was significantly higher than during light deprivation, leading to a shorter cardiac cycle duration. Seasonal dynamics of blood pressure characteristics were not evident, although during “white nights” at least 10 % female students had SBP higher than 130 mm Hg, and maximal SBP reached 135 mm Hg. KI values demonstrated significant changes in autonomic tone. During short daylight hours average characteristics of KI were negative and reflected activity of parasympathetic activity. Increase of sympathetic influences was during longer daylight hours. During “biological twilight” “Myocardium” index was significantly lower than during white nights. During short daylight hours only 10 % students showed “Myocardium” index over normal values (15 %), while half of respondents had higher values during white nights. “Rhythm” index was normal during the short daylight hours and significantly higher during the long daylight hours, only 10 % participants had normal values. Conclusions. The analysis of electrophysiological parameters of myocardium showed seasonal changes in female students and “white nights” were associated with more negative effects than “biological twilight”. During “white nights” we showed increase in integral indices of dispersion mapping, increase in resting HR and KI.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86601530","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 : 2022-08-25DOI: 10.18705/1607-419x-2022-28-4-464-476
A. Konradi, O. Drapkina, S. Nedogoda, G. P. Arutyunov, Y. Karpov, Z. Kobalava, Y. Orlova, D. Sychev, S. Zyryanov
On December 1, 2021, a meeting of the Council of experts on the treatment of hypertension, coronary heart disease, and chronic heart failure during the COVID-19 pandemic was held remotely to adjust and adapt current approaches to outpatient treatment of the above pathologies under the current epidemiological situation. The meeting was attended by leading Russian specialists from federal medical research centers of cardiology and therapy.
{"title":"Management of patients with hypertension, coronary heart disease and chronic heart failure during the COVID-19 pandemic in the primary care setting","authors":"A. Konradi, O. Drapkina, S. Nedogoda, G. P. Arutyunov, Y. Karpov, Z. Kobalava, Y. Orlova, D. Sychev, S. Zyryanov","doi":"10.18705/1607-419x-2022-28-4-464-476","DOIUrl":"https://doi.org/10.18705/1607-419x-2022-28-4-464-476","url":null,"abstract":"On December 1, 2021, a meeting of the Council of experts on the treatment of hypertension, coronary heart disease, and chronic heart failure during the COVID-19 pandemic was held remotely to adjust and adapt current approaches to outpatient treatment of the above pathologies under the current epidemiological situation. The meeting was attended by leading Russian specialists from federal medical research centers of cardiology and therapy.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"139 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79168536","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 : 2022-08-15DOI: 10.18705/1607-419x-2022-28-5-557-572
A. Kochetkov, S. V. Batyukina, N. A. Shatalova, V. A. De, I. S. Kulikov, N. A. Arablinsky, N. Voevodina, V. R. Shastina, S. Gorbatenkova, M. S. Chernyaeva, O. D. Ostroumova, D. Sychev
Background. Arterial hypertension (AH) is often associated with type 2 diabetes mellitus (DM2), is one of the leading modifiable risk factors for cardiovascular disease, atrial fibrillation (AF), chronic kidney disease (CKD). Progression of renal dysfunction is a powerful predictor of the onset of AF in patients with high blood pressure. Irrational prescription of drugs is a risk factor for adverse drug reactions, which is especially important for elderly patients and leads to an increased risk of adverse clinical outcomes.Objective. To analyze the concordance of pharmacotherapy with the STOPP/START criteria in comorbid elderly patients with AH and combined DM2, CKD and AF treated in a multidisciplinary hospitals.Design and methods. Included data from medical records of 1600 patients aged ≥ 65 years with AH and/or AF admitted to multidisciplinary hospitals in Moscow from July 1, 2018 to June 30, 2019. Patients were divided into two groups — (1) AH in combination with AF (n = 822, women — 73%, median age 87 [79; 90]) and (2) control group (n = 778, women — 79,9%, median age 78 [71; 85]) Evaluation of the appointment of drugs was made according to the “STOPP/START” criteria.Results. The number of patients who were not prescribed the recommended drugs was statistically significant (p < 0,001) and higher in the AH + AF group (785 people, 95,5%) compared to the control group (623 people, 80,1%). The number of patients who were prescribed potentially non-recommended drugs was similarly statistically significant (p < 0,001) higher in the AH + AF group (439, 53,4%) compared to the control group (328, 42,2%). The most common START criteria were: 1. Statins with a documented history of coronary, cerebral or peripheral vascular disease (in the AH + AF group — 672, 81,8% of the number of patients in the group; in the control group — 464, 59,6%; p < 0,001) 2. Clopidogrel in patients with ischemic stroke or a history of peripheral vascular disease (c respectively, 324, 39,4% and 237, 30,5%; p < 0,001) 3. Warfarin/direct oral anticoagulants in AF (in the group AG + FP — 294, 35,8%). The most common STOPP criteria were: 1. Drugs that can increase constipation in chronic constipation, if there is a more suitable alternative (in the AH + AF group — 160, 19,5% of the number of patients in the group; in the control group — 47,6%; p < 0,001). 2. Drugs with anticholinergic activity in chronic constipation (respectively, 111, 13,5% and 74, 9,5%; p = 0,013). 3. Angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers in patients with hyperkalemia (respectively, 26, 3,2 % and 94, 12,1%; p < 0,001). Similar results were obtained in the analysis of subgroups of AH + AF with concomitant DM2, CKD and without them.Conclusions. The results obtained dictate the need to optimize pharmacotherapy in elderly and very old patients with AH and comorbidities in a hospital setting. In practice, START criteria are more common than STOPP, that is, in reality, the nece
{"title":"Analysis of the structure of drug prescriptions in patients with arterial hypertension and atrial fibrillation in conditions of comorbidity and their compliance with the STOPP/START criteria","authors":"A. Kochetkov, S. V. Batyukina, N. A. Shatalova, V. A. De, I. S. Kulikov, N. A. Arablinsky, N. Voevodina, V. R. Shastina, S. Gorbatenkova, M. S. Chernyaeva, O. D. Ostroumova, D. Sychev","doi":"10.18705/1607-419x-2022-28-5-557-572","DOIUrl":"https://doi.org/10.18705/1607-419x-2022-28-5-557-572","url":null,"abstract":"Background. Arterial hypertension (AH) is often associated with type 2 diabetes mellitus (DM2), is one of the leading modifiable risk factors for cardiovascular disease, atrial fibrillation (AF), chronic kidney disease (CKD). Progression of renal dysfunction is a powerful predictor of the onset of AF in patients with high blood pressure. Irrational prescription of drugs is a risk factor for adverse drug reactions, which is especially important for elderly patients and leads to an increased risk of adverse clinical outcomes.Objective. To analyze the concordance of pharmacotherapy with the STOPP/START criteria in comorbid elderly patients with AH and combined DM2, CKD and AF treated in a multidisciplinary hospitals.Design and methods. Included data from medical records of 1600 patients aged ≥ 65 years with AH and/or AF admitted to multidisciplinary hospitals in Moscow from July 1, 2018 to June 30, 2019. Patients were divided into two groups — (1) AH in combination with AF (n = 822, women — 73%, median age 87 [79; 90]) and (2) control group (n = 778, women — 79,9%, median age 78 [71; 85]) Evaluation of the appointment of drugs was made according to the “STOPP/START” criteria.Results. The number of patients who were not prescribed the recommended drugs was statistically significant (p < 0,001) and higher in the AH + AF group (785 people, 95,5%) compared to the control group (623 people, 80,1%). The number of patients who were prescribed potentially non-recommended drugs was similarly statistically significant (p < 0,001) higher in the AH + AF group (439, 53,4%) compared to the control group (328, 42,2%). The most common START criteria were: 1. Statins with a documented history of coronary, cerebral or peripheral vascular disease (in the AH + AF group — 672, 81,8% of the number of patients in the group; in the control group — 464, 59,6%; p < 0,001) 2. Clopidogrel in patients with ischemic stroke or a history of peripheral vascular disease (c respectively, 324, 39,4% and 237, 30,5%; p < 0,001) 3. Warfarin/direct oral anticoagulants in AF (in the group AG + FP — 294, 35,8%). The most common STOPP criteria were: 1. Drugs that can increase constipation in chronic constipation, if there is a more suitable alternative (in the AH + AF group — 160, 19,5% of the number of patients in the group; in the control group — 47,6%; p < 0,001). 2. Drugs with anticholinergic activity in chronic constipation (respectively, 111, 13,5% and 74, 9,5%; p = 0,013). 3. Angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers in patients with hyperkalemia (respectively, 26, 3,2 % and 94, 12,1%; p < 0,001). Similar results were obtained in the analysis of subgroups of AH + AF with concomitant DM2, CKD and without them.Conclusions. The results obtained dictate the need to optimize pharmacotherapy in elderly and very old patients with AH and comorbidities in a hospital setting. In practice, START criteria are more common than STOPP, that is, in reality, the nece","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89984199","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 : 2022-08-15DOI: 10.18705/1607-419x-2022-28-6-710-717
V. Bykov, A. Bykova, O. Aliev, S. A. Stankevich, V. Khazanov, A. I. Vengerovsky, V. Udut
Background. Correction of endothelial dysfunction during arterial hypertension (AH) is an important measure in preventing cerebrovascular stroke. Drugs activating soluble guanylate cyclase (sGC) and 3’,5’-guanosine monophosphate (cGMP) production independently of nitric oxide (NO) were shown to be therapeutically useful in reducing the risk of stroke. The present work aims to study the antiaggregant and endothelium-protective activity of a new sGC stimulator, an indolinone derivative (2-[2-[(5RS)-5-(hydroxymethyl)-3-methyl-1,3-oxazolidine-2- yliden]-2-cyanoethylidene]-1H-indole-3(2H)-one (codename — GRS) in a model of ischemic stroke with AH. Prior studies have shown that GRS compound inhibits platelet aggregation, lowers blood pressure (BP) in spontaneouslyhypertensive SHR rats, prevents vascular occlusion in models of arterial and venous thrombosis. Antiplatelet drug clopidogrel, a P2Y12 receptor inhibitor, included in the standard of care for secondary prevention of ischemic stroke, was used as the reference drug.Objective. To assess the antiaggregant and endothelium-protective activity of a new indolinone derivative GRS, an sGC stimulator, compared to clopidogrel in a model of ischemic stroke concomitant with high arterial BP in spontaneously-hypertensive SHR rats.Design and methods. Focal brain ischemia/reperfusion was modelled in spontaneously-hypertensive SHR rats (n = 78). GRS in 10 mg/kg dose and clopidogrel in 10 mg/kg dose were administered orally once daily 3 days before modelling ischemia/reperfusion and for 5 days afterwards. Platelet aggregation and functioning of vascular endothelium were monitored.Results. Focal brain ischemia/reperfusion in SHR rats resulted in increased platelet aggregation and the development of endothelial dysfunction and disruption of vasodilatory function of endothelium. GRS compound and clopidogrel in repeated administration have prevented an increase in platelet aggregation (p < 0,05), GRS compound also alleviated endothelial dysfunction (p < 0,05).Conclusions. The indolinone derivative GRS, an sGC stimulator, inhibits increased platelet aggregation and prevents endothelial dysfunction in rats after focal brain ischemia/ reperfusion; the endothelium-protective effects of GRS aren’t related to its antiaggregant activity.
{"title":"Influence of a new stimulator of soluble guanylate cyclase on platelet aggregation and vascular endothelial function in experimental ischemic stroke against the background of arterial hypertension","authors":"V. Bykov, A. Bykova, O. Aliev, S. A. Stankevich, V. Khazanov, A. I. Vengerovsky, V. Udut","doi":"10.18705/1607-419x-2022-28-6-710-717","DOIUrl":"https://doi.org/10.18705/1607-419x-2022-28-6-710-717","url":null,"abstract":"Background. Correction of endothelial dysfunction during arterial hypertension (AH) is an important measure in preventing cerebrovascular stroke. Drugs activating soluble guanylate cyclase (sGC) and 3’,5’-guanosine monophosphate (cGMP) production independently of nitric oxide (NO) were shown to be therapeutically useful in reducing the risk of stroke. The present work aims to study the antiaggregant and endothelium-protective activity of a new sGC stimulator, an indolinone derivative (2-[2-[(5RS)-5-(hydroxymethyl)-3-methyl-1,3-oxazolidine-2- yliden]-2-cyanoethylidene]-1H-indole-3(2H)-one (codename — GRS) in a model of ischemic stroke with AH. Prior studies have shown that GRS compound inhibits platelet aggregation, lowers blood pressure (BP) in spontaneouslyhypertensive SHR rats, prevents vascular occlusion in models of arterial and venous thrombosis. Antiplatelet drug clopidogrel, a P2Y12 receptor inhibitor, included in the standard of care for secondary prevention of ischemic stroke, was used as the reference drug.Objective. To assess the antiaggregant and endothelium-protective activity of a new indolinone derivative GRS, an sGC stimulator, compared to clopidogrel in a model of ischemic stroke concomitant with high arterial BP in spontaneously-hypertensive SHR rats.Design and methods. Focal brain ischemia/reperfusion was modelled in spontaneously-hypertensive SHR rats (n = 78). GRS in 10 mg/kg dose and clopidogrel in 10 mg/kg dose were administered orally once daily 3 days before modelling ischemia/reperfusion and for 5 days afterwards. Platelet aggregation and functioning of vascular endothelium were monitored.Results. Focal brain ischemia/reperfusion in SHR rats resulted in increased platelet aggregation and the development of endothelial dysfunction and disruption of vasodilatory function of endothelium. GRS compound and clopidogrel in repeated administration have prevented an increase in platelet aggregation (p < 0,05), GRS compound also alleviated endothelial dysfunction (p < 0,05).Conclusions. The indolinone derivative GRS, an sGC stimulator, inhibits increased platelet aggregation and prevents endothelial dysfunction in rats after focal brain ischemia/ reperfusion; the endothelium-protective effects of GRS aren’t related to its antiaggregant activity.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74348770","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 : 2022-08-11DOI: 10.18705/1607-419x-2022-28-4-405-418
V. Ionin, V. Pavlova, A. M. Ananyin, E. Barashkova, E. Zaslavskaya, A. N. Morozov, E. Baranova
Objective. To determine the blood concentrations of biomarkers of fibrosis and inflammation in patients with metabolic syndrome (MS), atrial fibrillation (AF) and obstructive sleep apnea (OSA) and to establish their role in the formation of left atrial myocardial fibrosis. Design and methods. A cross-sectional case-control study included 286 patients aged 35 to 65 years: 78 patients with MS(+)/AF(+)/OSA(+), 79 patients with MS(+) / AF(+)/OSA(-), 73 patients with MS(+)/AF(-)/OSA(+) and 56 patients with MS(+)/AF(-)/OSA(-). Patients with AF and MS (n = 71) were assessed for the severity of left atrial myocardial fibrosis with electroanatomical mapping. Results. It was found that the concentration of profibrogenic biomarkers circulating in the blood of patients with MS(+)/AF(+)/OSA(+) is higher than in patients with MS(+)/AF(-)/OSA(+): galectin-3 (13,4 (8,5-17,6) and 8,4 (5,1-11,6) pg/ml, p < 0,0001), growth differentiation factor-15 (GDF-15) (1648,3 (775,32568,1) and 856,0 (622,5-1956,4) pg/ml, p < 0,0001), N-terminal peptide of type III procollagen (PIIINP) (95,6 (78,6-120,4) and 50,6 (38,9-68,3) ng/ml, p < 0,0001), N-terminal peptide of type I procollagen (PINP) (3459,4 (2167,1-4112,1) and 2355,3 (1925,0-3382,1) pg/ml, p < 0,0001). In the examined cohort of patients with OSA, positive correlations were found between galectin-3 and cardiotrophin-1 (r = 0,410, p = 0,00002), galectin-3 and GDF-15 (r = 0,430, p = 0,0003), galectin-3 and PIIINP (r = 0,451, p = 0,0001). Correlation analysis showed a strong positive relationship between the apnea/hypopnea index (AHI) and blood concentrations of GDF-15 (r = 0,661, p < 0,00001), galectin-3 (r = 0,519, p < 0,00001), interleukin 6 (r = 0,310, p = 0,0001) and C-reactive protein (CRP) (r = 0,361, p = 0,002). Negative correlations of the average level of SpO2 with CRP (r = -0,354, p = 0,001), galectin-3 (r = -0,451, p < 0,00001), GDF-15 (r = -0,637, p < 0,00001) were found. In patients with AF and OSA, fibrosis was more severe than in patients with AF without OSA (28,6 (23,6-36,6) and 13,5 (9,9-23,6) %, p = 0,0002). AHI positively correlated with the severity of fibrosis (r = 0,708, p < 0,00001). The patients with AF and OSA showed the strongest positive relationship between the severity of fibrosis and PINP (r = 0,572, p < 0,0001; в = 0,511, p < 0,0001) and galectin-3 (r = 0,449, p = 0,0009; в = 0,807, p < 0,0001). Conclusions. An increase in the concentration of fibrosis biomarkers in the blood is associated with an increase in the severity of left atrial myocardial fibrosis and probably has a pathogenetic role in increasing the risk of AF in patients with MS and OSA.
目标。测定代谢综合征(MS)、心房颤动(AF)和阻塞性睡眠呼吸暂停(OSA)患者血液中纤维化和炎症生物标志物的浓度，并确定其在左心房心肌纤维化形成中的作用。设计和方法。横断面病例对照研究纳入286例年龄在35 ~ 65岁的患者:78例MS(+)/AF(+)/OSA(+)， 79例MS(+)/AF(+)/OSA(-)， 73例MS(+)/AF(-)/OSA(+)， 56例MS(+)/AF(-)/OSA(-)。采用电解剖作图法评估房颤和多发性硬化症患者(71例)左心房心肌纤维化严重程度。结果。结果发现，MS(+)/AF(+)/OSA(+)患者血液中循环的促纤维化生物标志物浓度高于MS(+)/AF(-)/OSA(+)患者:半乳糖凝集素-3(13,4(8,5-17,6)和8,4 (5,1-11,6)pg/ml, p < 0,0001)，生长分化因子-15 (GDF-15)(1648,3(775,32568,1)和856,0 (622,5-1956,4)pg/ml, p < 0,0001)， III型前胶原n端肽(PIIINP)(95,6(78,6-120,4)和50,6 (38,9-68,3)ng/ml, p < 0,0001)， I型前胶原n端肽(PINP)(345,4(2167,1-4112,1)和2355,3 (1925,0-3382,1)pg/ml, p < 0,0001)。在OSA患者队列中，半乳糖凝集素-3与心营养因子-1呈正相关(r = 0,410, p = 0,00002)，半乳糖凝集素-3与GDF-15呈正相关(r = 0,430, p = 0,0003)，半乳糖凝集素-3与PIIINP呈正相关(r = 0,451, p = 0,0001)。相关分析显示，呼吸暂停/低通气指数(AHI)与血中GDF-15 (r = 0.661, p < 0.00001)、半凝集素-3 (r = 0.519, p < 0.00001)、白细胞介素6 (r = 0.310, p = 0.0001)、c反应蛋白(CRP) (r = 0.361, p = 0.002)浓度呈正相关。SpO2平均水平与CRP (r = -0,354, p = 0,001)、半凝集素-3 (r = -0,451, p < 0,00001)、GDF-15 (r = -0,637, p < 0,00001)呈负相关。房颤合并OSA患者比房颤不合并OSA患者纤维化更严重(28.6(23,6-36,6)%和13.5 (9,9-23,6)%，p = 0,0002)。AHI与纤维化严重程度呈正相关(r = 0,708, p < 0,001)。房颤和OSA患者纤维化严重程度与PINP呈正相关(r = 0.572, p < 0.0001;(r = 0,449, p = 0,0009;(p < 0,0001)。结论。血液中纤维化生物标志物浓度的增加与左心房心肌纤维化严重程度的增加有关，并且可能在MS和OSA患者中增加房颤风险方面具有病理作用。
{"title":"Atrial fibrillation in patients with obstructive sleep apnea and metabolic syndrome: the role of cytokines in the development of left atrial myocardial fibrosis","authors":"V. Ionin, V. Pavlova, A. M. Ananyin, E. Barashkova, E. Zaslavskaya, A. N. Morozov, E. Baranova","doi":"10.18705/1607-419x-2022-28-4-405-418","DOIUrl":"https://doi.org/10.18705/1607-419x-2022-28-4-405-418","url":null,"abstract":"Objective. To determine the blood concentrations of biomarkers of fibrosis and inflammation in patients with metabolic syndrome (MS), atrial fibrillation (AF) and obstructive sleep apnea (OSA) and to establish their role in the formation of left atrial myocardial fibrosis. Design and methods. A cross-sectional case-control study included 286 patients aged 35 to 65 years: 78 patients with MS(+)/AF(+)/OSA(+), 79 patients with MS(+) / AF(+)/OSA(-), 73 patients with MS(+)/AF(-)/OSA(+) and 56 patients with MS(+)/AF(-)/OSA(-). Patients with AF and MS (n = 71) were assessed for the severity of left atrial myocardial fibrosis with electroanatomical mapping. Results. It was found that the concentration of profibrogenic biomarkers circulating in the blood of patients with MS(+)/AF(+)/OSA(+) is higher than in patients with MS(+)/AF(-)/OSA(+): galectin-3 (13,4 (8,5-17,6) and 8,4 (5,1-11,6) pg/ml, p < 0,0001), growth differentiation factor-15 (GDF-15) (1648,3 (775,32568,1) and 856,0 (622,5-1956,4) pg/ml, p < 0,0001), N-terminal peptide of type III procollagen (PIIINP) (95,6 (78,6-120,4) and 50,6 (38,9-68,3) ng/ml, p < 0,0001), N-terminal peptide of type I procollagen (PINP) (3459,4 (2167,1-4112,1) and 2355,3 (1925,0-3382,1) pg/ml, p < 0,0001). In the examined cohort of patients with OSA, positive correlations were found between galectin-3 and cardiotrophin-1 (r = 0,410, p = 0,00002), galectin-3 and GDF-15 (r = 0,430, p = 0,0003), galectin-3 and PIIINP (r = 0,451, p = 0,0001). Correlation analysis showed a strong positive relationship between the apnea/hypopnea index (AHI) and blood concentrations of GDF-15 (r = 0,661, p < 0,00001), galectin-3 (r = 0,519, p < 0,00001), interleukin 6 (r = 0,310, p = 0,0001) and C-reactive protein (CRP) (r = 0,361, p = 0,002). Negative correlations of the average level of SpO2 with CRP (r = -0,354, p = 0,001), galectin-3 (r = -0,451, p < 0,00001), GDF-15 (r = -0,637, p < 0,00001) were found. In patients with AF and OSA, fibrosis was more severe than in patients with AF without OSA (28,6 (23,6-36,6) and 13,5 (9,9-23,6) %, p = 0,0002). AHI positively correlated with the severity of fibrosis (r = 0,708, p < 0,00001). The patients with AF and OSA showed the strongest positive relationship between the severity of fibrosis and PINP (r = 0,572, p < 0,0001; в = 0,511, p < 0,0001) and galectin-3 (r = 0,449, p = 0,0009; в = 0,807, p < 0,0001). Conclusions. An increase in the concentration of fibrosis biomarkers in the blood is associated with an increase in the severity of left atrial myocardial fibrosis and probably has a pathogenetic role in increasing the risk of AF in patients with MS and OSA.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"137 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84037657","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 : 2022-08-08DOI: 10.18705/1607-419x-2022-28-6-627-640
M. Batiushin
The article is a review of information about the management of arterial hypertension (AH) on hemodialysis. This problem is relevant due to poor elaboration. At the same time, the prevalence of AH on hemodialysis is 91,4 %. The article discusses surveys concerning criteria for determining AH on hemodialysis and methodological approaches to its registration, target values of blood pressure during therapy. The concept of intradialysis hypertension, issues of the pathogenesis of AH on hemodialysis are also considered. The author presents approaches to nondrug therapy and drug treatment of patients with AH on hemodialysis. In particular, approaches to the control of sodium and volemic status within the framework of patient-dependent and apparatus-dependent technologies are considered. Data on the effectiveness of the use of certain classes of antihypertensive drugs are presented, in particular, diuretics, blockers of the renin-angiotensin-aldosterone system, beta-blockers, calcium channel antagonists, mineralocorticoid receptors are considered. The article reflects the needs of modern clinical practice in conducting evidence-based medicine research and identifies the critical points of orientation of such research.
{"title":"Management of arterial hypertension in patients with chronic kidney disease on hemodialysis","authors":"M. Batiushin","doi":"10.18705/1607-419x-2022-28-6-627-640","DOIUrl":"https://doi.org/10.18705/1607-419x-2022-28-6-627-640","url":null,"abstract":"The article is a review of information about the management of arterial hypertension (AH) on hemodialysis. This problem is relevant due to poor elaboration. At the same time, the prevalence of AH on hemodialysis is 91,4 %. The article discusses surveys concerning criteria for determining AH on hemodialysis and methodological approaches to its registration, target values of blood pressure during therapy. The concept of intradialysis hypertension, issues of the pathogenesis of AH on hemodialysis are also considered. The author presents approaches to nondrug therapy and drug treatment of patients with AH on hemodialysis. In particular, approaches to the control of sodium and volemic status within the framework of patient-dependent and apparatus-dependent technologies are considered. Data on the effectiveness of the use of certain classes of antihypertensive drugs are presented, in particular, diuretics, blockers of the renin-angiotensin-aldosterone system, beta-blockers, calcium channel antagonists, mineralocorticoid receptors are considered. The article reflects the needs of modern clinical practice in conducting evidence-based medicine research and identifies the critical points of orientation of such research.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80856971","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 : 2022-08-01DOI: 10.18705/1607-419x-2022-28-6-614-626
A. Spiridonov, A. Khudiakova, E. Striukova
This review presents the results of research in the field of studying associations of biochemical and molecular genetic markers of kidney damage in arterial hypertension. Information on the topic from publications of PubMed, Google Scholar databases was used.
{"title":"Biochemical and molecular genetic markers of kidney damage in hypertension","authors":"A. Spiridonov, A. Khudiakova, E. Striukova","doi":"10.18705/1607-419x-2022-28-6-614-626","DOIUrl":"https://doi.org/10.18705/1607-419x-2022-28-6-614-626","url":null,"abstract":"This review presents the results of research in the field of studying associations of biochemical and molecular genetic markers of kidney damage in arterial hypertension. Information on the topic from publications of PubMed, Google Scholar databases was used. ","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81434902","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 : 2022-08-01DOI: 10.18705/1607-419x-2022-28-4-455-463
A. Vertkin, G. J. Knorring, M. I. Ottinova
Hypertension (HTN) is currently regarded as the most prevalent risk factor, which can lead to both stroke and cognitive impairment. The versatility and similarity of HTN and chronic cerebral ischemia (CCI) pathogenetic mechanisms should be considered in prevention and treatment strategies. The severity of pathological changes in central nervous system (CNS) depends on the degree of HTN and concomitant neurological pathologies. The drug effects on both vascular and cognitive dysfunctions as well as comorbidities and polypharmacy should be considered. The use of agents with polymodal pleiotropic effects both at metabolic and circulation levels appears feasible and rewarding ethylmethylhydroxypyridine malate can be recommended in HTN co-existent with CCI and cognitive disorders. The combination therapy of ethylmethylhydroxypyridine malate with antihypertensive, anti-ischemic drugs, anticoagulants and statins has been proven to be safe, shows low risk of adverse events and can be implemented in a wide range of vascular and comorbid diseases.
{"title":"Hypertension and cognitive impairment: relationship and management approaches","authors":"A. Vertkin, G. J. Knorring, M. I. Ottinova","doi":"10.18705/1607-419x-2022-28-4-455-463","DOIUrl":"https://doi.org/10.18705/1607-419x-2022-28-4-455-463","url":null,"abstract":"Hypertension (HTN) is currently regarded as the most prevalent risk factor, which can lead to both stroke and cognitive impairment. The versatility and similarity of HTN and chronic cerebral ischemia (CCI) pathogenetic mechanisms should be considered in prevention and treatment strategies. The severity of pathological changes in central nervous system (CNS) depends on the degree of HTN and concomitant neurological pathologies. The drug effects on both vascular and cognitive dysfunctions as well as comorbidities and polypharmacy should be considered. The use of agents with polymodal pleiotropic effects both at metabolic and circulation levels appears feasible and rewarding ethylmethylhydroxypyridine malate can be recommended in HTN co-existent with CCI and cognitive disorders. The combination therapy of ethylmethylhydroxypyridine malate with antihypertensive, anti-ischemic drugs, anticoagulants and statins has been proven to be safe, shows low risk of adverse events and can be implemented in a wide range of vascular and comorbid diseases.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77884976","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 : 2022-07-29DOI: 10.18705/1607-419x-2022-28-4-396-404
N. Karoli, O. T. Zarmanbetova, A. Rebrov
Background. Cardiovascular disease is one of the major causes of death throughout the world. Early detection of target organ damage is important for more successful cardiovascular prevention and improvement of patient outcomes. Vascular wall is one of the target organs, and its damage is associated with the loss of elastic properties and increase in stiffness. The increased vascular stiffness is an independent predictor of cardiovascular risk. Objective. To evaluate parameters of the 24-hour arterial stiffness monitoring in hypertensive and normotensive patients with bronchial asthma. Design and methods. The study enrolled 100 patients with asthma. The control group included 30 healthy volunteers matched by gender and age. Each patient underwent ambulatory blood pressure and arterial stiffness monitoring using BPLab MnSDP-2 device (Petr Telegin, Russia). Results. Normotensive patients with asthma show higher values of arterial stiffness index and pulse wave velocity in the aorta in comparison with the control group. Comorbid patients with bronchial asthma and hypertension show the highest arterial stiffness. Conclusion. Patients with asthma with and without hypertension demonstrated significantly increased arterial stiffness in comparison with control group.
{"title":"24-hour arterial stiffness monitoring in hypertensive and normotensive patients with bronchial asthma","authors":"N. Karoli, O. T. Zarmanbetova, A. Rebrov","doi":"10.18705/1607-419x-2022-28-4-396-404","DOIUrl":"https://doi.org/10.18705/1607-419x-2022-28-4-396-404","url":null,"abstract":"Background. Cardiovascular disease is one of the major causes of death throughout the world. Early detection of target organ damage is important for more successful cardiovascular prevention and improvement of patient outcomes. Vascular wall is one of the target organs, and its damage is associated with the loss of elastic properties and increase in stiffness. The increased vascular stiffness is an independent predictor of cardiovascular risk. Objective. To evaluate parameters of the 24-hour arterial stiffness monitoring in hypertensive and normotensive patients with bronchial asthma. Design and methods. The study enrolled 100 patients with asthma. The control group included 30 healthy volunteers matched by gender and age. Each patient underwent ambulatory blood pressure and arterial stiffness monitoring using BPLab MnSDP-2 device (Petr Telegin, Russia). Results. Normotensive patients with asthma show higher values of arterial stiffness index and pulse wave velocity in the aorta in comparison with the control group. Comorbid patients with bronchial asthma and hypertension show the highest arterial stiffness. Conclusion. Patients with asthma with and without hypertension demonstrated significantly increased arterial stiffness in comparison with control group.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"54 s68","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72389797","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 : 2022-07-18DOI: 10.18705/1607-419x-2022-28-4-357-375
S. Mironova, N. Koziolova
The review article presents the stages of the use of menopausal hormone therapy (MHT) from the standpoint of primary and secondary prevention of the risk of developing coronary heart disease (CHD) and deaths. Based on the data obtained, a number of guidelines and statement documents have been updated to reflect the need to comply with the “time hypothesis” in the appointment of MHT in order to improve the prognosis. The arguments of the possible use of MHT are shown both in the primary prevention of cardiovascular diseases in women with cardiovascular risk factors, and in patients with a history of coronary artery disease, myocardial infarctions, with the development of chronic heart failure and atrial fibrillation. In 2021, a proposal was put forward to determine the choice of MHT depending on the cardiovascular risk groups (CVR). However, such an approach to the choice of MHT excludes the personification and individualization of the possibility of using this method of treatment in the presence of certain factors of low, intermediate CVR, such as arterial hypertension, hypercholesterolemia, type 2 diabetes mellitus and others, especially with their good control. Therefore, the adoption of clinical decisions on the use of MHT in conditions of high CVR and the presence of individual clinically significant risk factors should be carried out by a multidisciplinary team, which will exclude both unmotivated prohibitions and appointments in the presence of contraindications.
{"title":"The use of menopausal hormone therapy in women at high cardiovascular risk","authors":"S. Mironova, N. Koziolova","doi":"10.18705/1607-419x-2022-28-4-357-375","DOIUrl":"https://doi.org/10.18705/1607-419x-2022-28-4-357-375","url":null,"abstract":"The review article presents the stages of the use of menopausal hormone therapy (MHT) from the standpoint of primary and secondary prevention of the risk of developing coronary heart disease (CHD) and deaths. Based on the data obtained, a number of guidelines and statement documents have been updated to reflect the need to comply with the “time hypothesis” in the appointment of MHT in order to improve the prognosis. The arguments of the possible use of MHT are shown both in the primary prevention of cardiovascular diseases in women with cardiovascular risk factors, and in patients with a history of coronary artery disease, myocardial infarctions, with the development of chronic heart failure and atrial fibrillation. In 2021, a proposal was put forward to determine the choice of MHT depending on the cardiovascular risk groups (CVR). However, such an approach to the choice of MHT excludes the personification and individualization of the possibility of using this method of treatment in the presence of certain factors of low, intermediate CVR, such as arterial hypertension, hypercholesterolemia, type 2 diabetes mellitus and others, especially with their good control. Therefore, the adoption of clinical decisions on the use of MHT in conditions of high CVR and the presence of individual clinically significant risk factors should be carried out by a multidisciplinary team, which will exclude both unmotivated prohibitions and appointments in the presence of contraindications.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79222344","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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