Pub Date : 2023-10-11DOI: 10.38109/2225-1685-2023-3-68-74
P. A. Semenova, V. A. Nevzorova, N. G. Plekhova, I. N. Chernenko, E. K. Lemtyugova
Purpose : to assess the state of mitochondrial membrane potential of blood leukocytes in acute coronary syndrome (ACS) depending on the presence and absence of type 2 diabetes mellitus (T2DM). Material and Methods . The study involved 100 people hospitalized at the regional vascular center (RCC) of the Vladivostok Clinical Hospital No. 1 with a diagnosis of ACS, aged 35 to 65 years. The control group consisted of 30 apparently healthy volunteers of the same age and sex. At the time of admission, all patients underwent studies for the diagnosis of ACS, including an assessment of the content of troponin I (TrI), and the marker of the precursor of the cerebral natriuretic peptide (NTproBNP) and the membrane potential of mitochondria (MPM) of blood leukocytes were determined. Results . Indicators of the state MMP made it possible to assess the content of dead and living cells in the blood of the examined persons. An increase in non-viable leukocytes in the blood patients with all types of ACS, including myocardial infarction (MI) and unstable angina (UA), was established. A direct relationship was found between the increase in the number of these cells and the content of TrI in MI and a direct relationship between it and NTproBNP both in MI and NS. In patients with ACS, no significant difference was found between the MMP values of leukocytes depending on the presence of T2DM. Conclusion . An increase in the MPMP of blood leukocytes in patients accompanies of the redox balance disturbance in ACS. The established relationship between MPMP indices in MI and the content of TrI can be considered as a confirming fact of the participation of cells with mitochondrial dysfunction in the development of ischemic necrosis. The found relationship between the increase in blood leukocyte MPMP in patients with ACS and the level of NTproBNP indicates a certain contribution of mitochondrial dysfunction of leukocytes to the development of myocardial remodeling, regardless of the clinical form of ACS and the presence of DM2.
{"title":"The state of the membrane potential of the mitochondria of blood leukocytes in acute coronary syndrome","authors":"P. A. Semenova, V. A. Nevzorova, N. G. Plekhova, I. N. Chernenko, E. K. Lemtyugova","doi":"10.38109/2225-1685-2023-3-68-74","DOIUrl":"https://doi.org/10.38109/2225-1685-2023-3-68-74","url":null,"abstract":"Purpose : to assess the state of mitochondrial membrane potential of blood leukocytes in acute coronary syndrome (ACS) depending on the presence and absence of type 2 diabetes mellitus (T2DM). Material and Methods . The study involved 100 people hospitalized at the regional vascular center (RCC) of the Vladivostok Clinical Hospital No. 1 with a diagnosis of ACS, aged 35 to 65 years. The control group consisted of 30 apparently healthy volunteers of the same age and sex. At the time of admission, all patients underwent studies for the diagnosis of ACS, including an assessment of the content of troponin I (TrI), and the marker of the precursor of the cerebral natriuretic peptide (NTproBNP) and the membrane potential of mitochondria (MPM) of blood leukocytes were determined. Results . Indicators of the state MMP made it possible to assess the content of dead and living cells in the blood of the examined persons. An increase in non-viable leukocytes in the blood patients with all types of ACS, including myocardial infarction (MI) and unstable angina (UA), was established. A direct relationship was found between the increase in the number of these cells and the content of TrI in MI and a direct relationship between it and NTproBNP both in MI and NS. In patients with ACS, no significant difference was found between the MMP values of leukocytes depending on the presence of T2DM. Conclusion . An increase in the MPMP of blood leukocytes in patients accompanies of the redox balance disturbance in ACS. The established relationship between MPMP indices in MI and the content of TrI can be considered as a confirming fact of the participation of cells with mitochondrial dysfunction in the development of ischemic necrosis. The found relationship between the increase in blood leukocyte MPMP in patients with ACS and the level of NTproBNP indicates a certain contribution of mitochondrial dysfunction of leukocytes to the development of myocardial remodeling, regardless of the clinical form of ACS and the presence of DM2.","PeriodicalId":495975,"journal":{"name":"Evrazijskij kardiologičeskij žurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136062674","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 : 2023-10-11DOI: 10.38109/2225-1685-2023-3-44-52
E. S. Allakhverdiev, E. A. Rezukhina, O. V. Slatinskaya, O. V. Rodnenkov, G. V. Maksimov, T. V. Martynyuk
In the complex pathogenesis of idiopathic pulmonary arterial hypertension (IPAH), which includes changes in biochemical and biophysical processes in various cell types as the cause of structural and functional impairment, inflammation and thrombosis of the pulmonary vessels, hypoxia also plays an important role due to conformational changes in hemoglobin molecules with changes in their structure and oxygen transport function impairment. Aim : Using the method of Raman (Raman scattering) spectroscopy, to study changes in the conformation and ability of hemoglobin (Hb) to bind oxygen in blood erythrocytes from the cubital vein in IPAH patients and healthy people. Materials and methods: The study included 39 patients with newly diagnosed IPAH with functional class I – 2 patients, II – 13 patients, III – 22 patients, IV – 2 patients. 15 patients were treatment naive. In 24 patients a “washout” period of trial therapy was conducted for 5–7 days. The control group included 10 healthy volunteers. Results : It was established that the Raman spectra of Hb of whole blood erythrocytes and isolated red blood cells (RBC) of IPAH patients have significant differences from the control group. The IPAH group was characterized by an increase in the probability of finding heme in a «dome-shaped form», which is typical for the deoxygenated form of Hb, changes in the conformation of globin and the porphyrin macrocycle were revealed. A significant role in the change in the oxygen-transport function of Hb in IPAH was played by a change in the conformation of membrane-bound hemoglobin, which was characterized by an increase in the contribution of symmetrical vibrations of pyrrole rings in hemoporphyrin relative to the control, which required further study. Probably, the reason for the decrease in the ability of the oxygen transport function of membrane-bound hemoglobin was the decrease in the efficiency of electrostatic interaction with the protein of band 3. In clinical case positive changes in spectroscopy parameters were shown in IPAH patient with the effective use of selexipag. Conclusions : For the first time, the possibility of using a non-invasive method of Raman spectroscopy to study changes in the oxygen transport function of erythrocytes in IPAH patients has been proven, which can serve as an additional method in the diagnostic algorithm of this disease.
{"title":"Possibility of evaluation of oxygen transport function in PAH patients on effective selexipag-based therapy","authors":"E. S. Allakhverdiev, E. A. Rezukhina, O. V. Slatinskaya, O. V. Rodnenkov, G. V. Maksimov, T. V. Martynyuk","doi":"10.38109/2225-1685-2023-3-44-52","DOIUrl":"https://doi.org/10.38109/2225-1685-2023-3-44-52","url":null,"abstract":"In the complex pathogenesis of idiopathic pulmonary arterial hypertension (IPAH), which includes changes in biochemical and biophysical processes in various cell types as the cause of structural and functional impairment, inflammation and thrombosis of the pulmonary vessels, hypoxia also plays an important role due to conformational changes in hemoglobin molecules with changes in their structure and oxygen transport function impairment. Aim : Using the method of Raman (Raman scattering) spectroscopy, to study changes in the conformation and ability of hemoglobin (Hb) to bind oxygen in blood erythrocytes from the cubital vein in IPAH patients and healthy people. Materials and methods: The study included 39 patients with newly diagnosed IPAH with functional class I – 2 patients, II – 13 patients, III – 22 patients, IV – 2 patients. 15 patients were treatment naive. In 24 patients a “washout” period of trial therapy was conducted for 5–7 days. The control group included 10 healthy volunteers. Results : It was established that the Raman spectra of Hb of whole blood erythrocytes and isolated red blood cells (RBC) of IPAH patients have significant differences from the control group. The IPAH group was characterized by an increase in the probability of finding heme in a «dome-shaped form», which is typical for the deoxygenated form of Hb, changes in the conformation of globin and the porphyrin macrocycle were revealed. A significant role in the change in the oxygen-transport function of Hb in IPAH was played by a change in the conformation of membrane-bound hemoglobin, which was characterized by an increase in the contribution of symmetrical vibrations of pyrrole rings in hemoporphyrin relative to the control, which required further study. Probably, the reason for the decrease in the ability of the oxygen transport function of membrane-bound hemoglobin was the decrease in the efficiency of electrostatic interaction with the protein of band 3. In clinical case positive changes in spectroscopy parameters were shown in IPAH patient with the effective use of selexipag. Conclusions : For the first time, the possibility of using a non-invasive method of Raman spectroscopy to study changes in the oxygen transport function of erythrocytes in IPAH patients has been proven, which can serve as an additional method in the diagnostic algorithm of this disease.","PeriodicalId":495975,"journal":{"name":"Evrazijskij kardiologičeskij žurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136062451","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 : 2023-10-11DOI: 10.38109/2225-1685-2023-3-54-61
A. S. Zalesov, D. Y. Kozmin, S. A. Budagaev, A. V. Afanasyev, R. M. Sharifulin, S. I. Zheleznev, A. V. Bogachev-Prokophiev, A. M. Chernyavsky
Background . Septal myectomy is currently the «gold» standard of surgical treatment of patients with obstructive hypertrophic cardiomyopathy. In some cases, isolated septal myectomy does not eliminate SAM-induced mitral insufficiency. Cardiac surgeons sometimes perform combined interventions on the mitral valve, such as «edge-to-edge» mitral valve repair. Aim . Evaluation of the safety and efficacy of combined edge-to-edge mitral valve repair in septal myectomy compared with isolated septal myectomy. Methods . Recruitment to the study was carried out for the period from 2019 to 2022 at the Meshalkin National Medical Research Center of the Ministry of Health of Russia. Twenty patients was performed combined «edge-to-edge» mitral valve repair with septal myectomy, 20 patients with isolated myectomy were included in the control group. The study assessed immediate and mid-term results after 12 months. Results . Combined edge-to-edge mitral valve repair demonstrates better intraoperative efficacy compared with isolated septal myectomy (95,0% versus 50,0%, p=0,001), but is accompanied by increased transmitral peak (6,8±2,1 vs 4,9±3,2 mmHg, p=0,03) and medium (3,4±1,4 vs 2,5±1,7 mmHg, p=0,05) gradients. Both techniques are associated with a low level of hospital mortality and complications in the early postoperative period, high survival after 12 months. Conclusion . Combined mitral valve repair using the «edge-to-edge» technique is comparable safe to isolated myectomy, but better eliminates SAM-induced mitral insufficiency. «Edge-to-edge» mitral valve repair is characterized by increased transmitral gradients.
背景。鼻中隔肌切除术是目前梗阻性肥厚性心肌病手术治疗的“金”标准。在某些情况下，孤立性膈肌切除术不能消除萨姆诱发的二尖瓣功能不全。心脏外科医生有时会对二尖瓣进行联合干预，如“边缘到边缘”二尖瓣修复。的目标。二尖瓣边缘对边缘联合修复与孤立二尖瓣切除术的安全性和有效性比较。方法。该研究的招募于2019年至2022年在俄罗斯卫生部Meshalkin国家医学研究中心进行。20例患者行“边缘到边缘”二尖瓣修复联合鼻中隔肌切除术，20例患者行分离性肌切除术作为对照组。该研究评估了12个月后的近期和中期结果。结果。与孤立的二尖瓣切除术相比，联合边缘到边缘二尖瓣修复术表现出更好的术中疗效(95,0%比50,0%，p= 0.001)，但同时伴有膈峰(6,8±2,1 vs 4,9±3,2 mmHg, p=0,03)和中瓣(3,4±1,4 vs 2,5±1,7 mmHg, p=0,05)梯度的增加。这两种技术在术后早期的住院死亡率和并发症水平较低，12个月后生存率较高。结论。使用“边缘对边缘”技术联合二尖瓣修复与孤立的心肌切除术相当安全，但更好地消除了sam诱导的二尖瓣功能不全。“边缘到边缘”二尖瓣修复的特点是增加了透射梯度。
{"title":"«Edge-to-edge» mitral valve repair for septal myectomy versus isolated myectomy: a pilot randomized trial","authors":"A. S. Zalesov, D. Y. Kozmin, S. A. Budagaev, A. V. Afanasyev, R. M. Sharifulin, S. I. Zheleznev, A. V. Bogachev-Prokophiev, A. M. Chernyavsky","doi":"10.38109/2225-1685-2023-3-54-61","DOIUrl":"https://doi.org/10.38109/2225-1685-2023-3-54-61","url":null,"abstract":"Background . Septal myectomy is currently the «gold» standard of surgical treatment of patients with obstructive hypertrophic cardiomyopathy. In some cases, isolated septal myectomy does not eliminate SAM-induced mitral insufficiency. Cardiac surgeons sometimes perform combined interventions on the mitral valve, such as «edge-to-edge» mitral valve repair. Aim . Evaluation of the safety and efficacy of combined edge-to-edge mitral valve repair in septal myectomy compared with isolated septal myectomy. Methods . Recruitment to the study was carried out for the period from 2019 to 2022 at the Meshalkin National Medical Research Center of the Ministry of Health of Russia. Twenty patients was performed combined «edge-to-edge» mitral valve repair with septal myectomy, 20 patients with isolated myectomy were included in the control group. The study assessed immediate and mid-term results after 12 months. Results . Combined edge-to-edge mitral valve repair demonstrates better intraoperative efficacy compared with isolated septal myectomy (95,0% versus 50,0%, p=0,001), but is accompanied by increased transmitral peak (6,8±2,1 vs 4,9±3,2 mmHg, p=0,03) and medium (3,4±1,4 vs 2,5±1,7 mmHg, p=0,05) gradients. Both techniques are associated with a low level of hospital mortality and complications in the early postoperative period, high survival after 12 months. Conclusion . Combined mitral valve repair using the «edge-to-edge» technique is comparable safe to isolated myectomy, but better eliminates SAM-induced mitral insufficiency. «Edge-to-edge» mitral valve repair is characterized by increased transmitral gradients.","PeriodicalId":495975,"journal":{"name":"Evrazijskij kardiologičeskij žurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136062680","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 : 2023-10-11DOI: 10.38109/2225-1685-2023-3-36-43
A. V. Azarov, M. G. Glezer, A. S. Zhuravlev, I. R. Rafaeli, S. P. Semitko, K. V. Gyul’misaruyan, S. A. Kurnosov
Aim . TIntroduction. To evaluate in-hospital angiographic and five-year posthospital clinical outcomes of percutaneous intervention strategy without stent implantation with immediate coronary artery stenting technique in STEMI patients with massive coronary thrombosis. Material and methods . The study enrolled 116 patients with primary STEMI myocardial infarction with the signs of massive thrombosis in the lumen of the main epicardial coronary artery with TIMI thrombus grade greater than 3 after antegrade blood flow restoration. In the 1st group of delayed intervention at the primary stage the blood flow was restored by small diameter balloon inflation and/ or manual vacuum thrombus aspiration until stable TIMI grade 3 blood flow was achieved, at control CAG on day 5-6 in 36 people the stent was not implanted due to insignificance of infarct-related coronary artery stenosis (stenosis less than 50% according to QCA). Immediate stent implantation was performed in 78 patients (group 2). The primary endpoint was the incidence of adverse cardiovascular events, including total mortality, recurrent myocardial infarction, repeated revascularization of the infarct-responsive artery. Secondary endpoint: frequency of achieving optimal myocardial perfusion as measured by angiography – TIMI blood flow and Myocardial Blush Grade. Results . The median follow-up period was 47 months. The incidence of the primary end point (MACE) was 15,8% in group 1 and 23,1% in group 2, with no statistically significant difference (p=0,408). Overall mortality (10,5% and 11,7%), the rate of repeat myocardial infarction (2,6% and 5,1%), and the rate of repeat target vessel revascularization (2,6% and 6,4%) were without significant advantage between subgroups. Optimal reperfusion (TIMI-3 and Myocardial Blush Grade 2-3 after primary procedure was achieved in significantly (p=0,02) more patients in group 1 (89%) than in group 2 (69,2%) ST segment resolution ≥70% after intervention was achieved in 87% of cases in group 1 and in 64,1% of cases in group 2 (p=0,011). Conclusion . In STEMI patients with massive coronary thrombosis, the method of delayed percutaneous intervention increases the rate of achieving optimal blood flow and allows avoiding stent implantation in the infarct-related artery in 50% of cases as compared to the method of immediate stenting. Both methods have comparable hospital and five-year clinical risks.
{"title":"Strategy of delayed intervention without stent implantation in myocardial infarction with ST segment elevation caused by massive thrombosis of the infarct-related artery","authors":"A. V. Azarov, M. G. Glezer, A. S. Zhuravlev, I. R. Rafaeli, S. P. Semitko, K. V. Gyul’misaruyan, S. A. Kurnosov","doi":"10.38109/2225-1685-2023-3-36-43","DOIUrl":"https://doi.org/10.38109/2225-1685-2023-3-36-43","url":null,"abstract":"Aim . TIntroduction. To evaluate in-hospital angiographic and five-year posthospital clinical outcomes of percutaneous intervention strategy without stent implantation with immediate coronary artery stenting technique in STEMI patients with massive coronary thrombosis. Material and methods . The study enrolled 116 patients with primary STEMI myocardial infarction with the signs of massive thrombosis in the lumen of the main epicardial coronary artery with TIMI thrombus grade greater than 3 after antegrade blood flow restoration. In the 1st group of delayed intervention at the primary stage the blood flow was restored by small diameter balloon inflation and/ or manual vacuum thrombus aspiration until stable TIMI grade 3 blood flow was achieved, at control CAG on day 5-6 in 36 people the stent was not implanted due to insignificance of infarct-related coronary artery stenosis (stenosis less than 50% according to QCA). Immediate stent implantation was performed in 78 patients (group 2). The primary endpoint was the incidence of adverse cardiovascular events, including total mortality, recurrent myocardial infarction, repeated revascularization of the infarct-responsive artery. Secondary endpoint: frequency of achieving optimal myocardial perfusion as measured by angiography – TIMI blood flow and Myocardial Blush Grade. Results . The median follow-up period was 47 months. The incidence of the primary end point (MACE) was 15,8% in group 1 and 23,1% in group 2, with no statistically significant difference (p=0,408). Overall mortality (10,5% and 11,7%), the rate of repeat myocardial infarction (2,6% and 5,1%), and the rate of repeat target vessel revascularization (2,6% and 6,4%) were without significant advantage between subgroups. Optimal reperfusion (TIMI-3 and Myocardial Blush Grade 2-3 after primary procedure was achieved in significantly (p=0,02) more patients in group 1 (89%) than in group 2 (69,2%) ST segment resolution ≥70% after intervention was achieved in 87% of cases in group 1 and in 64,1% of cases in group 2 (p=0,011). Conclusion . In STEMI patients with massive coronary thrombosis, the method of delayed percutaneous intervention increases the rate of achieving optimal blood flow and allows avoiding stent implantation in the infarct-related artery in 50% of cases as compared to the method of immediate stenting. Both methods have comparable hospital and five-year clinical risks.","PeriodicalId":495975,"journal":{"name":"Evrazijskij kardiologičeskij žurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136062681","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 : 2023-10-11DOI: 10.38109/2225-1685-2023-3-62-67
O. S. Ivanova, E. Y. Maychuk, I. V. Voevodina, I. A. Makarova, E. V. Akatova, A. I. Zavyalova, O. P. Nikolin
Objective : study of the relationship between arterial hypertension and arterial stiffness in women to identify potential markers of target organ damage and therapeutic targets of antihypertensive therapy. Materials and methods : the study involved 161 women who were divided into three groups depending on age and reproductive function. Group 1 consisted of 52 women aged 18 to 30; group 2 – 54 women aged 31 years before menopause; 3rd group – 55 women in the postmenopausal period. All women were questioned, clinical examination, determination of anthropometric data, measurement of carotid-femoral pulse wave velocity, determination of arterial stiffness by volumetric sphygmography, 24-hour blood pressure monitoring with assessment of aortic stiffness and characteristics of the central pulse wave. Results : 24-hour blood pressure monitoring revealed arterial hypertension in 38 (34,8%) women: 15 (27,8%) women in the 2nd group and 23 (41,8%) women in the 3rd group. Correlation analysis revealed the most significant correlations between the presence of arterial hypertension (R=0,45-0,71; p<<0,01) with central aortic pressure, double product index and average daily aortic pulse wave velocity in the aorta (PWVao), regardless of the state reproductive function. For women of reproductive age with arterial hypertension, the ambulatory vascular stiffness index (AASI: R=0,36; p=0,01) is more significant, while in the menopausal period, the arterial stiffness index (ASI: R=0,33; p=0,01). Correlation analysis did not reveal significant relationships between carotid-femoral pulse wave velocity and cardio-ankle vascular index (CAVI) with arterial hypertension in women of the 2nd and 3rd groups. The relationship between carotid-femoral pulse wave velocity and arterial hypertension in women was confirmed by analysis of variance (p=0,007). Conclusion : Central aortic pressure, carotid-femoral pulse wave velocity, AASI, ASI, PWVao – direct and indirect indicators of arterial stiffness – are interconnected with the presence of arterial hypertension in women of reproductive and menopausal age. In this regard, these indicators are potential markers of target organ damage in arterial hypertension.
{"title":"Arterial hypertension and stiffness in women of different age groups and reproductive status","authors":"O. S. Ivanova, E. Y. Maychuk, I. V. Voevodina, I. A. Makarova, E. V. Akatova, A. I. Zavyalova, O. P. Nikolin","doi":"10.38109/2225-1685-2023-3-62-67","DOIUrl":"https://doi.org/10.38109/2225-1685-2023-3-62-67","url":null,"abstract":"Objective : study of the relationship between arterial hypertension and arterial stiffness in women to identify potential markers of target organ damage and therapeutic targets of antihypertensive therapy. Materials and methods : the study involved 161 women who were divided into three groups depending on age and reproductive function. Group 1 consisted of 52 women aged 18 to 30; group 2 – 54 women aged 31 years before menopause; 3rd group – 55 women in the postmenopausal period. All women were questioned, clinical examination, determination of anthropometric data, measurement of carotid-femoral pulse wave velocity, determination of arterial stiffness by volumetric sphygmography, 24-hour blood pressure monitoring with assessment of aortic stiffness and characteristics of the central pulse wave. Results : 24-hour blood pressure monitoring revealed arterial hypertension in 38 (34,8%) women: 15 (27,8%) women in the 2nd group and 23 (41,8%) women in the 3rd group. Correlation analysis revealed the most significant correlations between the presence of arterial hypertension (R=0,45-0,71; p<<0,01) with central aortic pressure, double product index and average daily aortic pulse wave velocity in the aorta (PWVao), regardless of the state reproductive function. For women of reproductive age with arterial hypertension, the ambulatory vascular stiffness index (AASI: R=0,36; p=0,01) is more significant, while in the menopausal period, the arterial stiffness index (ASI: R=0,33; p=0,01). Correlation analysis did not reveal significant relationships between carotid-femoral pulse wave velocity and cardio-ankle vascular index (CAVI) with arterial hypertension in women of the 2nd and 3rd groups. The relationship between carotid-femoral pulse wave velocity and arterial hypertension in women was confirmed by analysis of variance (p=0,007). Conclusion : Central aortic pressure, carotid-femoral pulse wave velocity, AASI, ASI, PWVao – direct and indirect indicators of arterial stiffness – are interconnected with the presence of arterial hypertension in women of reproductive and menopausal age. In this regard, these indicators are potential markers of target organ damage in arterial hypertension.","PeriodicalId":495975,"journal":{"name":"Evrazijskij kardiologičeskij žurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136209479","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 : 2023-10-10DOI: 10.38109/2225-1685-2023-3-76-80
A. N. Kuchmin, T. S. Sveklina, P. D. Oktysyuk, A. I. Rechkalova, V. V. Konyaev
The review outlines modern concepts of the relevance of fixed-dose combination therapy comprising angiotensin-converting enzyme inhibitor and dihydropyridine calcium channel antagonist as an antihypertensive component with the HMG-CoA reductase inhibitor when treating hypertensive patients. We have identified the realms of its possible clinical use taking into consideration the comorbidity peculiarities. In addition, we provide main features of the current drugs’ clinical pharmacodynamics and outline their role in real clinical practice. Nevertheless the emphasis was placed on the modern single-pill combination of amlodipin, atorvastatin and perindopril. We concisely report the results data collected from the large, randomized, double-blind major clinical trials regarding the effectiveness of single pill combination of amlodipine, atorvastatin and perindopril , primary focusing on their cardioprotective features and overall safety profile.
{"title":"Fixed triple combination of amlodipine, perindopril and atorvastatin in the focus of cardiovascular effectiveness and safety","authors":"A. N. Kuchmin, T. S. Sveklina, P. D. Oktysyuk, A. I. Rechkalova, V. V. Konyaev","doi":"10.38109/2225-1685-2023-3-76-80","DOIUrl":"https://doi.org/10.38109/2225-1685-2023-3-76-80","url":null,"abstract":"The review outlines modern concepts of the relevance of fixed-dose combination therapy comprising angiotensin-converting enzyme inhibitor and dihydropyridine calcium channel antagonist as an antihypertensive component with the HMG-CoA reductase inhibitor when treating hypertensive patients. We have identified the realms of its possible clinical use taking into consideration the comorbidity peculiarities. In addition, we provide main features of the current drugs’ clinical pharmacodynamics and outline their role in real clinical practice. Nevertheless the emphasis was placed on the modern single-pill combination of amlodipin, atorvastatin and perindopril. We concisely report the results data collected from the large, randomized, double-blind major clinical trials regarding the effectiveness of single pill combination of amlodipine, atorvastatin and perindopril , primary focusing on their cardioprotective features and overall safety profile.","PeriodicalId":495975,"journal":{"name":"Evrazijskij kardiologičeskij žurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136356884","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 : 2023-10-10DOI: 10.38109/2225-1685-2023-3-6-35
O. A. Kislyak, I. V. Leontyeva, A. V. Starodubova, A. A. Alersandrov, M. G. Bubnova, Yu. R. Varaeva, A. A. Kamalova, L. V. Kozlova, E. V. Pavlovskaya, D. A. Polunina, V. A. Revyakina, V. B. Rozanov, D. I. Sadykova, E. S. Slastnikova, T. V. Strokova, S. A. Ushakova
The EAC Guidelines represent the views of the EAC, and were produced after careful consideration of the scientific and medical knowledge, and the evidence available at the time of their publication.
《EAC指南》代表了EAC的观点，是在仔细考虑了科学和医学知识以及出版时可用的证据后编制的。
{"title":"Eurasian clinical guidelines for the prevention of cardiovascular diseases in childhood and adolescence (2023)","authors":"O. A. Kislyak, I. V. Leontyeva, A. V. Starodubova, A. A. Alersandrov, M. G. Bubnova, Yu. R. Varaeva, A. A. Kamalova, L. V. Kozlova, E. V. Pavlovskaya, D. A. Polunina, V. A. Revyakina, V. B. Rozanov, D. I. Sadykova, E. S. Slastnikova, T. V. Strokova, S. A. Ushakova","doi":"10.38109/2225-1685-2023-3-6-35","DOIUrl":"https://doi.org/10.38109/2225-1685-2023-3-6-35","url":null,"abstract":"The EAC Guidelines represent the views of the EAC, and were produced after careful consideration of the scientific and medical knowledge, and the evidence available at the time of their publication.","PeriodicalId":495975,"journal":{"name":"Evrazijskij kardiologičeskij žurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136357989","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 : 2023-10-10DOI: 10.38109/2225-1685-2023-3-82-88
O. Iu. Mironova, M. V. Berdysheva, E. S. Deeva, E. M. Elfimova
Cardiovascular diseases are one of the most common causes of death in both developing and developed countries of the world. Despite the improvement in primary prevention, the prevalence of cardiovascular diseases has continued to grow in recent years. Therefore, it is extremely important both to study the molecular pathophysiology of cardiovascular diseases in depth and to find new methods for early and appropriate prevention, diagnosis and treatment of these diseases. In the last decade, a large amount of research has focused on the study of microRNAs as potential diagnostic biomarkers, as well as their role in the treatment of cardiovascular diseases. microRNAs are endogenous small (21-23 nucleotides) ribonucleotides involved in the regulation of protein synthesis from amino acids based on matrix RNA. microRNAs are involved in the regulation of the expression of the majority (>60%) of genes encoding proteins, mainly due to its suppression, modulate numerous signaling pathways and cellular processes and participate in intercellular communication. Along with this, the important role of microRNAs in the cardiovascular system has been proven: participation in the regulation of processes such as angiogenesis, contractility of heart cells, control of lipid metabolism, the rate of fibrosis and atherosclerosis, which makes it possible to use microRNAs as therapeutic agents. Thus, the article considers the issue of the availability of several approaches to treatment involving microRNAs: overexpression of exogenous microRNAs to reduce the expression of genes with undesirable properties, overexpression of microRNA inhibitors, the use of «false» microRNAs or «sponges» that act as competitive inhibitors. The use of viruses with a positive (semantic) RNA chain resembling endogenous mRNAs is also considered. The author pays special attention to the important role of microRNAs in a number of cardiovascular diseases: microRNA-based therapy has been demonstrated in the treatment of diseases such as heart failure, dyslipidemia, acute coronary syndrome, arterial hypertension, as well as arterial hypertension caused by OSA. Studies proving the positive effect of microRNAs on slowing down the development of atherosclerosis are considered, which may allow them to be used as new therapeutic agents that can lead to optimization of approaches to the treatment of cardiovascular diseases. Particularly active is the development of drugs based on RNA interference (RNAi), which use recently discovered pathways of endogenous short interfering RNAs and become universal tools for effective suppression of protein expression. Thus, the use of certain drugs based on RNA interference in a number of clinical studies has shown a significant decrease in the level of non-HDL cholesterol and triglycerides in the treatment of dyslipidemia and NT-proBNP in the treatment of hereditary transtyretin amyloidosis. This article touches upon the issue of such an important problem as myocardia
{"title":"MicroRNA: a clinician’s view of the state of the problem. Part 3: MicroRNA and approaches to the treatment of cardiovascular diseases","authors":"O. Iu. Mironova, M. V. Berdysheva, E. S. Deeva, E. M. Elfimova","doi":"10.38109/2225-1685-2023-3-82-88","DOIUrl":"https://doi.org/10.38109/2225-1685-2023-3-82-88","url":null,"abstract":"Cardiovascular diseases are one of the most common causes of death in both developing and developed countries of the world. Despite the improvement in primary prevention, the prevalence of cardiovascular diseases has continued to grow in recent years. Therefore, it is extremely important both to study the molecular pathophysiology of cardiovascular diseases in depth and to find new methods for early and appropriate prevention, diagnosis and treatment of these diseases. In the last decade, a large amount of research has focused on the study of microRNAs as potential diagnostic biomarkers, as well as their role in the treatment of cardiovascular diseases. microRNAs are endogenous small (21-23 nucleotides) ribonucleotides involved in the regulation of protein synthesis from amino acids based on matrix RNA. microRNAs are involved in the regulation of the expression of the majority (>60%) of genes encoding proteins, mainly due to its suppression, modulate numerous signaling pathways and cellular processes and participate in intercellular communication. Along with this, the important role of microRNAs in the cardiovascular system has been proven: participation in the regulation of processes such as angiogenesis, contractility of heart cells, control of lipid metabolism, the rate of fibrosis and atherosclerosis, which makes it possible to use microRNAs as therapeutic agents. Thus, the article considers the issue of the availability of several approaches to treatment involving microRNAs: overexpression of exogenous microRNAs to reduce the expression of genes with undesirable properties, overexpression of microRNA inhibitors, the use of «false» microRNAs or «sponges» that act as competitive inhibitors. The use of viruses with a positive (semantic) RNA chain resembling endogenous mRNAs is also considered. The author pays special attention to the important role of microRNAs in a number of cardiovascular diseases: microRNA-based therapy has been demonstrated in the treatment of diseases such as heart failure, dyslipidemia, acute coronary syndrome, arterial hypertension, as well as arterial hypertension caused by OSA. Studies proving the positive effect of microRNAs on slowing down the development of atherosclerosis are considered, which may allow them to be used as new therapeutic agents that can lead to optimization of approaches to the treatment of cardiovascular diseases. Particularly active is the development of drugs based on RNA interference (RNAi), which use recently discovered pathways of endogenous short interfering RNAs and become universal tools for effective suppression of protein expression. Thus, the use of certain drugs based on RNA interference in a number of clinical studies has shown a significant decrease in the level of non-HDL cholesterol and triglycerides in the treatment of dyslipidemia and NT-proBNP in the treatment of hereditary transtyretin amyloidosis. This article touches upon the issue of such an important problem as myocardia","PeriodicalId":495975,"journal":{"name":"Evrazijskij kardiologičeskij žurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136358492","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 : 2023-10-09DOI: 10.38109/2225-1685-2023-3-90-94
E. A. Butorova, O. V. Stukalova
Diagnosis of myocarditis remains one of the most difficult clinical problems in cardiology. In connection with the coronavirus infection COVID-19 caused by the acute respiratory virus SARS-CoV-2, non-invasive diagnosis of myocarditis is an urgent task. The most informative method for diagnosing myocarditis is magnetic resonance imaging [1,2]. The arsenal of MRI includes a number of pulse sequences that make it possible to identify and evaluate the process of inflammation in its various phases. Various pulse sequences (T2-weighted images or T2-mapping, delayed contrast, T1-mapping) allow not only to diagnose the disease, but also to determine the stages of damage. The ability of MRI to differentiate ischemic and non-ischemic lesions [3] is used in emergency cardiology for various myocardial injuries. The peculiarity of this clinical case is the use of MRI diagnostics in a patient with a typical clinical picture of acute coronary syndrome in the emergency department of cardiology. The data of the contrast MRI of the heart allowed the patient to make the correct diagnosis.
{"title":"Case report: role of cardiac MRI in the diagnosis of myocarditis","authors":"E. A. Butorova, O. V. Stukalova","doi":"10.38109/2225-1685-2023-3-90-94","DOIUrl":"https://doi.org/10.38109/2225-1685-2023-3-90-94","url":null,"abstract":"Diagnosis of myocarditis remains one of the most difficult clinical problems in cardiology. In connection with the coronavirus infection COVID-19 caused by the acute respiratory virus SARS-CoV-2, non-invasive diagnosis of myocarditis is an urgent task. The most informative method for diagnosing myocarditis is magnetic resonance imaging [1,2]. The arsenal of MRI includes a number of pulse sequences that make it possible to identify and evaluate the process of inflammation in its various phases. Various pulse sequences (T2-weighted images or T2-mapping, delayed contrast, T1-mapping) allow not only to diagnose the disease, but also to determine the stages of damage. The ability of MRI to differentiate ischemic and non-ischemic lesions [3] is used in emergency cardiology for various myocardial injuries. The peculiarity of this clinical case is the use of MRI diagnostics in a patient with a typical clinical picture of acute coronary syndrome in the emergency department of cardiology. The data of the contrast MRI of the heart allowed the patient to make the correct diagnosis.","PeriodicalId":495975,"journal":{"name":"Evrazijskij kardiologičeskij žurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135147108","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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