Kardiologiya最新文献

Aim: To study the prevalence of cardiovascular risk factors (RFs) associated with obesity in young people studying at a multidisciplinary university, as well as to analyze the awareness of students about the potential relationship between these RFs and cardiovascular diseases.

Material and methods: This cross-sectional study included in the final analysis 1158 students of the Moscow State University without known chronic non-communicable diseases (CNCDs). Participants filled out a standard "Questionnaire for persons under 65 years of age to identify CNCDs, their RFs, and the use of non-prescribed narcotic drugs and psychotropic substances", which included a question to identify individuals with a high level of physical activity (PA), as well as an additional questionnaire with open-ended questions on RFs for cardiovascular diseases (CVDs).

Results: The prevalence of obesity in young people studying at the multidisciplinary university was 5.0%, overweight 13.6%, and abdominal obesity (AO) 12.7%. Correlation analysis showed that the body mass index (BMI) had weak but significant relationships with systolic blood pressure (r = 0.434; p < 0.001), total cholesterol (r = 0.170; p < 0.001), and blood glucose (r = 0.185; p < 0.001). Young people with obesity consumed significantly less vegetables and fruits than those with normal BMI (p=0.032). There were more smokers among overweight and obese patients (p=0.019), probably due to an unhealthy behavior pattern in general. Unhealthy diet was named as a RF for CVD by ⅔ of the surveyed young people; more than ¾ were aware of the negative impact of low PA on the cardiovascular system. Obesity was named as a RF by less than 20% of the respondents regardless of gender. The awareness of students with obesity or overweight about obesity as a RF for CVD was generally higher than in the general group (p<0.001). However, only 41.3% of those with a BMI of 30 kg/m2 or more named obesity as a RF for CVD.

Conclusion: Understanding the prevalence of behavioral RFs for CVD, awareness of the related risks, and the need to maintain health among young people is critical for prevention of CVD. Interventions targeting university students should promote healthy eating behavior, increased PA, and weight control.

Aim: Studies have shown a significant correlation between atherosclerosis and profilin-1. However, there is no information in the literature on the concentration of profilin in hemodialysis (HD) patients. This research examined the association between profilin-1 and carotid intima-media thickness (CIMT), as a marker of early atherosclerosis in HD patients.

Material and methods: 50 chronic HD patients and 38 healthy, control patients were included in this study. CIMT was measured by high-resolution ultrasonography.

Results: The HD patients were older and had higher concentrations of profilin-1, C reactive protein (CRP), uric acid, parathormone, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) than the control patients. In the HD patients, variables impacting CIMT were examined. CIMT and profilin-1 were significantly correlated (r = 0.637, p <0.01), as were CIMT and age (r = 0.424, p = 0.002). Linear regression analysis revealed that profilin-1 is a significant and independent predictor of carotid intima-media thickness (CIMT). Higher profilin-1 levels were associated with increased CIMT values.

Conclusion: For the first time, it has been shown that HD patients had greater concentrations of profilin-1 than healthy controls. Also, an independent relationship between profilin-1 and CIMT in HD patients was demonstrated.

Objective: Analyze the clinical characteristics and resuscitation outcomes of patients with in-hospital cardiac arrest (IHCA) and explore the factors affecting the success rate of cardiopulmonary resuscitation in IHCA patients.

Material and methods: A retrospective observational study was conducted. Patients who received resuscitative treatment for IHCA between September 2022 and December 2023 were evaluated. Clinical data and prognostic information were collected and analyzed, including age, gender, underlying diseases, time of cardiac arrest, cause of cardiac arrest, presence of shockable rhythm, application of defibrillation, duration of CPR (>30 min), presence of endotracheal intubation, cumulative dose of adrenaline, and resuscitation outcomes (return of spontaneous circulation, survival to discharge).

Results: A total of 323 IHCA patients were included in this study. After CPR treatment, 246 had return of spontaneous circulation (ROSC), with 90 surviving to discharge. Coronary artery disease, shockable initial rhythm, presence of a shockable rhythm during resuscitation, defibrillation, and absence of emergency endotracheal intubation differed statistically between the ROSC and non-ROSC groups (univariate analysis, p < 0.001) Age was a statistically significant determinant of whether patients survived to discharge (p < 0.05). Multivariate logistic regression analysis showed that CPR duration ≥ 30 min was an independent risk factor for ROSC, while younger age, application of emergency endotracheal intubation, and lower cumulative dose of adrenaline were independent protective factors for ROSC (p < 0.05).

Conclusion: Age lower than 60 years old, application of defibrillation, and emergency endotracheal intubation are positively associated with increased likelihood of ROSC. Age is an independent risk factor negatively related to survival after discharge. Clinicians should pay close attention to these factors to improve the outcomes of cardiopulmonary resuscitation patients.

Among the main priorities of the healthcare system is the problem of chronic heart failure (CHF). It is critically important to assess and reduce the incidence of CHF, improve the treatment of patients with CHF, increase the duration and quality of their life, and reduce the related financial burden. One of the approaches for monitoring the medical care in CHF patients is conducting a large, long-term observational registry study involving multiple medical organizations, with inclusion of the maximum number of patients with documented CHF, assessing continuity, diagnosis and treatment, adherence to treatment, the possibility of algorithmic selection of patients for high-tech medical care and preferential drug provision, morbidity among working/non-working, able-bodied/disabled patients, and assessing the quality of dispensary observation. This article announces a prospective-retrospective observational registry study "HOSTA CHF" (Characteristics Of the State of the sysTem of providing cAre to patients with Chronic Heart Failure in the regions of the Russian Federation: detection, diagnosis, treatment, observation), initiated at the Chazov National Medical Research Center of Cardiology.

Clinical symptoms of pulmonary hypertension (PH) are non-specific and are caused by both high pressure in the pulmonary artery system and progressive right ventricular failure. Instrumental diagnosis of pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) is complex and requires using invasive and non-invasive imaging methods in the diagnostic algorithm, among which echocardiography (EchoCG) plays an important role. In the initial (screening) evaluation, EchoCG allows assessing the probability of the presence of pulmonary hypertension, the structure and function of the right and left heart chambers, and possible causes of increased pulmonary artery pressure. Echocardiographic imaging is continuously evolving, and measurements made with new methods, such as myocardial strain and 3D imaging, provide access to more information about the right heart chambers in an expert center for the management of patients with PAH and CTEPH. This review describes the parameters and their prognostic value for the diagnosis of PH during both primary (screening) EchoCG and examination in an expert center. Echocardiographic examination of patients with PAH and CTEPH is presented according to their routing stages. Extended EchoCG protocols for primary (screening) examination and examination in an expert center are presented.

Aim         To evaluate the effect of intensive lipid-lowering therapy (LLT), including inclisiran prescribed in the acute phase of ST-segment elevation myocardial infarction (STEMI), on lipid profile in patients with extremely high risk (EHR) of cardiovascular complications (CVC).Material and methods        This prospective single-center clinical study included 20 patients (mean age 58.45±2.43 years, 75% men) with EHR of CVC and STEMI. All patients were prescribed combination LLT, including inclisiran. Lipid profile parameters were assessed 8±1 days after the initiation of therapy. Statistical analysis was performed with a STATISTICA 13.3 software.Results   Analysis of the lipid-lowering effect of inclisiran showed a significant decrease in total cholesterol from 5.13±0.29 to 2.81±0.26 mmol/l (45.2%; p<0.001) and low-density lipoprotein cholesterol (LDL-C) from 3.59±0.23 to 1.60±0.23 mmol/l (55.4%; p<0.001).Conclusion          The study showed a possibility of achieving statistically and clinically significant reduction in LDL-C in patients with EHR of CVC in the acute period of STEMI with the combination therapy including inclisiran during the inpatient treatment.

Aim: Coronary slow flow (CSF) is a condition characterized by below normal blood flow in coronary arteries without significant coronary stenosis. Its pathophysiology is unclear but may involve inflammation, endothelial dysfunction, and microvascular impairment. Chemerin, an inflammation-related adipokine, has been proposed as a potential biomarker in CSF. This study examines the relationship between serum chemerin concentrations and CSF.

Material and methods: A total of 100 patients who underwent coronary angiography were classified into CSF (n=50) and normal coronary flow (NCF, n=50) groups. Coronary flow rates were assessed using the Thrombolysis in Myocardial Infarction Frame Count (TFC) method. Serum chemerin concentrations were measured by ELISA. Logistic regression, correlation, and ROC analyses were performed to identify predictors of CSF and to evaluate diagnostic performance.

Results: Chemerin concentrations were significantly higher in the CSF group (p<0.001). Logistic regression identified chemerin as an independent CSF predictor (OR=1.097; 95 % CI: 1.022-1.177; p=0.005). Chemerin concentrations correlated positively with TFC (r=0.713, p<0.001). A chemerin cutoff value of 124.5 ng / ml provided 88 % sensitivity and 80 % specificity for CSF diagnosis.

Conclusion: Elevated serum chemerin is associated with CSF, suggesting its role in the pathogenesis of CSF and its potential as a diagnostic biomarker. Further research is needed to explore chemerin-targeted therapies in patients with CSF.

Cardiovascular diseases occupy one of the leading places in the structure of morbidity, mortality and disability of the population. Arterial hypertension (AH) is the major risk factor for the development of cardiovascular diseases. The problem of insufficient adherence to the treatment of AH remains unresolved in many countries. The administration of fixed combinations is a major way to increase adherence to antihypertensive therapy. In addition, the use of fixed combinations helps to improve the cardiovascular the prognosis in patients with AH by reducing the risk of developing cardiovascular complications.

The article presents a systematic review focused on clinical features of acute coronary syndrome (ACS) and approaches to its diagnosis in patients with aortic stenosis (AS), as well as approaches to managing the risks of adverse events. The review includes publications from 2000 to 2024. The information in the review by 80% reflects the reports for the recent 5 years. The main databases used in searching for information and writing the review were eLibrary.ru, PubMed, platforms of Nature publishing houses, Springer materials, and PLOS (Public Library of Science). The following keywords were used for the search of publications: aortic stenosis, myocardial infarction, acute coronary syndrome. A total of 105 full-text publications were found; 64 publications best matching the topic of the review were used. The article presents up-to-date data on the complexities of differential diagnosis of decompensated AS and ACS, the general pathogenesis of coronary atherocalcinosis and AS, and promising algorithms for surgical treatment of patients with a combination of AS and various forms of ischemic heart disease (acute and chronic).

Aim: Inflammation, in which macrophages play an important role as immune cells, is closely related to atrial fibrillation (AF). Recent studies have shown that macrophages participate electrical conduction in the heart, thus indicating that they have electrophysiological characteristics. However, whether the electrophysiology of macrophages is associated with AF or not remained unknown. Thus, we investigated the biological function changes in macrophages using patch-clamping after tachypacing to mimic AF.

Material and methods: Atrial myocytes and macrophages were cultured. RNA sequencing was performed to investigate the expression change of atrial myocytes after tachypacing. Patch-clamping was conducted to measure the change of APD and ICa,L in macrophages after tachypacing. Rapid atrial stimulation was performed to measure the AF incidence in macrophage-specific CX43 knockout mice.

Results: After tachypacing, the time required for 90% repolarization of the action potential and the ICa,L were reduced in macrophages. Furthermore, we found that tachypacing atrial myocytes led to the secretion of Wnt 7a, further inhibiting the expression of CACNA1C in macrophages. Moreover, the knockout of CX43 in macrophages decreased the incidence of AF in a mouse model of chronic inflammation.

Conclusion: The electrophysiology of macrophages is related to the development of AF and might be a potential therapeutic target for AF therapy. Prospects for the transfer of laboratory data to the clinic: 1) Regulation of macrophage electrophysiology might be a potential therapeutic target for atrial fibrillation (AF). 2) A Wnt 7a inhibitor could be used to decrease AF incidence. 3) Blocking the interaction between macrophages and atrial myocytes might be a potential therapeutic target for AF.