Pub Date : 2024-02-25DOI: 10.15829/1728-8800-2024-3914
T. G. Utina, D. U. Akasheva, D. V. Korsunsky, O. Dzhioeva, O. M. Drapkina
Aim. To study the relationship between the structural and functional left ventricular (LV) parameters and N-terminal pro-brain natriuretic peptide (NT-proBNP) and inflammatory markers in patients with type 2 diabetes (T2D) without clinical manifestations of cardiovascular diseases, as well as to evaluate the possibility of their use for early diagnosis of subclinical LV dysfunction.Material and methods. Data from 120 patients of both sexes aged 45-75 years (57,11±7,9 years) were analyzed. They were divided into three following groups: 1st — with T2D (n=47), 2nd — with prediabetes (n=20), 3rd — control (n=53). All participants underwent transthoracic echocardiography with assessment of the linear and volumetric heart dimensions, systolic and diastolic LV function. Speckle tracking echocardiography was analyzed with calculation of LV global longitudinal strain (GLS). The blood levels of NT-proBNP and inflammatory markers were determined (high-sensitivity C-reactive protein (hsCRP), fibrinogen, interleukin-6).Results. According to echocardiography, patients with carbohydrate metabolism disorders revealed significantly higher LV mass values, LV posterior wall thickness, and relative wall thickness in comparison with the control group. Transmitral flow parameters, as well as tissue Doppler sonography, in the T2D and prediabetes groups were significantly different from those in the control group. GLS in the groups of patients with carbohydrate metabolism disorders was lower than in the control group (p=0,001). The level of NT-proBNP was significantly higher in the T2D and prediabetes groups compared to the control group, while in all three groups it did not exceed normal values (p<0,001). A higher level of NT-proBNP was associated with hypertension — odds ratio (OR) 3,64 [1,02-13,04] (p=0,005), a decrease in LV ejection fraction — OR 1,25 [1,06-1 ,47] (p=0,007), concentric hypertrophy — OR 4,84 [1,43-16,41] (p=0,011) and decreased GLS — OR 1,85 [1,62-2,06] (p=0,005), an increase in the ratio of early and late diastolic transmitral flow (E/A) — OR 0,01 [0,008-0,416] (p=0,024) and isovolumic relaxation time (IVRT) — OR 1,08 [1,03-1,14] (p=0,03). The sensitivity and specificity of NT-proBNP as a test for predicting GLS reduction <-18% were 86 and 27%, respectively. The hsCRP level, within the reference values, was significantly higher in the T2D and prediabetes groups compared to the control group (p<0,001) and demonstrated a direct linear relationship with E/A, IVRT, early diastolic deceleration time (p<0,05). A higher level of hsCRP was significantly associated with diastolic dysfunction — OR 1,16 [1,02-1,32] (p=0,023), as well as with a GLS decrease <-18% — OR 1,58 [1,12-4,65] (p=0,03).Conclusion. In patients with T2D without clinical manifestations of cardiovascular disease, the presence of concentric LV myocardial hypertrophy, LV diastolic dysfunction and decreased GLS (<-18%) is associated with higher blood levels of NT-proBNP and hsCRP. However, in
{"title":"Biomarkers and subclinical left ventricular dysfunction in patients with type 2 diabetes without clinical manifestations of cardiovascular diseases","authors":"T. G. Utina, D. U. Akasheva, D. V. Korsunsky, O. Dzhioeva, O. M. Drapkina","doi":"10.15829/1728-8800-2024-3914","DOIUrl":"https://doi.org/10.15829/1728-8800-2024-3914","url":null,"abstract":"Aim. To study the relationship between the structural and functional left ventricular (LV) parameters and N-terminal pro-brain natriuretic peptide (NT-proBNP) and inflammatory markers in patients with type 2 diabetes (T2D) without clinical manifestations of cardiovascular diseases, as well as to evaluate the possibility of their use for early diagnosis of subclinical LV dysfunction.Material and methods. Data from 120 patients of both sexes aged 45-75 years (57,11±7,9 years) were analyzed. They were divided into three following groups: 1st — with T2D (n=47), 2nd — with prediabetes (n=20), 3rd — control (n=53). All participants underwent transthoracic echocardiography with assessment of the linear and volumetric heart dimensions, systolic and diastolic LV function. Speckle tracking echocardiography was analyzed with calculation of LV global longitudinal strain (GLS). The blood levels of NT-proBNP and inflammatory markers were determined (high-sensitivity C-reactive protein (hsCRP), fibrinogen, interleukin-6).Results. According to echocardiography, patients with carbohydrate metabolism disorders revealed significantly higher LV mass values, LV posterior wall thickness, and relative wall thickness in comparison with the control group. Transmitral flow parameters, as well as tissue Doppler sonography, in the T2D and prediabetes groups were significantly different from those in the control group. GLS in the groups of patients with carbohydrate metabolism disorders was lower than in the control group (p=0,001). The level of NT-proBNP was significantly higher in the T2D and prediabetes groups compared to the control group, while in all three groups it did not exceed normal values (p<0,001). A higher level of NT-proBNP was associated with hypertension — odds ratio (OR) 3,64 [1,02-13,04] (p=0,005), a decrease in LV ejection fraction — OR 1,25 [1,06-1 ,47] (p=0,007), concentric hypertrophy — OR 4,84 [1,43-16,41] (p=0,011) and decreased GLS — OR 1,85 [1,62-2,06] (p=0,005), an increase in the ratio of early and late diastolic transmitral flow (E/A) — OR 0,01 [0,008-0,416] (p=0,024) and isovolumic relaxation time (IVRT) — OR 1,08 [1,03-1,14] (p=0,03). The sensitivity and specificity of NT-proBNP as a test for predicting GLS reduction <-18% were 86 and 27%, respectively. The hsCRP level, within the reference values, was significantly higher in the T2D and prediabetes groups compared to the control group (p<0,001) and demonstrated a direct linear relationship with E/A, IVRT, early diastolic deceleration time (p<0,05). A higher level of hsCRP was significantly associated with diastolic dysfunction — OR 1,16 [1,02-1,32] (p=0,023), as well as with a GLS decrease <-18% — OR 1,58 [1,12-4,65] (p=0,03).Conclusion. In patients with T2D without clinical manifestations of cardiovascular disease, the presence of concentric LV myocardial hypertrophy, LV diastolic dysfunction and decreased GLS (<-18%) is associated with higher blood levels of NT-proBNP and hsCRP. However, in","PeriodicalId":9545,"journal":{"name":"Cardiovascular Therapy and Prevention","volume":"24 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140432251","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 : 2024-02-24DOI: 10.15829/1728-8800-2024-3925
S. Martsevich
The author comments on the significance and place of meta-analyses in modern evidence-based medicine, primarily in cardiology. The history of meta-analyses is briefly described. The main limitations of meta-analyses are reviewed. Examples are given where meta-analyses on the same problem had directly opposite results. The importance of meta-analyses in identifying side effects of drugs is discussed. The possibility of manipulating the results of meta-analyses is demonstrated. The significance of meta-analyses is currently being assessed through the example of the coronavirus pandemic, when different meta-analyses assessed the effectiveness and safety of the same drugs differently.The author concludes that meta-analyses should be excluded from level I evidence and given a more modest role in the hierarchy of evidence.
{"title":"Is meta-analysis the \"top of the evidence pyramid\" in cardiology?","authors":"S. Martsevich","doi":"10.15829/1728-8800-2024-3925","DOIUrl":"https://doi.org/10.15829/1728-8800-2024-3925","url":null,"abstract":"The author comments on the significance and place of meta-analyses in modern evidence-based medicine, primarily in cardiology. The history of meta-analyses is briefly described. The main limitations of meta-analyses are reviewed. Examples are given where meta-analyses on the same problem had directly opposite results. The importance of meta-analyses in identifying side effects of drugs is discussed. The possibility of manipulating the results of meta-analyses is demonstrated. The significance of meta-analyses is currently being assessed through the example of the coronavirus pandemic, when different meta-analyses assessed the effectiveness and safety of the same drugs differently.The author concludes that meta-analyses should be excluded from level I evidence and given a more modest role in the hierarchy of evidence.","PeriodicalId":9545,"journal":{"name":"Cardiovascular Therapy and Prevention","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140434741","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 : 2024-02-24DOI: 10.15829/1728-8800-2024-3737
O. M. Drapkina, V. I. Mazurov, A. I. Martynov, E. Nasonov, S. A. Saiganov, A. Lila, R. Bashkinov, I. N. Bobkova, C. Baimukhamedov, I. Z. Gaidukova, N. I. Guseinov, D. Duplyakov, M. Eliseev, A. Mamasaidov, N. A. Martusevich, Khilola T Mirakhmedova, I. Murkamilov, D. Nabieva, V. A. Nevzorova, O. D. Ostroumova, V. Salukhov, G. A. Togizbaev, E. Trofimov, Y. Khalimov, A. Chesnikova, S. Yakushin
.
.
{"title":"Consensus statement on the management of patients with asymptomatic hyperuricemia in general medical practice","authors":"O. M. Drapkina, V. I. Mazurov, A. I. Martynov, E. Nasonov, S. A. Saiganov, A. Lila, R. Bashkinov, I. N. Bobkova, C. Baimukhamedov, I. Z. Gaidukova, N. I. Guseinov, D. Duplyakov, M. Eliseev, A. Mamasaidov, N. A. Martusevich, Khilola T Mirakhmedova, I. Murkamilov, D. Nabieva, V. A. Nevzorova, O. D. Ostroumova, V. Salukhov, G. A. Togizbaev, E. Trofimov, Y. Khalimov, A. Chesnikova, S. Yakushin","doi":"10.15829/1728-8800-2024-3737","DOIUrl":"https://doi.org/10.15829/1728-8800-2024-3737","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":9545,"journal":{"name":"Cardiovascular Therapy and Prevention","volume":"39 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140435046","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 : 2024-02-24DOI: 10.15829/1728-8800-2024-3748
S. S. Murashko, S. Berns, I. Pasechnik
Aim. To evaluate any cardiovascular abnormalities in the postoperative period, their prevalence and impact on the course of postoperative period in patients after non-cardiac surgery, which underwent postoperative examinations of cardiovascular system.Material and methods. The study included 2937 patients. The assessed end points were postoperative cardiovascular events (CVEs). Along with major adverse cardiovascular events (MACE), we analyzed any cardiovascular abnormalities in the postoperative period as follows: electrocardiographic ST-T abnormalities, acute or decompensated heart failure (HF), arrhythmias, episodes of hypotension or hypertension, bleeding, thromboembolic events (TEEs), cerebrovascular events, postoperative delirium. Any CVEs constituted the any cardiovascular events' (ACVEs) group. Statistical analysis was carried out using the StatTech v program. 3.1.6 (OOO Stattekh, Russia).Results. Any postoperative complications according to the Clavien-Dindo classification were 54,7%, while grade 1 — 33,9%, grade 2 — 20,3%, grade 3 — 1 case, grade 4 — 0,4%, grade 5 — 0,1%. MACEs developed in 0,2% of cases. ACVEs amounted to 13,3%, including 2,3% — ST-T abnormalities, 6,3% — significant systolic blood pressure changes, 2,6% — arrhythmias, 0,7% — HF, 2,4% — bleeding, 1,1% — TEEs, 0,3% — delirium. In addition, 67 (17,5%) patients had ≥2 CVEs. Comparison of the length of hospital stay of patients with ACVEs, in particular with MACEs, ECG ST-T abnormalities, HF, arrhythmia, episodes of hypotension or hypertension, bleeding, TEEs, cerebrovascular events, delirium, with groups of patients without such complications revealed significant differences. ACVEs accounted for 1/4 of all postoperative complications and 2/3 of complications of grades 2-5.Conclusion. We expanded the concept of CVEs, united the totality of any cardiovascular abnormalities in the postoperative period, emphasized not only their clinical significance, but also the economic feasibility of taking into account ACVEs.
{"title":"Cardiovascular complications in non-cardiac surgery: what remains out of sight?","authors":"S. S. Murashko, S. Berns, I. Pasechnik","doi":"10.15829/1728-8800-2024-3748","DOIUrl":"https://doi.org/10.15829/1728-8800-2024-3748","url":null,"abstract":"Aim. To evaluate any cardiovascular abnormalities in the postoperative period, their prevalence and impact on the course of postoperative period in patients after non-cardiac surgery, which underwent postoperative examinations of cardiovascular system.Material and methods. The study included 2937 patients. The assessed end points were postoperative cardiovascular events (CVEs). Along with major adverse cardiovascular events (MACE), we analyzed any cardiovascular abnormalities in the postoperative period as follows: electrocardiographic ST-T abnormalities, acute or decompensated heart failure (HF), arrhythmias, episodes of hypotension or hypertension, bleeding, thromboembolic events (TEEs), cerebrovascular events, postoperative delirium. Any CVEs constituted the any cardiovascular events' (ACVEs) group. Statistical analysis was carried out using the StatTech v program. 3.1.6 (OOO Stattekh, Russia).Results. Any postoperative complications according to the Clavien-Dindo classification were 54,7%, while grade 1 — 33,9%, grade 2 — 20,3%, grade 3 — 1 case, grade 4 — 0,4%, grade 5 — 0,1%. MACEs developed in 0,2% of cases. ACVEs amounted to 13,3%, including 2,3% — ST-T abnormalities, 6,3% — significant systolic blood pressure changes, 2,6% — arrhythmias, 0,7% — HF, 2,4% — bleeding, 1,1% — TEEs, 0,3% — delirium. In addition, 67 (17,5%) patients had ≥2 CVEs. Comparison of the length of hospital stay of patients with ACVEs, in particular with MACEs, ECG ST-T abnormalities, HF, arrhythmia, episodes of hypotension or hypertension, bleeding, TEEs, cerebrovascular events, delirium, with groups of patients without such complications revealed significant differences. ACVEs accounted for 1/4 of all postoperative complications and 2/3 of complications of grades 2-5.Conclusion. We expanded the concept of CVEs, united the totality of any cardiovascular abnormalities in the postoperative period, emphasized not only their clinical significance, but also the economic feasibility of taking into account ACVEs.","PeriodicalId":9545,"journal":{"name":"Cardiovascular Therapy and Prevention","volume":"91 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140433730","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 : 2024-02-14DOI: 10.15829/1728-8800-2024-3886
E. I. Gusev, O. Drapkina, M. Martynov, A. P. Glukhareva, E. V. Yutskova
Aim. To study changes in blood pressure (BP) in patients with acute hemispheric ischemic stroke (AIS), to correlate BP in patients with AIS with BP in patients with chronic brain ischemia, and to study the association of various BP indices with stroke severity and recovery.Material and methods. We included 235 patients with hemispheric AIS (age 64±11 years; women, 41,3%). BP was assessed 6 times as follows: by patient’s self-measurement during the month before the stroke onset, in the ambulance, in the admission department, in the intensive care unit using 24-hour blood pressure monitoring (BPM), in the neurologic department (BPM), and 90 days after stroke. In patients with chronic cerebral ischemia (178 patients, age 62±13 years, 46,1% women), BP was assessed 3 times: by patient’s self-measurement during the month before hospitalization, in the admission department, and in the neurologic department (BPM).Results. Patients with AIS within the month before stroke had higher systolic and pulse pressure than patients with chronic cerebral ischemia. During the acute stroke period, patients with AIS despite reaching target systolic and diastolic BP had significantly increased variability of systolic and diastolic BP compared to patients with chronic brain ischemia. Systolic BP ≥160 mm Hg recorded consecutively in ambulance, in admission department, and in intensive care unit, as well as pulse pressure ≥60 mm Hg, and systolic BP variability ≥18 mm Hg recorded on day 1-2 and day 9-10, positively correlated with National Institute of Health Stroke Scale (NIHSS) score (r≥0,37, p≤0,0017) on day 10 and with modified Rankin Scale (mRS) score (r≥0,29, p≤0,006) on day 90.Conclusion. Patients with hemispheric AIS had significantly higher systolic BP and pulse pressure within the month before stroke. During the first 10 days of AIS persistent increase in systolic, diastolic, and pulse pressure, and BP variability was associated with more severe stroke and less favorable outcome. These results should be taken into account when administering antihypertensive treatment.
{"title":"Prognostic value of blood pressure in the acute period of hemispheric ischemic stroke","authors":"E. I. Gusev, O. Drapkina, M. Martynov, A. P. Glukhareva, E. V. Yutskova","doi":"10.15829/1728-8800-2024-3886","DOIUrl":"https://doi.org/10.15829/1728-8800-2024-3886","url":null,"abstract":"Aim. To study changes in blood pressure (BP) in patients with acute hemispheric ischemic stroke (AIS), to correlate BP in patients with AIS with BP in patients with chronic brain ischemia, and to study the association of various BP indices with stroke severity and recovery.Material and methods. We included 235 patients with hemispheric AIS (age 64±11 years; women, 41,3%). BP was assessed 6 times as follows: by patient’s self-measurement during the month before the stroke onset, in the ambulance, in the admission department, in the intensive care unit using 24-hour blood pressure monitoring (BPM), in the neurologic department (BPM), and 90 days after stroke. In patients with chronic cerebral ischemia (178 patients, age 62±13 years, 46,1% women), BP was assessed 3 times: by patient’s self-measurement during the month before hospitalization, in the admission department, and in the neurologic department (BPM).Results. Patients with AIS within the month before stroke had higher systolic and pulse pressure than patients with chronic cerebral ischemia. During the acute stroke period, patients with AIS despite reaching target systolic and diastolic BP had significantly increased variability of systolic and diastolic BP compared to patients with chronic brain ischemia. Systolic BP ≥160 mm Hg recorded consecutively in ambulance, in admission department, and in intensive care unit, as well as pulse pressure ≥60 mm Hg, and systolic BP variability ≥18 mm Hg recorded on day 1-2 and day 9-10, positively correlated with National Institute of Health Stroke Scale (NIHSS) score (r≥0,37, p≤0,0017) on day 10 and with modified Rankin Scale (mRS) score (r≥0,29, p≤0,006) on day 90.Conclusion. Patients with hemispheric AIS had significantly higher systolic BP and pulse pressure within the month before stroke. During the first 10 days of AIS persistent increase in systolic, diastolic, and pulse pressure, and BP variability was associated with more severe stroke and less favorable outcome. These results should be taken into account when administering antihypertensive treatment.","PeriodicalId":9545,"journal":{"name":"Cardiovascular Therapy and Prevention","volume":"79 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140456825","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 : 2024-02-14DOI: 10.15829/1728-8800-2024-3837
M. Kudryavtseva, E. V. Ryzhkova, O. Kulikova, E. Mershina, V. Sinitsyn, O. Drapkina, R. Myasnikov
Left ventricular (LV) hypertrophy implies structural cardiac changes and, as a consequence, an increase in myocardial mass. Currently, there are many causes of this condition as follows: hypertension, aortic stenosis, hypertrophic cardiomyopathy, exercise, storage diseases (AL, ATTR amyloidosis, Danon disease, Anderson-Fabry disease, etc.), metabolic disorders. Despite the currently existing diagnostic algorithms for LV hypertrophy, establishing a correct diagnosis can take a long time, and controversial research results can lead to false conclusions. This article presents a case report of a patient with LV hypertrophy, an atypical clinical performance and ambiguous paraclinical data, which led to certain diagnostic difficulties.
{"title":"Multidisciplinary approach in the differential diagnosis of left ventricular hypertrophy: a case report","authors":"M. Kudryavtseva, E. V. Ryzhkova, O. Kulikova, E. Mershina, V. Sinitsyn, O. Drapkina, R. Myasnikov","doi":"10.15829/1728-8800-2024-3837","DOIUrl":"https://doi.org/10.15829/1728-8800-2024-3837","url":null,"abstract":"Left ventricular (LV) hypertrophy implies structural cardiac changes and, as a consequence, an increase in myocardial mass. Currently, there are many causes of this condition as follows: hypertension, aortic stenosis, hypertrophic cardiomyopathy, exercise, storage diseases (AL, ATTR amyloidosis, Danon disease, Anderson-Fabry disease, etc.), metabolic disorders. Despite the currently existing diagnostic algorithms for LV hypertrophy, establishing a correct diagnosis can take a long time, and controversial research results can lead to false conclusions. This article presents a case report of a patient with LV hypertrophy, an atypical clinical performance and ambiguous paraclinical data, which led to certain diagnostic difficulties.","PeriodicalId":9545,"journal":{"name":"Cardiovascular Therapy and Prevention","volume":"178 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140456643","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 : 2024-02-14DOI: 10.15829/1728-8800-2024-3936
D. M. Aronov, M. Bubnova
The review discusses studies on clinical effects of exercise in patients after acute myocardial infarction and cardiovascular surgical interventions. Evidence of the high clinical effectiveness of training as an important component of cardiac rehabilitation programs is presented. The review presents the results of clinical studies on cardiac rehabilitation conducted in different countries.
{"title":"Clinical effects of training programs in cardiac rehabilitation. Experience from different countries","authors":"D. M. Aronov, M. Bubnova","doi":"10.15829/1728-8800-2024-3936","DOIUrl":"https://doi.org/10.15829/1728-8800-2024-3936","url":null,"abstract":"The review discusses studies on clinical effects of exercise in patients after acute myocardial infarction and cardiovascular surgical interventions. Evidence of the high clinical effectiveness of training as an important component of cardiac rehabilitation programs is presented. The review presents the results of clinical studies on cardiac rehabilitation conducted in different countries.","PeriodicalId":9545,"journal":{"name":"Cardiovascular Therapy and Prevention","volume":"176 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140457265","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 : 2024-02-08DOI: 10.15829/1728-8800-2023-3872
A. A. Kucherov, A. Ershova, V. Syutkin, O. Drapkina
Liver transplantation (LT) requires not only a carefully organized system for monitoring the condition of patients in the early postoperative period, but also reliable coordination of the actions of doctors of different specialties in the long-term period. This is due to improved survival of liver transplant recipients and a shift in the mortality structure towards cardiovascular diseases and the need to correct metabolic complications that often occur in recipients, in particular hyperlipidemia. Treatment of lipid metabolism disorders after LT includes lifestyle changes, immunosuppressive and lipid-lowering therapy (LLT), which reduces cardiovascular risk. The use of LLT in patients after LT is limited by potential side effects caused by drug interactions, in particular myopathy up to rhabdomyolysis. According to current clinical guidelines, the safest treatment for patients after LT is pravastatin and fluvastatin, the use of which is limited by low availability and low efficacy. It seems promisingto improve LLT in patients after LT through the use of ezetimibe, which has a potentially favorable tolerability profile when combined with immunosuppressants, as well as pitavastatin, which is metabolized through cytochrome P-450 isoenzymes not involved in the metabolism of immunosuppressants, and metabolically neutral PCSK9 inhibitors.
{"title":"Features of lipid-lowering therapy in liver transplant recipients","authors":"A. A. Kucherov, A. Ershova, V. Syutkin, O. Drapkina","doi":"10.15829/1728-8800-2023-3872","DOIUrl":"https://doi.org/10.15829/1728-8800-2023-3872","url":null,"abstract":"Liver transplantation (LT) requires not only a carefully organized system for monitoring the condition of patients in the early postoperative period, but also reliable coordination of the actions of doctors of different specialties in the long-term period. This is due to improved survival of liver transplant recipients and a shift in the mortality structure towards cardiovascular diseases and the need to correct metabolic complications that often occur in recipients, in particular hyperlipidemia. Treatment of lipid metabolism disorders after LT includes lifestyle changes, immunosuppressive and lipid-lowering therapy (LLT), which reduces cardiovascular risk. The use of LLT in patients after LT is limited by potential side effects caused by drug interactions, in particular myopathy up to rhabdomyolysis. According to current clinical guidelines, the safest treatment for patients after LT is pravastatin and fluvastatin, the use of which is limited by low availability and low efficacy. It seems promisingto improve LLT in patients after LT through the use of ezetimibe, which has a potentially favorable tolerability profile when combined with immunosuppressants, as well as pitavastatin, which is metabolized through cytochrome P-450 isoenzymes not involved in the metabolism of immunosuppressants, and metabolically neutral PCSK9 inhibitors.","PeriodicalId":9545,"journal":{"name":"Cardiovascular Therapy and Prevention","volume":" 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139792548","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 : 2024-02-08DOI: 10.15829/1728-8800-2023-3863
K. A. Kaperiz, A. O. Rastatueva, I. Yavelov, O. Drapkina
Aim. In patients with acute thrombophlebitis of the great saphenous vein and/or large tributaries, compare the effectiveness and safety of 1,5-month fondaparinux sodium therapy and endovenous laser ablation in the area of the saphenofemoral junction in combination with shortterm anticoagulation or without anticoagulant therapy.Material and methods. This prospective, single-center, randomized, open-label clinical trial included 105 patients with acute great saphenous vein thrombophlebitis at a distance of at least 5 cm from the saphenofemoral junction. Thirty-four patients were randomized into the group of endovenous laser ablation in the area of the saphenofemoral junction without the anticoagulant therapy. The group of endovenous laser ablation in combination with 7-day fondaparinux sodium included 35 patients, while the group of 1,5-month treatment with fondaparinux sodium — 36. In all cases, class 2 compression stockings were used for 1,5 months. Clinical manifestations of venous thrombosis and its prevalence according to compression ultrasonography were assessed in the first 45±2 days from the start of treatment.Results. The mean age of patients was 49,1±13,7 years. There were more women (73,3%). The prevalence of risk factors for the occurrence and progression of venous thrombosis was low. Previous episodes of thrombophlebitis were observed in 3 (2,9%) patients. External factors that could provoke venous thrombosis were identified in 21 (20,0%) patients. Thrombosis was located in the great saphenous vein in 97,1% of patients, while large tributaries were involved in 25,7% of cases. The median distance from the proximal thrombus to the saphenofemoral junction was 45,2 cm. Patients randomized to the pharmacotherapy group were significantly older (mean age 49,1±13,7, 45,9±13,3 and 53,8±13,2 years, respectively; p=0,032), had slightly less pain and swelling. In all patients, after endovascular laser obliteration, a stable flow cessation at the intervention site was achieved. There were no cases of progression of venous thrombosis. After 7±2 days, in all groups there was a significant decrease in the proportion of patients with clinical manifestations of venous thrombosis, as well as the severity of persistent clinical manifestations. After 45±2 days, clinical manifestations were observed in a few patients and their severity was minimal. However, in the drug treatment group, a more frequent persistence of edema was noted both after 7±2 days (26,5, 20,0 and 47,7%, respectively; p=0,036) and after 45±2 days, (0, 2,9 and 16,7%, respectively; p=0,01). Hematomas and bruises were exclusive hemorrhagic complications. Hematomas were revealed in groups with endovenous laser ablation only. All hemorrhagic complication were minor according to World Society of Thrombosis and Hemostasis (ISTH) and type 1 according to Academic Research Consortium (BARC) classifications.Conclusion. In outpatients with low risk of recurrence and mainly distal localization of acu
{"title":"Endovenous laser ablation and drug treatment of acute great saphenous vein ascending thrombophlebitis: comparison of three approaches to the treatment of patients","authors":"K. A. Kaperiz, A. O. Rastatueva, I. Yavelov, O. Drapkina","doi":"10.15829/1728-8800-2023-3863","DOIUrl":"https://doi.org/10.15829/1728-8800-2023-3863","url":null,"abstract":"Aim. In patients with acute thrombophlebitis of the great saphenous vein and/or large tributaries, compare the effectiveness and safety of 1,5-month fondaparinux sodium therapy and endovenous laser ablation in the area of the saphenofemoral junction in combination with shortterm anticoagulation or without anticoagulant therapy.Material and methods. This prospective, single-center, randomized, open-label clinical trial included 105 patients with acute great saphenous vein thrombophlebitis at a distance of at least 5 cm from the saphenofemoral junction. Thirty-four patients were randomized into the group of endovenous laser ablation in the area of the saphenofemoral junction without the anticoagulant therapy. The group of endovenous laser ablation in combination with 7-day fondaparinux sodium included 35 patients, while the group of 1,5-month treatment with fondaparinux sodium — 36. In all cases, class 2 compression stockings were used for 1,5 months. Clinical manifestations of venous thrombosis and its prevalence according to compression ultrasonography were assessed in the first 45±2 days from the start of treatment.Results. The mean age of patients was 49,1±13,7 years. There were more women (73,3%). The prevalence of risk factors for the occurrence and progression of venous thrombosis was low. Previous episodes of thrombophlebitis were observed in 3 (2,9%) patients. External factors that could provoke venous thrombosis were identified in 21 (20,0%) patients. Thrombosis was located in the great saphenous vein in 97,1% of patients, while large tributaries were involved in 25,7% of cases. The median distance from the proximal thrombus to the saphenofemoral junction was 45,2 cm. Patients randomized to the pharmacotherapy group were significantly older (mean age 49,1±13,7, 45,9±13,3 and 53,8±13,2 years, respectively; p=0,032), had slightly less pain and swelling. In all patients, after endovascular laser obliteration, a stable flow cessation at the intervention site was achieved. There were no cases of progression of venous thrombosis. After 7±2 days, in all groups there was a significant decrease in the proportion of patients with clinical manifestations of venous thrombosis, as well as the severity of persistent clinical manifestations. After 45±2 days, clinical manifestations were observed in a few patients and their severity was minimal. However, in the drug treatment group, a more frequent persistence of edema was noted both after 7±2 days (26,5, 20,0 and 47,7%, respectively; p=0,036) and after 45±2 days, (0, 2,9 and 16,7%, respectively; p=0,01). Hematomas and bruises were exclusive hemorrhagic complications. Hematomas were revealed in groups with endovenous laser ablation only. All hemorrhagic complication were minor according to World Society of Thrombosis and Hemostasis (ISTH) and type 1 according to Academic Research Consortium (BARC) classifications.Conclusion. In outpatients with low risk of recurrence and mainly distal localization of acu","PeriodicalId":9545,"journal":{"name":"Cardiovascular Therapy and Prevention","volume":"63 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139853952","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 : 2024-02-08DOI: 10.15829/1728-88002023-3870
O. Drapkina, S. Berns, M. G. Chashchin, A. Gorshkov, O. V. Zhdanova, L. N. Ryzhakova
The article discusses the effectiveness and safety of homologous and heterologous revaccination for Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in people of different age groups.Aim. The study the severity and duration of immune response in people of different age groups after SARS-CoV-2 revaccination.Material and methods. The study was carried out as part of the prospective registry Saturn, which included persons who received various SARS-CoV-2 revaccination regimens (homoand heterologous) based on the combination of two vaccines: Gam-COVID-Vac and Covivac. Group I (n=106) included persons who received a homologous revaccination with Gam-COVID-Vac, while group II (n=54) — heterologous revaccination with Gam-COVID-Vac and Covivac, group III (n=40) — homologous Covivac revaccination. In addition, all participants in the study were divided into two age categories: ≥60 years (n=33) and <60 years, (n=167). In all participants, the medical history was collected. At each visit, we assessed the quantitative level of specific IgG SARS-CoV-2 S-protein antibodies and plasma coagulation using the thrombodynamics method. At visits 1, 3 and 5, blood was collected to assess T-cell immunity activity (T-Spot.COVID test, Oxford Immunotec) to the SARS-CoV-2 virus.Results. Revaccination in persons ≥60 years of age ensures the intensity of humoral (quantitative level of specific IgG SARS-CoV-2 S-protein antibodies) and cellular immunity (quantitative assessment of SARS-CoV-2 spike protein-specific (panel A) and nucleocapsid-specific T-lymphocytes) comparable to that in younger individuals (<60 years). Revaccination did not increase the plasma thrombogenic potential in vaccinated people, regardless of age.Conclusion. In the group of vaccinated people ≥60 years old, an adequate humoral and cellular immune response was developed, which persisted for a year after revaccination, and even more intense cellular immunity was demonstrated compared to vaccinated people <60 years old. The plasma thrombogenic potential did not increase during vaccination and revaccination, regardless of age.
{"title":"Severity and duration of immune response in people of different age categories after SARS-CoV-2 revaccination","authors":"O. Drapkina, S. Berns, M. G. Chashchin, A. Gorshkov, O. V. Zhdanova, L. N. Ryzhakova","doi":"10.15829/1728-88002023-3870","DOIUrl":"https://doi.org/10.15829/1728-88002023-3870","url":null,"abstract":"The article discusses the effectiveness and safety of homologous and heterologous revaccination for Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in people of different age groups.Aim. The study the severity and duration of immune response in people of different age groups after SARS-CoV-2 revaccination.Material and methods. The study was carried out as part of the prospective registry Saturn, which included persons who received various SARS-CoV-2 revaccination regimens (homoand heterologous) based on the combination of two vaccines: Gam-COVID-Vac and Covivac. Group I (n=106) included persons who received a homologous revaccination with Gam-COVID-Vac, while group II (n=54) — heterologous revaccination with Gam-COVID-Vac and Covivac, group III (n=40) — homologous Covivac revaccination. In addition, all participants in the study were divided into two age categories: ≥60 years (n=33) and <60 years, (n=167). In all participants, the medical history was collected. At each visit, we assessed the quantitative level of specific IgG SARS-CoV-2 S-protein antibodies and plasma coagulation using the thrombodynamics method. At visits 1, 3 and 5, blood was collected to assess T-cell immunity activity (T-Spot.COVID test, Oxford Immunotec) to the SARS-CoV-2 virus.Results. Revaccination in persons ≥60 years of age ensures the intensity of humoral (quantitative level of specific IgG SARS-CoV-2 S-protein antibodies) and cellular immunity (quantitative assessment of SARS-CoV-2 spike protein-specific (panel A) and nucleocapsid-specific T-lymphocytes) comparable to that in younger individuals (<60 years). Revaccination did not increase the plasma thrombogenic potential in vaccinated people, regardless of age.Conclusion. In the group of vaccinated people ≥60 years old, an adequate humoral and cellular immune response was developed, which persisted for a year after revaccination, and even more intense cellular immunity was demonstrated compared to vaccinated people <60 years old. The plasma thrombogenic potential did not increase during vaccination and revaccination, regardless of age.","PeriodicalId":9545,"journal":{"name":"Cardiovascular Therapy and Prevention","volume":" 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139792251","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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