The article presents the examination of three generations of a family with diagnosed left ventricular noncompaction (LVNC) and various phenotypic manifestations of the disease (isolated, hypertrophic and dilated type of LVNC). As a result of a molecular genetics tests, a previously undescribed single nucleotide deletion in the PRDM16 gene was revealed in all family members with the LVNC phenotype, leading to a frameshift mutation in exon 9 and the formation of a premature termination codon. This gene encodes a transcription factor responsible for after-birth suppressing the expression of genes involved in prenatal and postnatal development. Despite the presence of previous studies showing the relationship of the PRDM16 gene with LVNC development, currently there are insufficient data to prove the pathogenicity of the identified variant. However, the segregation of the symptomatic variant in three generations supports the association of the identified variant with LVNC. With the accumulation of information about changes in PRDM16 in patients with cardiomyopathies, it is possible to change the status of this gene and clarify its contribution to primary heart diseases.

Extent of cardiac surgery aid has dropped significantly globally due to reallocation of health care resources due to COVID-19 pandemic.
Aim. To evaluate the results of chosen management strategy for patients with coronary artery disease (CAD) and COVID-19 manifested in the early postoperative period after coronary artery bypass grafting.
Material and methods. We present our experience of treating 19 patients with CAD and COVID-19 manifested in the early postoperative period after coronary artery bypass grafting. The main symptoms of COVID-19 in these patients were high-grade fever, severe general weakness, shortness of breath, and decreased blood oxygen saturation. Laboratory data showed significant increases in fibrinogen, C-reactive protein, ferritin, procalcitonin, and D-dimer levels. In all patients, according to the chest computed tomography, a picture of unilateral or bilateral multisegmental pneumonia in the form of ground-glass opacity areas was determined. The damaged lung area varied from 10% to 55%.
Results. Patients were treated in accordance with the Russian guidelines, followed by transfer to continue therapy in specialized infectious diseases hospitals. Sixteen patients transferred to infectious diseases hospitals were subsequently discharged from in a satisfactory condition. Three patients died from various complications of COVID-19 (mortality rate, 16%).
Conclusion. The development of new screening strategies, standard guidelines and protocols for the management of cardiac surgery patients in a pandemic will contribute to an earlier detection of COVID-19 and, accordingly, a timely change in treatment strategy.

Aim. To improve the long-term outcomes of patients with atrial fibrillation (AF) after cardioembolic stroke by creating and testing a comprehensive ambulatory monitoring system.
Material and methods. The present study included 139 AF patients after cardioembolic stroke for the period 2016-2019, of which 80 (57,55%) were women and 59 (42,45%) were men. The mean age of the patients was 72,25±6,33
years. Before the hospital discharge, all patients signed an informed consent and were randomized into two groups. Patients of the group I (n=72) were followed up during the year in accordance with a specially developed comprehensive ambulatory monitoring system. This system included a rehabilitation program created individually for each patient, monthly visits to a physician-researcher, during which a complex of diagnostic tests was carried out. Also, the changes of complaints, symptoms, and medical adherence were assessed. The latter was corrected. A physician talked with the patient's relatives about the need to comply with the recommended medication regimen, supporting the motivation for treatment. Patients of group II (n=67) were followed up at the primary care level in accordance with the current program, and a control visit to was performed for them once — after 12 months.
Results. After one-year follow-up, a significant decrease in all-cause mortality was obtained in the first group in comparison with the second one: 3 (4,17%) and 18 (26,87%) deaths, respectively (p=0,021).
In addition, in group II, a relationship was found between the death and absence of anticoagulant therapy (odds ratio, 7,68; 95% confidence interval, 1,59-37,03; p=0,01). The ROC analysis confirmed the relationship between the absence of anticoagulant therapy and death, while the regression quality was good (area under the curve, 0,77, sensitivity — 94,74%, specificity — 59,17%).
Conclusion. Comprehensive ambulatory monitoring program for AF patients after cardioembolic stroke has proven high effectiveness, and its widespread practice is an urgent task of modern healthcare.

Over the past century, an increase in life expectancy has been observed in Russia and in the world. According to the United Nations, by 2100, the number of centenarians worldwide will reach 25 million. Despite the annual increase in the number of super-centenarians, this age group remains poorly understood.
Aim. To estimate the prevalence of cardiovascular diseases (CVD) and the main risk factors among super-centenarians in Moscow.
Material and methods. According to the register of long-livers in Moscow, 82 people aged 95 to 105 were included. Participants were examined at home.
The history of life and the presence of chronic diseases was collected by participant words. To assess the state of cardiovascular system, an ultrasound of the heart and main arteries was performed.
Results. Conventional CVD risk factors were the exception rather than the rule among study participants (smoking — 8 patients (9,8%), alcohol abuse — 4 (4,9%), obesity — 6 (7,3%)). Dyslipidemia was relatively widespread (n=37; 45,1%), however, there were no pronounced abnormalities in the lipid profile: the maximum increase in low-density lipoproteins was 5,6 mmol/L. The most common CVDs among the participants were hypertension (n=64; 78%), coronary artery disease (n=42; 51,2%), and heart failure (n=26; 31,7%); other diseases were much less common. The most common echocardiographic changes were left atrial dilatation (n=38; 74,5%), increased left ventricular mass, thickening of left ventricular posterior wall (n=24; 48%) and interventricular septum (n=51; 100%). Diastolic and systolic heart failure were not widespread among long-livers: 16 (32%) and 2 (3,9%), respectively. Despite a rather large number of atherosclerotic plaques in the common carotid and femoral arteries, the number of hemodynamically significant plaques was low (n=3; 4,6%). An intima-media thickening up to 1,0-1,1 mm was found.
Conclusion. Long-livers in Moscow are characterized by a low prevalence of traditional CVD risk factors (with the exception of hypertension) and a fairly high prevalence of atherosclerotic CVDs, which are characterized by a subclinical course.

The genetic architecture of blood pressure (BP) includes more than 30 genes, the polymorphic variants of which cause phenotypic heterogeneity of BP. Given that a human genetic information is largely stable from birth, it can act as an early predictor of hypertension (HTN). Identification of polymorphic variants of genes associated with a high HTN risk may be one of the promising areas of early diagnosis and prevention of this disease. In addition, the availability of this data will make it possible to clarify the prognosis of patients already with HTN, as well as to personalize the treatment approach. The review analyzes the papers devoted to the molecular genetic basis of hypertension and identifies the possible role of gene polymorphism of the renin-angiotensin-aldosterone system in hypertension development. A large number of studies have revealed an association between HTN and polymorphic variants of the ACE, AGT, AGTR1 genes. In addition, polymorphism of these genes is involved in the development of atherosclerosis and related diseases, kidney and central nervous system disorders, and justifies the effectiveness of angiotensin-converting enzyme inhibitors in the treatment of HTN.

Hypertension (HTN) is an important modifiable risk factor for cardiovascular disease associated with poor outcomes and high health care costs. The assessment of cardiovascular risk (CVR) according to the current ESC/ESH guidelines for the treatment of hypertensive patients presents a number of difficulties and initiates the search for new diagnostic methods that contribute to understanding the patient's phenotype, personalizing diagnostic and treatment tactics, and improving the outcomes of hypertensive patients. Regulatory mechanisms involved in the body's orthostatic response, such as activation of the sympathetic nervous system, catecholamine production, endothelial function, significantly contributes to maintaining blood pressure levels. Their violation plays an active role in hypertension development, which allows considering orthostatic HTN in a hypertensive patient as a marker of CVR stratification. The article discusses the diagnostic criteria for orthostatic HTN, its pathophysiological mechanisms and possible use as a marker of CVR stratification.

Coronary artery disease (CAD) remains the leading cause of death and disability in developed countries. Using traditional risk factors for CAD, it is possible to predict the likelihood of acute coronary events in no more than 50% of cases. Therefore, the study of influence of genetic and epigenetic factors on the development of CAD is extremely important. Research in recent years has shown that vitamin D deficiency is a new risk factor for atherosclerosis and immune inflammation. Vitamin D implements protective effects against immune inflammation through receptors in the vascular wall. A single nucleotide polymorphism of the vitamin D receptor (VDR) gene is a potential risk factor for CAD associated with low vitamin D levels. VDR expression correlates with the expression of pro-inflammatory cytokines and is regulated by microRNAs — microRNA-125a-5p, microRNA-125b-5p, microRNA-214-3p and microRNA-21 These microRNAs regulate the action, synthesis and metabolism of vitamin D and can themselves be influenced by VDR signals through dynamic feedback, which can lead to destabilization of mRNA and inhibition of translation. This literature review highlights the effect of a single nucleotide polymorphism of the VDR gene and microRNA on the pathogenetic mechanisms of CAD.

At the end of the last century and, especially, in the first two decades of the 21st century, a significant technological breakthrough took place in clinical laboratory diagnostics in Russia. The transition from manual techniques to high-tech and high-performance automated systems has changed the potential of laboratory medicine. The laboratory has become a high-tech, rapidly developing branch of medical organizations. Following the changes in technology, the range of diagnostic tests began to alter, while the list of laboratory tests available grew. These dynamics are growing every year. Simple routine techniques, practiced for all patients, are complemented by more specific tests. The place of conventional routine tests has been determined by many years of practical experience, while modern analyzers allow the use of tests with a high evidence value of recommendations, which, in the context of evidence-based medicine, enable the clinician to conduct a personalized diagnostic search. At the same time, in order to use all the possibilities of laboratory medicine, the discipline Clinical Laboratory Diagnostics should be included in educational programs at different stages of a doctor's training.

The development of chronic kidney disease (CKD) is a risk factor not only for cardiovascular diseases, but also for heart failure (HF). This article is a literary review on the use of Sodium-glucose co-transporter-2 (NGLT2) inhibitors in patients with CKD and HF. The paper describes in detail the action of NGLT2 inhibitors in the light of nephro- and cardioprotection. In addition to the glucosuric effect of NGLT2 inhibitors, they have a natriuretic and diuretic effect. One of the effects of NGLT2 inhibitors is the ability to lower blood pressure. One of the key effects of NGLT2 inhibitors, explaining nephroprotection, is the influence on glomerular filtration. The ability of NGLT2 inhibitors to suppress the peroxidation in mitochondria of proximal tubular epithelium was shown. Another putative mechanism of the organ protection action of NGLT2 inhibitors is their ability to inhibit the activation of the sympathetic nervous system.
The results of studies using empagliflozin in HF and CKD are presented. In particular, the EMPA-REG OUTCOME study showed that in patients with type 2 diabetes and concomitant cardiovascular diseases, empagliflozin led to a 35% decrease in hospitalization risk due to decompensated HF and decrease of cardiovascular death risk by 38% regardless of baseline renal function. According to the EMPEROR-Reduced study, empagliflozin showed a favorable safety profile.

The classic Osborn wave in the form of characteristic changes at the depolarization end or ventricular repolarization beginning is more often associated with hypothermia (body temperature below 35,6° C). Some researchers have noticed Osborn wave at normal body temperature, various pathological conditions and diseases: hypercalcemia, myocardial ischemia, postoperative pericarditis, with central nervous system, etc. We presented a case report of a 72-year-old female inpatient with moderate COVID-19, confirmed by polymerase chain reaction, and 48% lung damage. Before admission to the hospital, electrocardiogram had no Osborn wave, which first appeared at admission. There was a significant increase in serum C-reactive protein and a moderate increase in serum biomarkers and no changes in intervals and segments on the electrocardiogram. The appearance of Osborn wave may be associated with intramyocardial electrolyte imbalance, a consequence of antiviral and antibacterial therapy that violate intraventricular conduction.

Takayasu's arteritis is a chronic granulomatous vasculitis of large vessels of unclear etiology, predominantly affecting the aorta and its main branches, with possible involvement of the coronary and pulmonary arteries. The true prevalence of this disease is unknown, but it is extremely low, given the rare diagnosis and the absence of pathognomonic symptoms. In clinical practice, the criteria proposed by the American College of Rheumatology are used for making a diagnosis. A wide range of imaging diagnostic techniques plays a significant role. This article provides a literature review and a case report of Takayasu's arteritis in a patient admitted with an acute coronary syndrome.

Pulmonary hypertension is a syndrome difficult for differential diagnosis, which is the outcome of various pathological conditions. With the exclusion of the most common causes of pulmonary hypertension (left heart disorders and pulmonary embolism), further search for cause often becomes an insoluble problem. Sezary syndrome is classified as a rare type of cutaneous T-cell lymphomas. Early diagnosis of this syndrome is important for the initiation of adequate therapy, since cases of complete recovery or long-term remission in patients with Sezary syndrome are very rare. A case report of Sezary syndrome verification in cardiology practice is described.

This collaborative statement from the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm Association/Asia Pacific Heart Rhythm Society describes the current status of mobile health (“mHealth”) technologies in arrhythmia management. The range of digital medical tools and heart rhythm disorders that they may be applied to and clinical decisions that may be enabled are discussed. The facilitation of comorbidity and lifestyle management (increasingly recognized to play a role in heart rhythm disorders) and patient self-management are novel aspects of mHealth. The promises of predictive analytics but also operational challenges in embedding mHealth into routine clinical care are explored.