Aim. This study aims to assess the incidence of heart failure (HF) and associated mortality, and also the burden on the healthcare system in the subjects of Russian Federation, based on the HF encoding data.

Material and methods. We made a structured request for the number of patients with HF and the number of cases of providing medical care in 2019. HF was understood to mean the presence of at least one of the codes I09.9, I11.0, I13.0, I13.2, I25.5, I42.0, I42.5, I42.6, I42.7, I42.8, I42.9, I43.0, I43.1, I43.2, I43.8, I50.X (expanded encoding) according to International Classification of Diseases 10th Revision. The code I50.X was considered separately (the standard HF enconding).

Results. The information about the incidence of HF, associated mortality and burden on the healthcare system was obtained from 15 subjects (53,6% from those that gave the data according to the request; the adult population is 18,9% from total adult population of Russian Federation). We noted significant heterogeneity between the regions. The median of the incidence of HF and associated mortality was 2,6 and 3,2% in accordance with the data of the expanded encoding, and 0,21 and 11,3% — according to the standard HF encoding. The presence of the code I50.x was observed in average in 9,4% of all cases of HF and defined the patients who frequently used emergency medical services and were frequently hospitalized (60 (18, 96) and 48 (20, 137) cases per 100 patients versus 9 (5, 24) and 17 (10, 70) cases in the expanded encoding).

Conclusion. According to the encoding, the indicators of the incidence of HF and associated mortality vary greatly between the regions, the median values are 2,6 and 3,2% in expanded and 0,21 and 11,3% in standard approaches. In the standard encoding, there were more frequent use of emergency medical services and less number of outpatient visits. The development and introduction of a unified approach to encoding and recording the cases of HF will provide obtaining objective statistical data and using them for management decisions.

Aim. This study aims to investigate the association of cystatin C with changes of left ventricular structure and function in individuals with different cardiovascular risk (CVR).

Material and methods. 267 patients with low-moderate (group I, n=58), high (group II, n=80) and extremely high (group III, n=129) CVR were examined. The level of serum cystatin C, creatinine and blood lipid spectrum, filtration rate of the kidneys and echocardiography indicators were estimated.

Results. Among all the study participants (n=267), 194 patients (72,6% of cases) had the increased level of serum cystatin C; 165 patients (61,7% of cases) showed the signs of the left ventricular hypertrophy (LVH). The increased level of serum cystatin C was observed in 51,7% of cases in group I; 75,0% — in group II and 80,6% — in group III. The values of glomerular filtration rate (GFR) calculated using the CKD-EPI and F. Hoek formula were the following: 100,2±17,0 ml/min/1,73 m² and 84,8±15,5 ml/min/1,73 m², p<0,05 in group I; 81,2±21,6 ml/min/1,73 m² and 63,1±18,3 ml/min/1,73 m², p<0,05 in group II; 63,0 (32,0;93,0) ml/min/1,73 m² and 55,1 (22,1;70,7) ml/min/1,73 m² — in group III. The LVH detection increased with the increase of the CVR degree (43,1% — in group I; 66,2% — in group II and 67,4% in group III). Relative wall thickness (RWT, units) increased significantly from the patients of group I (0,34±0,04 units) to the patients of group II (0,37±0,08 units) and III (0,38±0,06 units). Eccentric variant of LVH significantly prevailed in all the groups. On one side, it was found that the level of serum cystatin C was in direct correlation with left ventricular mass index (LVMI, r=0,268, p<0,05) and left ventricular RWT (r=0,190, p<0,05), and on the other side, the inverse relationship between LVMI and GFR for cystostatin C was observed (r=-0,324, p<0,05).

Conclusion. The results of the study showed that the level of serum cystatin C and LVMI value significantly increase with the increase of the CVR degree. The high levels of serum cystatin C are closely associated with the increase of LVMI and the changes in the RWT value. In turn, the increase of LVMI negatively correlated with filtration rate of the kidneys in patients with different CVR. Concerning the structural changes in the left ventricle, eccentric HLV prevailed in all the three groups.

Aim. This study aims to assess the clinical specificity of course of hypertensive disease (HD) during the first 6 months after new coronavirus infection (COVID-19) and to investigate prognostic significance of laboratory and instrumental parameters for organ dysfunctions in acute period of COVID-19 in patients with HD.

Material and methods. The study included 82 patients. The main group included 50 patients with HD duration of at least 3 years, who received antihypertensive therapy and had confirmed moderate COVID-19. The control group included 32 patients with HD and without COVID-19. The mean age was 63,6±7,9 years and 66,6±10,3 years, respectively. The standard parameters of carbohydrate and lipid metabolism, inflammatory markers, hematological indicators, glomerular filtration rate (GFR) were measured, and also arterial pressure, Ps, t^o C, SpO₂, peak expiratory flow rate (PEFR) were recorded. In 6 months we contacted by phone to conduct a survey concerning the 6-month period after hospitalization or outpatient examination with filling the questionnaire form SF-36.

Results. Before inclusion, 76,5% and 83,3% of the patients in the main and control groups, respectively, took 1 hypotensive drug; 17,7% and 16,6% — 2-3 drugs; 5,9% (p<0,05) of the patients from the COVID-19 group took the drugs irregularily before hospitalization. In 6 months, 3% in each group took 1 hypotensive drug, 50% — 2 drugs, and 47% — 3 drugs. For the control group this was: 77% — 2 and 20% — 3, respectively. After analyzing the SF-36 form, we found that the worsening of emotional health in the group with HD and COVID-19 correlated (p<0,05) with initial SpO₂ (r=-0,623), t^o C (r=-0,371), PEFR (r=0,423), and the degree of improvement — with GFR (r=0,339), total cholesterol (r=0,471) and platelet count (r=0,414). SF-36 also showed that in the main group, the worsening of physical health was associated with lower ALB (r=0,512), the higher increase of lactate dehydrogenase (r=0,342) and RBC (r=0,393).

Conclusion. In 6 months after moderate COVID-19, the patients develop pronounced emotional and physical disorders as well as the worsening of HD clinical course. Regarding to this, the parameters reflecting severity of systemic inflammation, impairment of liver function and changes in brain function in acute COVID-19 possessed the prognostic significance.

Aim. This study aims to assess the association between iron deficiency (ID) and recurrences of atrial fibrillation (AF) in patients after pharmacological cardioversion with amiodarone within 12 months.

Material and methods. The open-label, prospective, single-center study included 198 patients with non-valvular paroxysmal AF after successful pharmacological cardioversion with amiodarone. Group I included 116 patients with ID, and group II — 82 patients with normal iron status. The primary end-point of the study was the development of symptomatic AF recurrences within 12 months after the cardioversion which was estimated by the Kaplan-Meier method. The differences were considered statistically significant if p-value was <0,05.

Results. Absolute ID was found in patients of group I; anemia was revealed in 85,3% of the patients. The groups did not differ in basic clinical and demographical parameters, concomitant diseases and drug therapy. Along with that, the I group patients were older (the median was 73 (64,8-79) years old and 69 (63-75) years old, respectively, р=0,008), and their left ventricular mass was larger (the median was 145 (115-176) g and 132,5 (118,2-145) g, respectively, р=0,004). The sinus rhythm restoration in group I required less dose of amiodarone (the median was 450 (300-600) mg and 1000 (600-1200) mg, respectively, р<0,001) and less time from the start of the drug administration to the rhythm restoration (the median was 7 (3-10) and 12 (9-18) hours, respectively, р<0,001). During the 12-month follow-up period, 49 (42,2%) patients in group I and 16 (19,5%) patients in group II developed AF recurrences (р=0,0008), hazard ratio 2,64 (95% confidence interval: 1,5-4,65) (р=0,0003).

Conclusion. ID is associated with the increase of the number of symptomatic AF recurrences in patients after pharmacological cardioversion with amiodarone within 12 months.

Aim. This study aims to investigate the effect of senile asthenia syndrome (SAS) on the cardiovascular mortality risk within 12 months in patients over 70 years of age with myocardial infarction.

Material and methods. We performed a retrospective study of 92 patients over 70 years of age with myocardial infarction, who agreed to participate. To detect senile asthenia syndrome, we used the questionnaire "Age is not a hindrance". We estimated the anamnestic data, and also laboratory and instrumental parameters. The follow-up period was 12 months. As an end-point, the onset of an adverse event — cardiovascular death was chosen. Statistical nonparametric methods, ROC analysis, Kaplan-Meier survival analysis (p<0,05) were used.

Results. In 12 months, 19 patients (20,65%) met the end-point. The median (25%; 75%-quartile) of the numbers of points according to the questionnaire "Age is not a hindrance" was significantly higher in the group of dead patients than in the group without adverse outcomes — 4 (3; 5) and 2 (1; 4) points (p<0,001). When gaining 3 or more points according to the questionnaire "Age is not a hindrance", risk ratio of cardiovascular death within 12 months was 1,72; 95% confidence interval: 1,28-2,30 (p=0,001). In conduction of ROC analysis to predict adverse outcome when gaining 3 or more points according to the questionnaire "Age is not a hindrance", the area under the curve (AUC) was 0,78 (p<0,001), sensitivity — 89%, specificity — 60%.

Conclusion. The risk of cardiovascular death within 12 months after myocardial infarction in patients over 70 years of age with SAS increases by 72%. The inclusion of the results from the questionnaire "Age is not a hindrance" into prognostic models, and the SAS estimation in this cohort of patients will improve the risk stratification.

Aim. This study aims to determine the impact of invasive treatment strategy on long-term outcomes in patients with ST-segment elevation myocardial infarction (STEMI) in late admission to PCI center (12-48 hours from the symptom onset) in comparison with conservative management.

Material and methods. The study population included 154 people with STEMI, admitted to V. P. Polyakov Samara Regional Clinical Cardiology Dispensary during 12-48 hours after onset of myocardial ischemia symptoms, for the period of inclusion (2013-2017). The mean age of the patients was 57,2±9,2 years old. The study evaluated two time periods: intrahospital and long-term (during 4 years from the index hospitalization). The primary end-point: cardiovascular death. The secondary combined end-point included: myocardial infarction recurrence, life-threatening rhythm disturbances, acute bleeding, heart failure NYHA III-IV functional class. The patients were divided into two groups depending on initially chosen management strategy: invasive (I) (n=113; 73,4%) or conservative (II) treatment (n=41; 26,6%).

Results. Comparing frequency of occurrence of cardiovascular death depending on chosen treatment tactics, we found that the probability of lethal outcome from cardiovascular causes in conservatively treated patients increased by 20,64 times (95% confidence interval (CI): 1,04-408,61), p=0,018 during intrahospital period of the study. The analysis performed using the Kaplan-Meier method showed the medians of the time of lethal outcome occurrence: in conservative group — 76,5 months (95% CI: 67,6-85 months), in invasive group — 92,1 months (95% CI: 88,9-95,3 months), p=0,014.

Conclusion. This study presented the results of our own retrospective study which confirms that revascularization in late-presenting patients with STEMI (12-48 hours from the symptom onset) results in improving the outcomes in both intrahospital and long-term periods.

Aim. This study aims to assess the association between levels of biomarkers and postoperative complications in patients after thoracic and thoracoabdominal aortic reconstruction.

Material and methods. This study included 132 patients. The most of them underwent ascending aortic and aortic arch reconstruction (65 and 57, respectively).

The concentrations of proadrenomedullin, presepsin, procalcitonin, troponin I and N-terminal brain natriuretic peptide were measured before induction anesthesia, at the end of the surgical operation and in 6 hours after surgery.

Results. 69 patients had postoperative complications. Among them, inflammatory (27,3%) and cardiovascular complications (12,1%) prevailed. At the end of the surgical operation, the levels of the biomarkers in patients without postoperative complications and with postoperative complications were for presepsin 326 [206; 451] и 620 [332; 829] p<0,00001, tropononin I 0,77 [0,46; 1,39] and 1,49 [0,59; 3,39], p=0,01, proadrenomedullin 0,894 [0,683; 1,221] and 1,201 [0,944; 1,762], p=0,0002, procalcitonin 0,206 [0,147; 0,452] and 0,563 [0,307; 2,107], p=0,0002, respectively. According to log-linear regression model, the level of prepepsin at the end of the surgical operation >459,5 (odds ratio (OR) 6,84, 95% confidence interval (CI): 3,14-14,87) or proadrenomedullin >0,788 (OR 5,47, 95% CI: 1,52-19,68) are associated with the increased risk of postoperative complications. The level of presepsin >519,5 pg/ml at the end of the surgical operation (OR 4,55, 95% CI: 1,97-10,47) is associated with the increased risk of inflammatory complications. Regarding the prognosis of the risk of prolonged cardiotonic drug infusions, threshold values for troponin were >1,04 at the end of the surgical operation (sensitivity 75%, specificity 71,3%, AUC 0,785), >1,57 in 6 hours after surgery (sensitivity 81,3%, specificity 71,6%, AUC 0,794).

Conclusion. High levels of presepsin at the end of the surgical operation may be useful to predict the postoperative complications in patients who underwent the aortic surgery however, the low levels of presepsin do not exclude the development of postoperative complications. The increased level of troponin I at the end of the surgical operation and in 6 hours after surgery can be a predictor of the need for cardiotonic support in the postoperative period.

Aim. This study aims to compare the intraoperative, immediate postoperative and long-term postoperative results of stenting followed by final kissing balloon angioplasty (FKB) and without FKB for left coronary artery (LCA) bifurcation lesions in patients with chronic ischemic heart disease.

Material and methods. We plan to perform an open-label, prospective, randomized, single-center, cohort trial that will include 40 patients with left main coronary artery bifurcation lesion, who will undergo stenting procedure followed by FKB or without FKB, using the second-generation drug-eluting stents. Randomization into two groups will be done after performing coronary angiography, confirming the inclusion criteria and the absence of non-inclusion criteria and signing a written consent in 2 copies. Group 1 — stenting followed by FKB. Group 2 — stenting without FKB. The total follow-up period is 24 weeks. It is planned to contact by phone on 30th and 180th day (±7 days) of postoperative period to obtain the information about patient condition, general survival rate, the events of combined controlled points and drug therapy. During 2d phone contact, on 180th day (±7 days), a patient will be invited to undergo multispiral computed tomography of the coronary arteries.

The primary combined end-point: cardiac death, nonfatal myocardial infarction, acute cerebrovascular accident and the repeat target vessel revascularization. The secondary combined end-point: thrombosis and stent restenosis.

Conclusion. Our study will optimize the approach to the choice of stenting strategy (with or without FRB) for left main coronary artery bifurcation lesions in patients with chronic ischemic heart disease.

This article is about the experience in organizing and conducting the first Russian cardiology hackathon Cardio data hack UFA 2022 which took place in Ufa in November 2022. It describes the preparation stages and organizational conditions of the hackathon conducting, the ways of interacting between the event organizer and participants, and the methods of evaluating the tasks. The first hackathon case was the recognition of ventricular bigeminy in patients with 24-hour ECG recording; the second case was performing a meta-analysis of the studies which assessed efficacy and safety of oral anticoagulants in atrial fibrillation and chronic renal failure stages IV and V. The hackathon attracted 179 registered participants who formed 42 teams, but further only 37 of them confirmed their participation and formed 8 teams. 7 teams gave the final solution of the tasks, and 5 of them presented their results with 3 of them giving solutions for both cases. Eventually, there were obtained the prototypes of solution for bigeminy recognition during Holter monitoring and high-quality meta-analyses evaluating the efficacy and safety of oral anticoagulants.

As a clinical case, we present the "portrait" of a woman patient with acquired mitral valve (MV) defect against the background of infective endocarditis which was diagnosed during the third trimester of pregnancy. The patient underwent mitral valve replacement surgery with biological prosthesis "KemKor" followed by two successful deliveries. In 18 years after the correction of the mitral valve defect, she developed valve prosthesis dysfunction therefore, she underwent endovascular transcatheter implantation of bioprosthesis by method "prosthesis-into-prosthesis" in the mitral position.

This clinical case is unique in terms of the reasoning the biological prosthesis choice to correct acquired MV defect in a patient of reproductive age, the long-term period of the bioprosthesis functioning and the correction of further developed valve dysfunction using the techniques of transcatheter implantation.

Aim. This study aims to compare efficacy and safety of direct oral anticoagulants (DOAC) with vitamin K antagonist (VKA) in patients with atrial fibrillation (AF) and chronic kidney disease (CKD) stages IV and V.

Material and methods. We systematically searched the PubMed, Google Scholar, Web of Science databases from 1990 to 2022 and included all published studies that compared DOACs with VKA in patients with atrial fibrillation and chronic kidney disease stages IV and V. To search the articles, we used the PICO strategy: Patient, Intervention, Comparison, Outcome of Interest. Data extraction was undertaken by five independent researches, and then a meta-analysis was performed.

Results. Out of all, 6 studies were included in the meta-analysis: 3 randomized controlled trials (n=353) and 3 retrospective analyses (n=37470). The efficacy of DOACs was comparable with VKA. In terms of safety, DOACs and VKA also showed no statistical differences: hemorrhagic stroke, major/minor/gastrointestinal bleeding, general mortality.

Conclusion. In terms of efficacy and safety, the indicators of DOACs and VKA were generally comparable.

This review considers the risk factors for arterial hypertension (AH) progression, obstructive sleep apnea syndrome (OSAS) and novel coronavirus infection (COVID-19) as potential variables for the prognostic models of estimating the probability of destabilization of the mentioned conditions. The most published studies consider AH and OSAS as the risk factors influencing the course of COVID-19, while moderate and mild COVID-19 can be destabilizing factor regarding to AH and OSAS. In addition, COVID-19, AH and OSAS are interrelated with sleep quality. The worsening of sleep quality often can be both a consequence of these diseases and a factor aggravating their course, and also can cause the increased vulnerability to acute diseases. An increased body mass index is a universal risk factor for many diseases and clinical conditions, and the monitoring of body mass increases the degree of the control of the diseases associated with obesity. In addition, the worsening of sleep quality can be both a consequence of any of above-mentioned conditions and a factor aggravating their course. Also, a promising direction for improving prognostic models is the analysis of autonomic dysfunction in patients.