on behalf of the Committees of the Russian Society of Cardiology for work with medical schools of the Russian Federation and for educational activities and youth policy

Cardiovascular diseases take a leading place in the morbidity pattern worldwide, and therefore improving the cardiology education in medical schools is very relevant. In addition, the rapid development of diagnostic and treatment methods poses very different challenges for students and teachers. In particular, at present, high-tech methods, such as radiofrequency ablation, molecular diagnostics, are practically not included in the standard curriculum. Also, differences in educational tracks in different universities often do not allow creating a single educational cardiology space. The article discusses the continuity of cardiology education at the university at different departments (study years), as well as theoretical, practical competencies of 3-6 study years at internal medicine departments, as well as electives and academic competitions in cardiology and the related problems.

Aim. To study the efficacy and safety of acetazolamide administered orally to patients with decompensated heart failure (HF) at the hospital stage within 72 hours from admission, compared with standard therapy.

Material and methods. This open-label, prospective, randomized, multicenter study is planned to include 400 patients urgently admitted to hospital with NYHA class II-IV decompensated HF: 200 patients each in the standard therapy group and additional acetazolamide (tablets) group. The primary endpoint includes the number of patients who achieved compensation in accordance with the criteria for diuretic therapy discontinuation. There are secondary endpoints: increase in urine output in the first 72 hours of hospitalization (since randomization), weight loss, 24-hour natriuresis, length of stay in hospital, length of stay in the intensive care unit, 90-day any-cause death, 90-day cardiovascular death, 90-day death due to chronic HF decompensation or acute decompensated HF, the number of pleuro- and pericardiocentesis episodes during the hospitalization, scale for clinical condition assessment of HF patient (SHOKS) at discharge from the hospital, 6-minute walk test at discharge from the hospital. The planned follow-up duration is a hospital period with an assessment of the clinical picture and laboratory parameters. Telemedicine contact with patients is carried out after 14, 30 and 90 days using a structured questionnaire.

Conclusion. Analysis of clinical, laboratory and echocardiographic parameters of patients using acetazolamide tablets will make it possible to determine the criteria for the effectiveness of diuretic therapy in patients with decompensated HF in the short and long term.

The issue of optimal surgical scope in patients with aortic root abscess due to infective endocarditis remains open, since there are different strategies and interventional methods. In addition, the guidelines do not give preference to any particular type of surgical intervention and recommend an individual approach to each situation. The study included 25 patients with aortic root abscess due to aortic valve infective endocarditis. The most frequently performed surgical intervention in patients was the Ross procedure (n=12, 48%). Eight (32%) patients of the center underwent aortic homograft root replacement. Combined surgery was performed in 7 (28%) patients as follows: 3 (12%) patients — interventions on the mitral valve (all patients underwent mitral valve repair due to mitral valve involvement in abscess), 3 (12%) — coronary artery bypass grafting, 1 (4%) — ascending aortic replacement due to dilatation. Five- and ten-year survival after surgical treatment of patients with aortic root abscess was 86,9% and 78,6%, respectively. There was no reintervention and recurrence of infective endocarditis in the long-term period.

Aim. To assess postoperative complications and predictors of mortality in surgery for left-sided infective endocarditis (IE).

Material and methods. The retrospective analysis included 222 cases of IE in 216 patients who were operated on from January 2015 to November 2022. Inclusion criteria: age of patients ≥18 years, definite or probable (Duke criteria) left-sided IE of aortic and/or mitral valves. There were following exclusion criteria: isolated right-sided IE (tricuspid valve, pacemaker endocarditis), nonbacterial thrombotic endocarditis and chronic IE. Endpoints: inhospital mortality, postoperative complications (delirium; perioperative stroke; resternotomy for bleeding; perioperative myocardial infarction; acute heart failure requiring extracorporeal membrane oxygenation or intra-aortic balloon pumping; respiratory failure requiring tracheostomy; acute kidney injury requiring renal replacement therapy; conduction disorder requiring pacemaker implantation).

Results. Median age was 53 [38,0; 61,0] years, while the majority of patients were men (73,9%). Inhospital mortality was 8,6%. The most common postoperative complications were delirium (19,8%) and bleeding requiring resternotomy (10,4%). The incidence of perioperative stroke was 2,3%, perioperative myocardial infarction - 0,9%, respiratory failure with tracheostomy – 4,5%, pacemaker implantation – 2,7%, renal replacement therapy – 6,8%. According to multivari ate analysis, Predictors of inhospital mortality were creatinine clearance level (odds ratio (OR), 0,976; 95% confidence interval (CI): 0,956-0,996; p=0,020), time of cardiopulmonary bypass (OR, 1,014; 95% CI: 1,006-1,021 , p<0,001), deli rium (OR, 7,058; 95% CI: 1,824-27,330, p=0,005) and acute kidney injury requiring renal replacement therapy (OR, 28,620; 95% CI: 6,508-125,964; p<0,001).

Conclusion. Surgical treatment of left-sided IE has satisfactory inho spital outcomes. The study identified simple clinical factors (creatinine clearance, cardiopulmonary bypass time, delirium, acute kidney injury) associated with inhospital mortality.

We present a clinical description of a patient with recurrent resistant episodes of ventricular tachycardia that first appeared at the myocarditis onset and remained the only disease manifestations for several years. During follow-up, the patient was diagnosed with dilated cardiomyopathy, which required heart transplantation.

Nonvalvular atrial fibrillation (AF) is the most common cause of arterial thromboembolism, especially of ischemic stroke. Other than stroke AF-associated embolic events are usually underestimated but at least similarly important. We present a rare case of simultaneous multiple embolism in a 70 years old women with permanent AF.

To date, there is no doubt about the participation of triglyceride-rich lipoproteins in atherogenesis. However, the variety of clinical manifestations of hypertriglyceridemia does not always allow timely recognition of patients with high cardiovascular risk for the timely initiation of therapy. The article presents 3 following cases: patient with isolated hypertriglyceridemia without clinical manifestations and with a good response to treatment, a patient with skin manifestations of hypertriglyceridemia and a patient with severe multifocal atherosclerosis, diabetes and recurrent pancreatitis. References are also provided for each case.

With an increase in the average life expectancy of the population, the prevalence of sarcopenic obesity (SO) is correspondingly growing. Existing definitions of SO are based on description of sarcopenia and obesity, but there is currently no consensus defining thresholds for either of these conditions, making an accurate diagnosis difficult. At the same time, its treatment is important to prevent disability in the elderly. In this regard, the purpose of this review was to analyze the ultrasound potential for SO diagnosis. Since ultrasound is cheaper, more portable, and more accessible than other methods, it has the potential to be widely used as a clinical screening tool for identifying people with SO. Also, this method can be used to diagnose obesity, thereby leveling the errors in body mass index.

The aim of this review was to evaluate the current literature on various methods of pulse oximetry, their advantages and disadvantages. Modern pulse oximetry methods generally correlate well with invasive saturation monitoring, which makes it possible to be widely used in clinical practice. At the same time, in order to improve the accuracy of saturation measurements, existing limitations of various pulse oximetry methods should be taken into account. The emergence and introduction into clinical practice of reflectance pulse oximetry can largely compensate for the limitations of traditional transmission pulse oximetry regarding peripheral hypoperfusion, low response time, and features of patient's nails. In the event of special situations when pulse oximetry may not be accurate enough (carbon monoxide poisoning, methemoglobinemia, severe anemia, severe tricuspid insufficiency, etc.), a thorough clinical assessment of the patient is recommen ded, as well as invasive saturation monitoring.

Low-grade systemic inflammation, myocardial stress, and extracellular matrix fibrosis lead to heart failure with preserved ejection fraction (HFpEF). The HFA-PEFF diagnostic algorithm and the H2FPEF score are recommended for detecting HFpEF. Their low compliance is the reason for improving the methods for diagnosing HFpEF. Modern paraclinical diagnostics of HFpEF includes an assessment of the left ventricular filling pressure during diastolic stress test. Phase analysis of left atrial strain during resting echocardiography may be promising to conclude an increase in mean left atrial pressure. Research interest is growing in relation to biomarkers involved in the regulation of collagen synthesis. Together, paraclinical diagnostics help to characterize sequential morphofunctional cardiac remodeling, increasing the possibility of HFpEF detection.

The current classification of heart failure (HF) is based on the myocardium systolic function. However, due to the polyetiological nature of the HF with preserved ejection fraction (HFpEF) and its increasing prevalence and clinical significance, a more advanced approach to the clinical assessment of patients is needed to determine the management tactics focused on the patient's phenotype. At the same time, a single algorithm for phenotyping patients with HF has not been formulated yet. There is also no terminological unity in approaches. A review of 47 original articles published in the period from 2015 to 2022 in English on Elsevier, Pubmed, Web of Science databases with a following keywords "HFpEF", "phenotype", "clusters", "phenotypic spectrum", "diastolic dysfunction" makes it possible to identify several different approaches to phenotyping HFpEF, which are based on the etiology, pathophysiological mechanisms or clinical manifestations. Differences in the algorithms used for classification lead to the formation of groups of patients with different characteristics. Today it becomes obvious that in order to develop an optimal phenotyping approach and patient-oriented management of HFpEF, a combined analysis of a large number of anamnestic, clinical and paraclinical data is necessary. To solve such a problem, unified clustering system for HFpEF types should be created, which will be basis for phenotyping patients proposed by the authors.