Genetic factors play an important role in pathogenesis of many diseases. It has been shown that potential-dependent Na, K, and Ca channels have common characteristics in their molecular structure, which should be taken into account when assessing physiological functioning of these channels. Hereditary diseases due to channel pathology are called channelopathies, or primary electrical heart disorders (long QT interval syndrome, short QT interval syndrome, Brugada syndrome, catecholamine-dependent ventricular tachycardia, idiopathic ventricular fibrillation, Lenegre disease, hereditary Wolf-Parkinson-White syndrome, hereditary atrial fibrillation). The second leading cause of sudden cardiac death (SCD), after coronary heart disease, is secondary hereditary electrical disorders (hypertrophic cardiomyopathy, dilated cardiomyopathy, right ventricular arrhythmogenic dysplasia, isolated left ventricular non-compaction). Genetically determined cardiac arrhythmias (CA), with or without structural heart pathology, manifest in young age (with an exception of Brugada syndrome) and have specific phenotypic and genotypic characteristics. Timely diagnostics of these diseases should be based on ECG screening (ideally performed before 3 years of age) and EchoCG. In addition, examination of families with high SCD risk has an important diagnostic value. High total SCD risk in treated patients with genetically determined CA is an indication for cardioverter-defibrillator implantation. Optimal strategy of SCD prevention in patients with genetically determined CA includes baseline risk assessment and ongoing monitoring, according to the individual risk profile. This review describes clinical and molecular features of genetically determined CA, SCD risk criteria, and modern views on diagnostics and treatment of these patients.

The aim of the study was to clarify the differences in renal, vaso-renal, vascular, and endocrine disorders and dysfunctions between labile (borderline and Stage I) and stable arterial hypertension (Stage I-II, and malignant hypertension; ESH/ESC classification, 2007). The study included 1846 patients (837 men, 1009 women; age 16-72 years), divided into 5 age groups: 16-29, 30-39, 40-49, 50-59, and 60-72 years. Each age group was additionally divided into subgroups with labile and stable arterial hypertension (LAH, SAH). A complex clinical, biochemical, hormonal, and instrumental examination was performed 3-5 days after hospital admission and 3-4 weeks after the start of in-hospital treatment. It was shown that pathogenetic differences between LAH and SAH manifested in higher prevalence of vaso-renal pathology in SAH patients, with some forms of vaso-renal disease observed in SAH only. SAH patients were characterised by increased renin activity and microalbuminuria (a marker of renal glomerular pathology), reduced volume of functioning renal parenchyma, and disturbed renal nitrogen and electrolyte excretion. In addition, SAH patients had higher prevalence of AH in family anamnesis, as well as more pronounced left ventricular hypertrophy and arterial remodelling. Metabolic syndrome manifestations, such as diabetes mellitus and overweight, were also more prevalent in SAH individuals. Hypertensive crises developed more often in SAH patients. Finally, in women with SAH, higher plasma levels of gonadotropins LH, FSH, and prolactin were registered.

The study was analyzing the features of identical hemodynamic microcirculation types (HMT) in healthy people and patients with arterial hypertension (AH). In total, 80 patients with Stage II-III AH and 39 healthy men and women were included in the study. In AH patients, all HMT variants were characterised by pre-capillary vasoconstriction, to some extent compensated due to increased pulse filling of micro-vessels. Both in healthy people and AH patients, normocirculatory HMT could be regarded as the most balanced. Venous hyperemia was typical for AH patients with hyperemic HMT, due to intensified microcirculatory regulation processes. Low tissue perfusion in healthy people and AH patients with spastic HMT could be explained by advanced vascular and extravasal changes. Healthy participants with congestive HMT also had demonstrated intensification of active microcirculation control mechanisms – endothelial, neurogenic, and myogenic ones. AH patients, on the contrary, were characterised by depression of peripheral hemodynamics-regulating mechanisms. HMT analysis could facilitate identification of healthy people with higher disease risk, as well as AH patients with high risk of target organ damage and poor prognosis.

The paper analyses cardiac arrhythmia structure, heart rate variability and ventricular repolarisation parameters in patients with arterial hypertension (AH) and metabolic syndrome (MS). The comparison group included 50 patients with AH only. The combination of AH and MS was characterised by increased electrical myocardial instability, manifested in higher incidence of supraventricular and ventricular extrasystoles (including high-grade extrasystoles), hypersympathicotonia, and increased heterogeneity of ventricular repolarisation processes.

In 122 patients with chest pain syndrome, anamnestic and clinical data, as well as the results of oesophagogastroduodenoscopy, veloergometry, 24-hour ECG monitoring, and 24-hour pH monitoring, were analysed. All participants were divided into three groups: Group 1 – patients with gastro-oesophageal reflux disease (GERD) only; Group 2 – patients with coronary heart disease (CHD) only; and Group 3 – patients with GERD and CHD. Adverse mutual effects of GERD and CHD were demonstrated, based on clinical and instrumental data. Primary and secondary ECG changes were identified, and a method for simultaneous 24-hour ECG and pH monitoring was proposed as a differential diagnostic tool in patients with chest pain syndrome.

The paper presents the results of 3 prospective, randomised, double-blind, placebo-controlled trials of patients with coronary heart disease (CHD) and peripheral artery disease (PAD). The aim was to compare veloergometry parameters and skeletal muscle strength in CAD patients, as well as exercise capacity dynamics in PAD patients, during long-term standard therapy with or without additional administration of mildronate (M). According to 3- and 12-month results for CAD patients, M groups demonstrated substantial increases in veloergometry exercise duration and maximal workload, as well as skeletal muscle strength, compared to placebo groups. In PAD patients, 24-week M therapy was associated with substantial increase in absolute claudication distance (ACD) during treadmill test, compared to placebo. Long-term M therapy was effective and safe. Positive effects on ACD were observed even one month after the end of M treatment.

The paper is focused on taurine role in various physiological and pathophysiological processes, its effects on free radical oxidation, taurine effectiveness in chronic heart failure (CHF), and the role of free radical oxidation in heart failure development. The results of numerous experimental and clinical studies are summarised.

This review focuses on endothelium interaction with inflammatory mediators. C-reactive protein (CRP) plays a role in inflammation activation, endothelin-1 production increase, and lipid peroxidation enhancement, which results in endothelial dysfunction. The other consequences include vasoconstriction, blood pressure increase, thrombosis, and, finally, cardiovascular events.

Aim: Lowering BP to normal levels without quality of life deterioration is the most important means of reducing cardiovascular risk. Recent studies have challenged the position of beta-adrenoreceptor antagonists (beta-blockers) as first-line antihypertensive drugs. Nebivolol is a third-generation, highly selective beta (1)-blocker that causes vasodilation through nitric oxide (NO) release. This meta-analysis investigates the efficacy and tolerability of nebivolol compared with other antihypertensive drugs and placebo in patients with hypertension. Methods: Twelve randomized controlled studies were included, in which nebivolol 5 mg once daily was compared with the recommended clinical doses of other antihypertensive drugs (n=9), placebo (n=2), and both (n=1). The clinical studies were selected after a MEDLINE search up to 2007, using the key words “nebivolol” and “hypertension”. Results: Antihypertensive response rates (the percentage of patients achieving target BP levels or a defined DBP reduction) were higher with nebivolol than with ACE inhibitors (odds ratio [OR] 1,92; p=0,001) and all antihypertensive drugs combined (OR 1,41; p=0,001) and similar to beta-blockers, calcium channel antagonists (CCAs) and the angiotensin receptor antagonist (ARA) losartan. Moreover, a higher percentage of patients receiving nebivolol achieved target BP levels compared with patients treated with losartan (OR 1,98; p=0,004), CCAs (OR 1,44; p=0,024), and all antihypertensive drugs combined (OR 1,35; p=0,012). The percentage of patients experiencing adverse events did not differ between nebivolol and placebo; adverse event rates were significantly lower with nebivolol than losartan (OR 0,52; p=0,016), other beta-blockers (OR 0,56; p=0,007), nifedipine (OR 0,49; p<0,001), and all antihypertensive drugs combined (OR 0,59; p><0,001). Conclusion: Results of previous pharmacokinetic studies suggest that nebivolol 5 mg may not conform completely to the definition of a classic beta-blocker, demonstrating additional antihypertensive effect due to endothelial NO release-mediated vasodilation. This meta-analysis showed that nebivolol 5 mg achieved similar or better rates of treatment response and BP normalization than other drug classes and other antihypertensive drugs combined, with similar tolerability to placebo and significantly better tolerability than losartan, CCAs, other beta-blockers, and all antihypertensive drugs combined. Although not definitive, this meta-analysis suggests that nebivolol 5 mg is likely to have advantages over existing antihypertensives and may have a role in the first-line treatment of hypertension.> <0,001), and all antihypertensive drugs combined (OR 0,59; p <0,001). Conclusion: Results of previous pharmacokinetic studies suggest that nebivolol 5 mg may not conform completely to the definition of a classic beta-blocker, demonstrating additional antihypertensive effect due to endothelial NO release-mediated vasodilation. This meta-analysis showed that nebivolol 5 mg achieved similar or better rates of treatment response and BP normalization than other drug classes and other antihypertensive drugs combined, with similar tolerability to placebo and significantly better tolerability than losartan, CCAs, other beta-blockers, and all antihypertensive drugs combined. Although not definitive, this meta-analysis suggests that nebivolol 5 mg is likely to have advantages over existing antihypertensives and may have a role in the first-line treatment of hypertension. 

The medical community has to address global problems of Russian population health. There is a discrepancy between the magnitude of claimed and practically assessed population health problems, which has been demonstrated in this review of medical and philosophical literature.